How Prevention can work in Ramsey County
by Victoria Reinhardt

I believe wholeheartedly in the economic and societal benefits of prevention. As the saying goes, an ounce of prevention is worth a pound of cure. Several months ago I discussed Ramsey County Homeless Prevention Programs in this column. By providing cost-effective homeless prevention programs, taxpayer dollars are ultimately saved because the use of more costly services is diminished. Today, I want to talk about the Ramsey County Mental Health/Chemical Dependency Division. This is another preventative service that Ramsey County offers to its’ residents.

This division administers 12 broad categories of services including a community mental health center, case management for the mentally ill, chemical assessment and referral and day treatment programs. In addition, the Division operates a 55 bed secure detoxification center. Finally, the Division contracts with Hewitt House. Hewitt House offers an intensive 5 day adult mental health crisis program.

For the last 28 years this Ramsey County Division was located at 529 Jackson Ave. The facility was inadequate from many perspectives and I was happy to play a role in finding a new location for this service. The Division is now located at 1919 University Avenue, Suite 200 in St. Paul.

In 1997, Ramsey County responded to over 14,090 phone requests for assistance and saw almost 5000 clients. Of the 5000 clients seen, 2500 are categorized as having serious and persistent problems. As recently as 20 years ago, the majority of these individuals would have been committed to state hospitals at an exorbitant cost to taxpayers. Last year, only 10% of that number needed to be committed. The vast majority of clients with serious and persistent problems receive mental health case management through Ramsey County at a fraction of the cost and are able to function as contributing members of the community. Using County funds in conjunction with free medication samples from pharmaceutical companies, the division is able to provide medications to clients who are unable to afford them. This prevents clients from being incapacitated from their illness and allows them to function in the community while avoiding hospitalization and the associated costs. The establishment of Hewitt House in 1993 further reduced the need for hospitalization. Hewitt House is a 5 day overnight adult mental health crisis program. In 1997 there were 962 admissions at a cost of approximately $730,000. The cost to hospitalize these persons would have been $3,848,000. Over three million taxpayer dollars were saved. In addition, the use of Hewitt House provides for a much faster integration of the client back into the community.

The other 2500 people served in 1997 included those with depressive disorders, children and adults who had been victims, and in some cases perpetrators of physical and sexual abuse, individuals involved with corrections, and those with chemical dependencies. By intervening in the early stages of mental illness, it is possible to prevent permanent deterioration that occurs when mental illness is left untreated. The emphasis for the care administered to these clients of Ramsey County is to preserve families and maintain involvement in schools and employment. The division is also focusing on vocational services and has been able to obtain employment for some individuals.

Recently, the Chemical Dependency Services Management Team requested that the Ramsey County Board provide support for board and lodging services for 23 chemically dependent adult women. Studies show that by providing separate housing from the actual treatment facility, it is possible to reduce costs enormously. In 1997, Ramsey County placed 433 chemically dependent women in costly residential treatment programs. It is estimated that at least 30% of these women could be served on an outpatient basis, at half the current cost of residential treatment, if a board and lodging program were available. Needless to say, I was happy to vote in favor of this option.

Ramsey County also provides chemical dependency services for the working poor. Without this service, working adults who require chemical dependency treatment would be required to quit their jobs and go into treatment. This program prevents the loss of employment and the need for public assistance. It allows individuals to receive treatment while continuing to work and pay taxes.

Ramsey County provides mental health and chemical dependency services to adults and children in order to assist them in achieving and maintaining their maximum level of health, independence and self-sufficiency. By intervening early, creatively, and aggressively with this population, we are able to create healthier individuals and, consequently, a healthier community - and, as the above examples show, we’re doing it cost effectively. If you are interested in further information, please call the Ramsey County Mental Health / Chemical Dependency Services Division at 523-7900.


Author: Commissioner Reinhardt

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