South Dakota facility bringing cultural compassion to addiction treatment

Kelsey Sjaarda, clinical program manager, The Link at Avera McKennan Hospital and University Health Center, speaks Tuesday at the HIMSS24 annual conference in Orlando.

Photo: Jeff Lagasse/Healthcare Finance News

ORLANDO – In a world of high addiction rates, mental healthcare crises and increasing suicide rates, one healthcare organization in South Dakota is trying something a little different.

Kelsey Sjaarda, clinical program manager, The Link at Avera McKennan Hospital and University Health Center, helps oversee a program at a community triage center in Sioux Falls that provides 24/7 care and support for individuals struggling with mental health crises and addiction, with a patient population disproportionately represented by Native Americans and people of color, despite the population being about 80% Caucasian.

The triage center – a unique public-private partnership between the city, county and two largest healthcare organizations in the state – has helped divert citizens in crisis from law enforcement and hospital emergency departments, which are not fully equipped to provide the kind of compassionate and personalized care needed for each individual.

In her session "A Culturally Sensitive Approach to Acute Mental Health and Addiction Care" at the HIMSS24 conference here Tuesday, Sjaarda said that since its opening, the center's culturally sensitive care approach has reduced the number of custody holds – drug and alcohol emergency law enforcement holds – by more than 90%.

It's a change that was needed, particularly for minority populations. A health needs assessment in 2016 showed that behavioral health was a top-five diagnosis in the area, and alcohol-related deaths were eight times higher for Native Americans than for their white counterparts.

When establishing The Link, the goals were to provide better access, reduce unnecessary ER visits and jail bookings, reduce inpatient behavioral health hospitalizations, and to just normalize the conversation around mental health and addiction. Four funding partners helped get the program off the ground, and The Link also collaborated with Urban Indian Health to combat that local population's ongoing behavioral health struggles.

The idea is to operate with compassion and safety while connecting people to the appropriate health resources, said Sjaarda.

The services The Link offers include a sobering observational program that allows acutely intoxicated people to rest and recover, a substance withdrawal management program, a mental health crisis stabilization program and post-sexual assault care. Staff includes a nurse practitioner, a 24/7 nursing staff, behavioral health technicians, paramedics and triage technicians. No referrals are needed for the facility, and patients can be dropped off there by EMS technicians if necessary.

"Forming a group of stakeholders in the community is something that has been really vital for us," said Sjaarda. "These people that we're serving need a lot of intervention."

About half of the patients seen at The Link say they would have had no other place to go, she said. The withdrawal program, which treats people through their withdrawal symptoms for about three days, has a 77% completion rate to date, with the primary substance of concern being alcohol. An integrated EHR program allows for continuity of care.

Current challenges include high turnover and finding appropriate staffing, although the staff that do stick it out tend to know where their patients are coming from.

"It's a challenge to really find the staff who are invested," said Sjaarda. "A lot of our staff have had addiction and are on the other side of it, so they have a lot of compassion for that.

"We've proven the concept; now we just have to perfect the structure," she said.
 

Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.