GRAND RAPIDS — With the state Legislature facing a $6 billion deficit in its most recent session, the Minnesota division of the National Alliance for Mental Illness did not expect much new money for mental health services. So instead, it focused on policy.
“We knew we had to watch very carefully about what was going on but also think about what were some policy things that didn't cost money that we could get through this,” said Sue Abderholden, the executive director of NAMI Minnesota, who is retiring in October.
NAMI hosted a stop in Grand Rapids on Wednesday, July 30, at Woodland Bank as part of its statewide Summer Listening Tour. Abderholden led a presentation on new legislation and policy updates on mental health matters. A full list of legislative outcomes on mental health matters can be found on NAMI’s website.
After the presentation, members of the community asked questions and shared their thoughts and experiences with mental health services. NAMI will use the input to determine how to advocate for mental health needs in state legislation.
Some mental health care providers in attendance expressed concern about a lack of expert staffing and space for psychiatric services, particularly in the emergency room, where beds can be scarce and wait times are long, leading to some mental health patients being discharged when they still need help.
Lynn Cochran, a NAMI board member who has been involved with mental health services for 20 years, shared her concerns about some medical providers not seeing mental health as a medical issue.
“I think there's a really big improvement in mental health understanding and reducing stigma, helping people accept and get services earlier in their life,” Cochran said.
“But there's also still an underlying stigma that somehow it's their fault, or somehow that somebody caused that for them, and that it's not a medical service that they need.”
Marian Barcus, president of the Grand Rapids affiliate of NAMI, said the organization has worked hard to raise awareness about mental illness and reduce stigma in the local community.
“But still, there is some apprehension about being with people who have mental illness and understanding that it is a mental illness,” Barcus said. “It’s not who that person is. It is an illness.”
Attendees also expressed concerns with Itasca County using County-Based Purchasing for public health insurance under IMCare, citing IMCare ending its in-network contract with Lakeview Behavioral Health in December 2023. County-Based Purchasing lets Minnesota counties run their own medical assistance programs, arranging and paying for local health care services for those enrolled.
Abderholden noted and addressed any concerns brought up for discussion, including worries about the broader mental health care system.
“It’s not that the system is broken,” Abderholden said. “It’s never been built.”
Those experiencing a mental health emergency are encouraged to call the national Suicide and Crisis Lifeline at 988 for assistance. Note that the Press 3 option specifically for LGBTQ+ individuals is no longer available at the national level.
Mental health and family
As the advocate of her 54-year-old daughter, Darrow Christensen,75, drove nearly an hour to attend the event.
Christensen’s daughter has been in and out of facilities for her mental health since she was 14, facing difficulties getting the help and services she needs. At her daughter’s request, Christensen holds power of attorney for her daughter, interacting with medical providers and government agencies on her behalf.
“I love her,” Christensen said. “I'd stand in front of a moving train to save her. And I think I still have a chance to save her, and so I don't dare stop.”
Despite the legal authority to do so, Christensen has frequently struggled to see her daughter’s needs met and intervene for her. She said many medical providers and facility personnel have refused to listen to her or declined to share important health information because her daughter is an adult.
Abderholden confirmed that, with the power of attorney, Christensen has the right to request assistance and services for her daughter and should have access to her daughter’s medical information. Abderholden added that even without power of attorney, privacy law does not bar providers from sharing any information whatsoever with family and loved ones, only medical records.
In many cases, the families and loved ones of those struggling with mental health can help identify when and how they need care, Abderholden said. She gave the example of a woman who could tell by her husband’s footsteps when he was about to go into a manic episode.
“Families are the canaries in the coal mine,” she said.
Christensen encouraged families to support their loved ones with mental illnesses and to watch and listen for signs when they are struggling.
“I have friends and relatives who think ‘[Christensen’s daughter] made her bed. Let her sleep in it.’ That's not what mental illness is,” she said. “They don't make their own beds. They shouldn't be sleeping in it. They need help and support, and that first love and support should come from their family.”
Medicaid and Medicare cuts
July 30 marked the 60th anniversary of Medicaid and Medicare, which received more than $1 trillion in cuts over the next 10 years as part of President Donald Trump’s Big Beautiful Bill. The cuts will go into effect in December 2026, after the midterm elections.
At the NAMI event, Abderholden explained how the cuts would devastate Medicaid and Medicare, especially when it comes to covering mental healthcare.
“They’re not cutting it by saying, ‘We’re going to really focus on fraud and abuse,’ which is done by providers and not individuals,” she said. “They’re doing it because people are going to lose their insurance. That’s how they’re saving a trillion dollars.”
About 16 million people will lose health coverage by 2034, according to estimates from the Congressional Budget Office. That includes about 140,000 Minnesotans, according to the state Department of Human Services.
Roughly 40% of non-elderly adults on Medicaid have a mental health condition or a substance use disorder, and one in three people with mental illness rely on Medicaid, according to NAMI.
“Private insurance doesn’t cover some of the treatment and services that people with mental illnesses actually need,” Abderholden said. “So, I think we will see more people ending up in crisis and ending up in jail, ending up in the emergency room, and we might see the suicide rate increase as well.”
Between work requirements and eligibility checks every six months, counties will have too much paperwork to submit to the state system on time, leaving many who are eligible uninsured, Abderholden said. She added that sudden mental health emergencies, especially first-time emergencies, may keep people from being able to work at that moment, preventing them from accessing Medicaid when they need it.
Cost sharing will also likely be a barrier to care, as even small levels of cost sharing have proven to keep low-income individuals from seeking care when they need it, according to a 2017 study. Their conditions only get worse, leading to more harm and a more expensive hospital visit further down the line, Abderholden said.
“These changes to Medicaid are horrible, frankly, and they’re going to be really detrimental, especially to young people experiencing their first mental illness,” she said.
Christensen said she is worried about what the cuts will mean for her daughter.
“I’m afraid she won’t have any help, and she’ll be homeless and won’t make it through the winter,” she said. “She always worries about being the blue body under the bridge in Duluth, and I have the same fear.”
The cuts will be fatal for many people, local NAMI president Barcus said.
“People will die, and it will probably never be reported that they died from lack of medical assistance,” she said. “It will be reported that they died of heart disease. They died of diabetes. They died of suicide.”
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