There can be no doubt that Alaska’s mental health care system is in crisis, struggling to cope with some of the greatest gaps in capacity and coverage in decades. At the state’s flagship Alaska Psychiatric Institute, almost half the rooms are empty, a problem that has persisted for several years. The consequences are tremendous, and damaging at both the personal and societal scales. And although Alaska is facing a host of pressing issues — a substantial budget deficit, the future of the Permanent Fund dividend and nation-highest rates of domestic violence and sexual assault — the state’s mental health services may be the most glaring, broken system facing Alaska. Gov.-elect Mike Dunleavy and the Legislature should make addressing it a top priority.
It’s not as though this is a new problem for the state. For years, the ADN’s reporters and columnist Charles Wohlforth have examined the breakdowns and failures that have led us to where we are today. But despite the acknowledged severity of the issues, which led to the September resignations of major figures charged with overseeing the state’s system, there has been little progress made — in fact, it’s easy to make the argument that things are worse now than at any point in recent memory. At least a half-dozen patients committed to the state’s care for mental health issues were sent to prison because of capacity problems at API. When patient treatment begins to resemble the “warehousing” model of asylums, there can be no denying that serious problems exist and must be addressed immediately.
So what has caused the degradation of Alaska’s mental health services? There are many factors, but two primary ones stand out: organizational and managerial failures, as well as tight budgets. Although the state has tried to address organizational issues, most recently through the aforementioned resignations, there is little to show for the periodic shakeups: API’s issues have persisted for years. Also, the past two decades have seen atrophy in Alaska’s community mental health services, which has the compounding effect of increasing the burden on API, as well as on hospitals and other care facilities not designed for chronic mental health treatment.
The failures within Alaska’s mental health care system are not only distressing with regard to our goal of helping those in need of services to maintain their health and dignity, they are tremendously costly to our state. Facilities such as hospitals and prisons, which have neither the capacity nor the mission to provide chronic, long-term mental health care, are being pressed into service. The half-operative API can’t come near addressing the mental health needs of Anchorage’s population, much less the many remote communities without such services. As a result, those with unaddressed mental health issues often experience homelessness, and some are the perpetrators and victims of crimes. They are more likely to abuse substances because of their unmet health needs. All of these factors drive other major, expensive problems our state is struggling to address.
What can and should be done to turn things around? The Alaska Mental Health Trust has a role to play. Although the group does not have the resources to stand up community mental health services on its own, it can and should be the intermediary between the state and potential providers, identifying the roadblocks that have caused the failure of community services and working with state policymakers to address them.
For its part, the state must do everything in its power to get API running at full capacity. The facility has 80 beds; at last count, only 45 were occupied because of staff shortages. Incoming Gov. Mike Dunleavy and his Commissioner of Health and Social Services should make it a top priority to make sure the facility is fully staffed and that previous safety issues have been addressed, issuing an emergency declaration if necessary. In the longer term, the state must work to facilitate the expansion of community mental health services, so that patients can receive treatment in their home communities and be supported by those who love and care for them.
It is a moral imperative that we do better for Alaskans in need of mental health services. Our system is broken, and we have been reaping the consequences. We have felt their tremendous toll on all of our communities. We can abide the status quo no longer.
The views expressed here are those of the Anchorage Daily News, as expressed by its editorial board, which welcomes a broad range of viewpoints. Current editorial board members are Ryan Binkley, Andy Pennington, Julia O’Malley, Tom Hewitt and Andrew Jensen. To submit a piece for consideration, email firstname.lastname@example.org. Send submissions shorter than 200 words to email@example.com or click here to submit via any web browser.