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Law enforcement reacts to closing of local BHU

WORTHINGTON -- When Sanford Regional Hospital Worthington announced last week it would close its behavioral health unit, Nobles County Sheriff Kent Wilkening was immediately concerned.

"Last year, we took 32 people to the hospital on 72-hour holds," he stated.

Nobles County Attorney Gordon Moore is also bothered by the decision, calling the closing of the unit a "lose/lose situation" for the city of Worthington. The fact that he and Wilkening were not brought into any discussions regarding the closing of the unit before the decision was made was unsettling to them both, he said.

"We've had two admissions in the last 48 hours," Moore stated last week. "Where are we going to house the folks that need care?"

During a press conference March 30, SRHW Chief Executive Officer Lynn Olson said a transition of behavioral health services to Avera Marshall Regional Health Center would be effective July 1. He noted that an overall trend in behavioral health care is to treat patients in less intense settings and in their own communities, with a focus away from inpatient facilities.

"We had gradually been seeing our numbers dwindling. We have been averaging about three patients a day," he stated.

Wilkening said the amount of 72-hour holds averaged 27 a year between 1999 and 2009. In that 10-year span, the lowest number of holds per year was 18 in 2006. The 19 holds in 2000 jumped to 30 in 2001.

SRHW Chief Nursing Officer Jennifer Weg said the hospital will be working with law enforcement as plans to help patients access care are made.

"We recognize that law enforcement and the court system have a very big part on the continuum of care, and they have a perspective to be given attention to," Weg said.

Triage, Weg said, will still be done at the emergency room at SRHW.

"A patient can be assessed here, then a consultation with psychiatry is available through Avera," Weg explained. "From that, we are able to find the best plan for the patient."

How patients will be transported is something that still needs to be discussed. Ambulance and law enforcement services have been used in the past in some cases, and the committee will look at alternatives, also.

Wilkening said the unit will be missed in the area and the cost to his office could be substantial in transportation or loss of law enforcement coverage while someone is being transported.

"We only transport when it is court-ordered," he explained. "The hospital is going to have to figure out how to get them to Marshall."

Moore said he fears patients will end up either in jail or not getting the services they need.

"The jail and holding cells are not equipped to handle people with acute mental crisis," he explained. "Rural Minnesota, left without resources to deal with people in acute crisis ... that leaves law enforcement to be on the front lines of those crises."

Weg said law enforcement and social services have a big role to play in the next steps of planning and transition.

"We are very cognitive of their perspective," she explained. "And this is our community too -- this is not the end of care for patients."

Wilkening and Moore both said the behavioral health unit at the hospital was far from perfect, but it was part of the "safety net."

"I don't care how this is spun," Moore stated. "It is a loss for our community. This is something we relied upon on a weekly basis."

Wilkening believes Sanford was more concerned about saving money than about the effect the loss of the unit would have on the community.

"I understand dollars and cents," he said. "But when do you look at what's good for a community, the need in the area, and let that weigh over the dollars?"