Providence to close Alaska’s only short-term adolescent mental health crisis center

Alaska’s only short-term residential mental health program for adolescents is closing, cutting off a critical service in a state where options for teenagers in crisis are already limited.

Providence Alaska will close its Crisis Recovery Center in mid-May, the health care system said this week. Officials said the unexpected loss of a $1.2 million state health department grant led to the decision to close the facility located on Piper Street in Anchorage next to the Alaska Psychiatric Institute.

Providence, the nonprofit Catholic health care system giant that operates the center, also operates the state’s largest hospital.

Since 2007, the Crisis Recovery Center has served adolescents who are suicidal, harming themselves or otherwise in crisis with an intensive, inpatient therapeutic program. It is the only program of its kind in Alaska.

The pending loss of the facility is “devastating,” said Amanda Metivier, the co-founder of Facing Foster Care in Alaska, a nonprofit advocacy group for youth in the foster care system.

Without it, Metivier said, more Alaska youths who are suicidal, self-harming or otherwise in need of care may end up in hospital emergency rooms, sometimes for days on end; at North Star Behavioral Health, the private, for-profit psychiatric treatment facility in Anchorage; or at Outside facilities thousands of miles away.

In recent years, North Star and its parent company have been the subject of federal investigation, lawsuits and legislation aimed at providing more oversight of youth in locked psychiatric hospitals.

[‘I watched it rapidly turn into absolute chaos’: Inside the deepening dysfunction at North Star psychiatric hospital]

In a statement Wednesday, Providence blamed the closure on the loss of the annual grant administered by the state that was “rescinded by the government” in March.

Without the grant, the hospital statement said, the Crisis Recovery Center was projected to lose $2 million annually.

“Without sustainable funding we can no longer operate the CRC,” it said. “This decision does not reflect the quality of patient care or dedication of our caregivers.”

The $1.2 million annual grant came from a federally funded state Department of Health treatment and recovery grant, state health department officials said in a statement.

It was cut as the Trump administration yanked back lingering COVID-related grants in March, including billions sent to state health departments across the country. The resulting cuts prompted the loss of 30 state health department positions, among other programs.

“Due to the federal government’s early termination of remaining COVID-related appropriations in March, (the state) was required to cancel the COVID-funded portion of the grant that was supporting the subacute adolescent psychiatric treatment center,” the health department said, in reference to the Crisis Recovery Center closure.

The funds tied to COVID relief were scheduled to end Sept. 30, according to the Department of Health.

Providence, which owns five hospitals and 28 clinics across Alaska, warned its employees in a letter reported by the Oregonian earlier in April of a “perfect storm” of economic pressures.

In a statement, Providence said it was “facing headwinds in its health care ministry,” including “proposed cuts to Medicare and Medicaid, a national labor shortage, higher prices for medical supplies and pharmaceuticals due to inflation, and delayed and denied payment from commercial insurers.”

The grant money was a “significant portion” of the center’s annual $3 million budget, Providence officials said in an email Thursday. The hospital system said it wasn’t aware the source of the money for the $1.2 million annual grant “had been changed to federal dollars until after the grant termination.”

The hospital system appealed the state’s decision and was denied, officials said.

The state “understands the critical nature of these services,” the Department of Health said in its statement. “We understand the many fiscal pressures occurring across the health care system and look forward to seeing how Providence plans to keep the commitments they’ve made to the Anchorage area and the state regarding behavioral health crisis services.”

Alaska has long had a much higher suicide rate than the national average. Emergency room visits related to suicide attempts are highest among youths ages 11-14 and 15-19, according to state data.

A state survey released last year found that 19% of high school students polled reported attempting suicide at least once within the past year, up from 9% in in 2011, while 23% said they considered suicide. Some 43% of respondents said they felt persistently sad or hopeless.

The center seemed to be the rare place where youths in foster care who spent time there left with good things to say, Metivier said.

“It also has positive reviews from youth,” she said. “It’s the setting that’s least restrictive, and it really is therapeutic and supportive.”

The loss of the center signals a “a real problem for the state,” which generally needs more bed space and capacity for mental and behavioral health patients, youth and adult, said Ann Ringstad, the director of the Alaska chapter of the National Alliance on Mental Illness.

Patients come in through referrals from health care providers, or from desperate visits to the emergency room, said Emily Nelson, a mental health counselor for the program.

For many, it’s the first time in a hospital, Nelson said. Often it is the patient’s first time in a residential setting for mental health care, she said.

“The need is there,” she said.

The center serves adolescents who are considered “subacute,” meaning that are not safe at home, often because of the risk of self harm or suicide, but don’t require higher level hospital emergency care and treatment. The average stay is about three weeks, much shorter than traditional residential psychiatric programs for youth, where teens often stay from nine months to a year.

Nelson made a public post about the Crisis Recovery Center’s impending closure on Facebook. Reactions have poured in, she said.

“I’ve had lots of people reach out to me and say that the (center) saved their life, or saved their child’s life,” she said.