Through our fingers

NWA would regret loss of stabilization unit

In our ongoing support for services to help people facing mental health challenges in Northwest Arkansas, we’re beginning to wonder if we’re not deluding ourselves.

It was in 2018 and 2019 when thenGov. Asa Hutchinson and state lawmakers worked to create what he called a pilot project featuring four 16-bed mental health facilities around the state known as crisis stabilization units. With inadequate medical help for those in the grips of mental illness in many areas of the state, the idea was to create places where law enforcement could take people going through a mental health crisis for treatment, rather than incarceration in local jails. At these CSUs, people could stay for as long as three days, with help to get back on medication or otherwise begin an ascent out of their momentary crisis.

Mentally ill people aren’t afflicted on purpose. They need treatment. They don’t get what they need in jail.

Pulaski County (Little Rock), Craighead County (Jonesboro) and Sebastian County (Fort Smith) were selected as the home sites for these regional facilities. It was not a given that one of them would end up in Washington County. Some folks thought Sebastian County’s selection might convince the governor to spread the resources to a different region of the state. But Northwest Arkansas is growing by leaps and bounds, so a compelling case was made that a crisis stabilization unit in Benton or Washington county made sense. It ended up in Fayetteville, in property owned by Washington County, which spent $250,000 for renovations. It’s also designed to meet the needs of Benton, Madison, Carroll, Boone and Newton counties.

But maybe everyone who supported the Northwest Arkansas Crisis Stabilization Unit was wrong.

Why would anyone say such a thing? It hasn’t been smooth sailing for the unit in Fayetteville. Its first contracted medical provider bailed out of the arrangement in 2021 when the state reduced funding. The University of Arkansas for Medical Sciences stepped in, pledging its commitment to the CSU treatment model, but it took more than a year to get it reopened.

In fiscal 2023, which ended in June, the Department of Human Services said Sebastian County averaged 80 admissions per month; Pulaski County had 67; and Craighead County had 38.

The Fayetteville CSU saw 14, on average.

Then came July of this year, when the state notified Washington County of its plans to further cut funding, from $90,000 a month to $62,500. County Judge Patrick Deakins said at the time the cut was a surprise that threatened the unit’s existence.

The funding cut was the same for all four CSUs, but the other three have seen far more patients each month than the one in Fayetteville and been more successful at billing insurance or Medicaid for treatments provided. To bean counters in Little Rock, the utilization problem in Northwest Arkansas makes it look like money could be spent more efficiently elsewhere.

And maybe they have a point. As valuable as we thought a unit dedicated to behavioral health intervention in a crisis was a desperately needed option, the fact few agencies direct patients into the stabilization unit suggests we might be in the minority. The units, originally envisioned to take law enforcement referrals, will today accept referrals from emergency rooms and other medical facilities. Our impression is they’re not going to turn away anyone in need of crisis intervention.

Then again, perhaps the fits and starts the Northwest Arkansas unit has gone through have created such inconsistency that it’s been difficult to build up local awareness and buy-in about what the unit has to offer. Could this be a problem of marketing?

Is it that agencies and hospitals in Northwest Arkansas simply don’t interact with people who need the CSU’s services?

We’d be shocked if that’s the case. With Northwest Arkansas’ growing population, it seems to us a 16-bed facility capable of providing intervention for up to three days would be in high demand.

Granted, law enforcement officers must go through some training to be able to recognize potential patients who would benefit from the CSU services. Perhaps that’s just too much for some of the agencies. Maybe throwing them in jail is simpler. But with a CSU available, the right thing to do is to get people the mental health services they need.

Will all this ultimately lead to a closure of the Northwest Arkansas Crisis Stabilization Unit?

The good news is the state recently found some one-time federal grant money that will be used to maintain the $90,000-per-month funding level through the rest of fiscal 2024. It provides a chance — maybe a last chance — for the Northwest Arkansas unit to prove there’s a need for its services. Financial sustainability is a goal of the state.

We remain convinced there are people in the region who need the services the CSU can provide, but it requires leadership in law enforcement, emergency rooms, the greater medical community and other facilities to get them directed to the Fayetteville unit.

Otherwise, the CSU may fall into the category of “You don’t know what you’ve got until it’s gone.” If Northwest Arkansas’ unit can’t find more support, the region will have lost a resource it will one day wish it had back.