Shortage of mental-health professionals makes getting treatment more difficult

No one can know who the next deranged killer might be, mental-health experts say.

“There is no predictor where we’d be able to say in mental health that this person is going to do something very dangerous,” said Rick Gertsema, clinical supervisor of the recently opened Amberwing Center for Youth and Family Well-being in Duluth.

Kathy Bergum, social service supervisor for children’s mental health in St. Louis County, agreed: “None of us can envision this kind of action on anyone’s part.”

The horrific events in the town of Newtown, Conn., a week ago today, in which 20-year-old Adam Lanza fatally shot his mother and then killed 26 children and adults at an elementary school before taking his own life, has prompted national soul-searching:

How could such a disturbed young man fall through the cracks and fail to get the help that might have averted his actions? And if such an event could happen in an idyllic community like Newtown, is any place safe?

“I don’t know if it’s possible to identify every person that’s a potential threat out there,” said Dave Lee, Carlton County director of public health and human services and a licensed mental-health clinician. “I think what we can do is develop our services to be more responsive to people so it’s easier to reach out.”

The Northland is in the midst of a variety of efforts to do exactly that, Lee and others in the field say. But a shortage of professionals in the region still means a long wait for some young people who need help.

Aimed at shortening that wait is Amberwing, a new intensive mental-health treatment center for ages 0 to 25 in a building that seems more like a north woods lodge than a health facility. It’s off Rice Lake Road not far from Marshall School, and it has been open since Sept. 4.

Amberwing is a “partial hospital” program, meaning its clients aren’t kept overnight, but they do get much more intensive therapy over daily seven-hour visits than they would get in traditional outpatient treatment, Gertsema said.

“We deal with the kids who are in crisis,” he said.

Although Amberwing has room to treat up to 60 kids, it’s staffed for 32 in four programs, Gertsema said, and it already has a waiting list of 20 for its program for teens. Treatment lasts an average of 15 days. Children already have been enrolled in the program from as far as three hours away, he said. Some families have stayed in hotels while their son or daughter was in treatment.

Amberwing also has an intensive outpatient program for adults ages 18 to 25. It takes place three evenings a week in three-hour sessions.

Amberwing grew out of a realization that the mental-health needs of children and young adults in the Northland were underserved, said Patricia Burns, president of the Miller-Dwan Foundation, which led the $6.5 million campaign that built it.

“It was shocking, when you started looking at the statistics, to see the need for mental-health care,” Burns said. “In 2009, we were losing two kids a month to death by either suicide or a drug overdose.”

That statistic covered Northeastern Minnesota and Northwestern Wisconsin, she said, and it was almost twice the per-capita rate experienced in the Twin Cities.

Amberwing fills the gap between hospital treatment for the dangerously mentally ill and those who receive therapy once a month or once every couple of weeks, Burns said.

Amberwing is “a very positive thing for kids who need extended residential treatment,” said Dan D’Allaird, a clinical psychologist who works with children at the Duluth Psychological Clinic. But it brought an unintended consequence. Many clinicians left outpatient facilities to work at Amberwing. That created more of a gap for treatment of children who are not yet in crisis, D’Allaird said.

Wait times in the Northland remain long for those kids, D’Allaird said: two to three months for psychological assessments, up to six months for initial psychiatric appointments.

“We just don’t have enough testing psychologists or psychiatrists in the region,” he said.

Another challenge is convincing people to continue to seek treatment once they’ve turned 18.

“Once a younger person turns 18, we can often transition into the adult world of mental-health services, but they have to be willing to accept those services,” Bergum said. “Often an 18-year-old has a lot of freedom but maybe not a lot of maturity or wisdom.”

If they are obviously dangerous to themselves or others, adults can be committed to psychiatric care, she said, but if they don’t reach that extreme they can only be helped if they want help.

We might not want to go farther than that as a society, D’Allaird said.

“A Big Brother society would mandate that this Lanza got help when he seemed the least bit deviant,” he said. “Most of us, even today, would say we don’t want to go that far.”

What we can do, D’Allaird said, is try to remove the stigma from mental-health care so that people who need help are more willing to seek it. Encouraging steps have been taken in that direction, he said. For instance, the PBS North program “Speak Your Mind” often has people with mental illnesses as guests. The National Alliance on Mental Illness, a support group for children and adults who have mental illnesses and their families, has a chapter in Duluth.

“I think understanding the biological basis of a lot of mental-health problems takes those problems out of the realm of character and into the realm of illness,” D’Allaird said.

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