OPINION: The federal investigation of Alaska’s mental health services is a wake-up call. We’re already working to improve the situation.

I read with interest Michelle Theriault Boots’ Dec. 16 article “Department of Justice investigation finds Alaska unnecessarily institutionalizes children, violating federal law.” The story and the report raise important issues, and I’m hopeful that ultimately the Department of Justice (DOJ) investigation will result in an improved mental health care system to better serve Alaska’s children and families. It will take the combined efforts of the state, local communities and providers to get there.

The enormity of the problem can seem overwhelming. But I’m happy to report that progress is being made. The Medicaid Section 1115 waiver has added new services and options to the continuum of care in Alaska, including services like intensive outpatient and partial hospitalization programs which are designed to provide a high level of care while keeping kids with their families. While it isn’t feasible to offer an in-person partial hospitalization program in every community in Alaska, it is a short-term program lasting two to three weeks, so that some families are able to relocate during treatment and follow up via telehealth. Alaska Behavioral Health and Volunteers of America both offer PHP programs for children and teens in the Anchorage area.

Providing enough services in rural communities is always going to be a challenge. Alaska Behavioral Health recently received federal funding to start a Rural Child Trauma Center. Through this grant, Alaska Behavioral Health will be providing trauma training to rural community members, teaching them to identify the signs of trauma, respond appropriately, and effectively connect children to follow up care — whether that is via telehealth, a short-term intensive program or a local provider. Training for providers is also part of the grant.

Other efforts have focused more on wellness and building resilience. Stacy Rasmus and the University of Alaska Fairbanks Center for Alaska Native Health Research (CAHNR) have done tremendous work helping communities develop wellness programs for their youth and researching the outcomes to see what works. More funding is needed to keep these programs going and reach more communities.

Adequate staffing is a major concern for both inpatient and outpatient care, as recent reporting has highlighted. The University of Alaska Anchorage’s School of Social Work’s $1.5 million grant, announced in early December, is a step in the right direction to meeting this workforce challenge. Plans are being developed to bring a psychiatry residency program to Alaska as a way of recruiting more physicians to the state.

There are no doubt policy and regulatory changes that need to be examined. How and why and how much does Alaska’s Medicaid program pay for inpatient care versus outpatient care? Are there really no other options for young people with mental health needs, and if that is true, how do we find or create other options? How can we increase access to mental health care in schools? How can we better support families who are struggling? My Senate Majority colleagues and I are aware of these needed improvements. Along with Senate Health Committee chairman, Sen. David Wilson, we will be focusing on solutions.

This DOJ report is the nudge (or maybe it’s more a of a shove) that our state, legislators, providers and communities need to build on the momentum only just started by the 1115 waiver and make the bigger changes we need to serve our children safely and effectively, in their communities, with their families.


Alaska Sen.-elect Cathy Giessel, MS, APRN, Fellow-AANP, served in the Alaska Senate for 10 years and now represents Senate District E. She serves on the Board of Directors for Alaska Behavioral Health.

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Cathy Giessel

Cathy Giessel, a Republican, is a former Alaska state senator. She represented District N, covering parts of Anchorage and communities along Turnagain Arm.