New report, stemming from lawsuit, details DHSS plans to change psych hold practices

First page of new DHSS report, January 22, 2020.
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JUNEAU (KTUU) - A new report released Wednesday, stemming from a lawsuit over psychiatric patients held involuntarily in jails and emergency rooms, details upcoming changes the State of Alaska is making regarding mental health evaluations, including a 90-day plan for moving toward new practices.

"This was a comprehensive process," said Adam Crum, DHSS Commissioner. "This document was put together with a lot of effort. We knew this was an opportunity as a state to show how we can fix or start the process of fixing our behavioral health system."

The 30-page report lays out plans for the Department of Health and Social Services' future, focused primarily on systemic operations of involuntary psychiatric holds, even when the individuals haven't been charged with crimes.

"The crux of it is that individuals were being held within [the Department of Corrections] and in emergency departments longer than necessary to get them to these designated beds," said Stacie Kraly of DHSS.

The Alaska Psychiatric Institute, a treatment facility that's over the years become a source of strife - including accusations of rape, riot and abuse - was built with 225 beds in 1962. Thirty years later, in 1992, it was determined that the needed capacity was about 114. A working group and legislative action, however, saw a new API opened with just 80 beds, along with the consideration that community resources would also handle inpatient treatment.

However, according to the document released Wednesday, "given the increase in cases and the lack of a full continuum of care for behavioral health emergencies in the state, many components of this system are continually stretched beyond capacity, especially in Anchorage."

One section of the report also states that "in practice... Alaska never developed a strong system of behavioral health community services."

While parts of the report delve further into the history of the statewide psychiatric program, ahead lie changes new to the system, including the establishment of a crisis placement response team for better discharge planning and making adjustments so that the current Careline may evolve into a truly statewide organization. Careline is based in Fairbanks, but accepts calls from all over Alaska.

Over the next three months, DHSS said, the department will create a position and hire a coordinator. The moves are expected to reduce the administrative burdens on certain facilities as well as the Alaska Department of Law. DHSS will also contract with Mental Health Providers who will evaluate patients and will order admissions at API by priority instead of only chronology.

"Say in Fairbanks, where it's been 40-below," said DHSS' Heather Carpenter, "you might have someone in a cabin that needs the care first. So somebody sitting in an ER bed is not going to be prioritized over that person out in a vulnerable location."

Channel 2's Kortnie Horazdovsky contributed to this report.
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