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Northwood Children's Services opens shelter beds for mental health crisis situations

Duluth News-Tribune - 9/6/2022

Sep. 6—DULUTH — Duluth nonprofit Northwood Children's Services has introduced a new option for children in St. Louis County going through mental health crises. Northwood's diagnostic assessment center in Duluth Heights, which has the capacity for seven children to stay at a time, now has two beds designated for crisis stabilization.

Richard Wolleat, president and CEO of Northwood, said they've worked together with St. Louis County Children and Family Services to create shelter space for children age 5-18 with acute needs and behavior, including self-harm and suicidal tendencies, physical aggression, and risky behaviors such as running away or alcohol and substance use and abuse.

Wolleat said other shelters in Duluth also serve youth experiencing crises, but Northwood employees are trained to deal with the most specific or intensive mental health needs children may have.

"Some of the kids that were coming to the (other) shelters, they were finding that their needs were just way too acute for them to be able to manage their behaviors," Wolleat said. "That's what we do. We're used to dealing with kids with pretty acute behaviors."

The diagnostic assessment center, which has been around for 30 years, spends 35 days getting to know children and taking a holistic assessment of social and developmental psychiatric testing, educational testing, family history and medical assessments. While children in crisis who stay at the diagnostic center don't undergo exactly the same evaluations, they participate in much of the same programming.

Jamie Ross, director of community residential services for Northwood, said throughout the day, the children work together with staff in group discussions, games and activities that help them learn and apply life skills including anger management, friendship building, self-control and self-confidence. They also do their own cooking and laundry with help from staff.

"The more interventions that we have in place of those pre-coping skills of getting them out and active and having a structured setting, they seem to do much better in that than just sitting back and observing," Ross said.

Children needing crisis stabilization are evaluated by staff during their stay to determine what the next best step for them is, which may sometimes be to come back to the diagnostic assessment center for its full programming.

"It's kind of interesting how they come here and they feel safe and supported and secure," Ross said. "Their level of intensity of behaviors drop pretty quickly because of the trained staff and the empathy that the staff use with the kids and the amount of support that we give them within the system."

Paula Stocke, deputy director of St. Louis County Public Health and Human Services, first approached Northwood Children's Services with the idea of the crisis shelter because a need in the county was growing, while resources were scarce.

"We knew the need was here now, so we said, let's pilot this, and see how it goes and see how it grows," Stocke said. "We hear from our children's mental health supervisors and case managers. They spend so much time looking for resources that can help support children in our communities, and there just aren't the resources. So often, children get sent out of the region or sometimes even out of the state, to where there are mental health supports."

Stocke said more crisis-level mental health needs have been present in children the county works with, and there haven't been in-home services available for them. She and Wolleat said the COVID-19 pandemic's isolation especially had negative impacts on mental health conditions, leaving more children feeling depressed or anxious, and getting help became harder for some to access.

Because there aren't enough facilities to take in children in crisis mental health situations, they often have to stay in emergency rooms for extended stays. Wolleat added that the availability of intensive mental health facilities and their capacities have decreased, too.

"There was a crisis before the pandemic, and the pandemic just made it worse," Wolleat said. "Kids sitting in ERs for a month having a mental health crisis? That's just not best practice. Hopefully we can move to get kids out of that setting, get them here and assess them and get them the services that they need. We're excited to be able to do it."

While Northwood serves children from around Minnesota, the crisis beds are reserved for St. Louis County residents. The children who are referred there are known to the Children and Family Services Division and are selected based on the severity of their needs.

"We fully recognize that serving two kids at a time isn't a huge program, but it helps. Every little bit helps," Wolleat said. "It was just a good fit because we do those really comprehensive assessments, and a pretty detailed assessment is required to do crisis stabilization as well, so it just made sense to designate two slots for St. Louis County kids who might need this level of care."

Wolleat said it's too soon to know how long a crisis stabilization stay will be, but they hope to be able to refer children to their next program within a month. St. Louis County placed the shelter's first two children into the program last month, when the crisis stabilization shelter was introduced Aug. 1.

"We, of course, have had to put parameters around the decision-making as to who can be served there," Stocke said, saying children are selected based on their needs, mental health conditions and if they will be a good match with Northwood's staff and other children in the center.

Stocke said the program is starting small while they learn how it can be used to best serve the children. If a demonstrated need for more beds is proven, Northwood has space to expand in its other locations around Duluth. The county also has additional community partners they hope will create similar programs in the upcoming year.

"Because Northwood's capacity is limited to grow, we're trying it out and seeing how it goes, and then hopefully we can continue to develop," Stocke said. "As well as develop other interventions before it becomes a crisis. That's our best hope — that kids can get the help and support they need before it gets to that point. So it really is building out that whole continuum, which requires our whole community."


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