BISMARCK – Despite progress made by lawmakers this year, North Dakota still faces major hurdles in helping residents struggling with mental illness and substance abuse disorders, the head of an interim committee that will study behavioral health needs said Wednesday.

“We have very big challenges in front of us,” said Rep. Kathy Hogan, D-Fargo, chairwoman of the interim Human Services Committee.

Lawmakers entered this year’s legislative session with the final report from Iowa-based Schulte Consulting LLC, which was hired after the 2013 session to conduct an interim study on behavioral health services in North Dakota.  

The report recommended changes in six key areas: service shortages, workforce expansion, insurance coverage, communication, data collection and research, and the structure and responsibility of the state Department of Human Services.

The Legislature passed several bills last spring related to behavioral health services, including one that gives the department $750,000 for a voucher system to address underserved areas and help pay for addiction treatment services.

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“I think people began to recognize that it’s a major problem,” Hogan said, noting 20 lawmakers have asked to be updated with information received by the 17-member committee this interim. “I think getting to the solutions is the harder process.”

As directed by the Legislature, the committee will study the behavioral health needs of youths and adults, as well as access, availability and delivery of services. Members will develop recommendations – and any bill drafts necessary to implement them – for the 2017 Legislature.

Elizabeth Faust, senior medical director for behavioral health for Blue Cross Blue Shield of North Dakota, told committee members that steps are needed to ensure that evidence-based, high-quality care is provided consistently to all.

Mental health and substance use disorders affect about 20 percent of Americans, costing billions of dollars in direct care, mortality, morbidity, crime and workplace costs, she said.

“The answer is not going to be spending more resource. The answer is going to be spending resource more wisely,” she said.

A stakeholders group compiled its own report with recommendations for lawmakers, but Sen. Tim Mathern, D-Fargo, said the needs weren’t clearly conveyed. Nancy McKenzie, executive director of PATH ND, said while there were some successes, the stakeholders were “a little bit” disappointed in the outcome and are already discussing how to approach the 2017 Legislature.

Nancy Vogeltanz-Holm, a professor at the University of North Dakota School of Medicine and Health Sciences and director of its Center for Health Promotion and Prevention Research, said North Dakota’s rates of most behavioral health disorders are lower than or similar to national rates, with two exceptions: The state ranks among the highest in alcohol use disorders and youth suicide, with the former perhaps exacerbating the latter, she said.

She said more intervention is needed at younger ages, and she was glad to see the Legislature addressing the workforce shortage, as the state ranked 43rd in mental health workforce availability in 2013.

Faust said there’s a growing swell of efforts to integrate behavioral health care into primary care settings and a growing recognition of the costs of untreated mental illness and substance abuse on jails and workplaces.

“If we don’t address it, it is going to crush us,” she said.