API 2000: Time to Reconsider?

API 2000:
Time to Reconsider?
by Jim Gottstein

The views expressed here are solely mine, and not the position of the Alaska Mental Health Board.

For another view see the Response by Loren Jones, CMH/API 2000 Project Director

After my first Alaska Mental Health Board Meeting (as a member) in January of 1999, I wrote an article entitled A Consumer Member's Report on Alaska Mental Health Board Issues, the first section of which was on API Downsizing (API 2000). API 2000 is a plan to reduce the capacity of the state mental hospital to 54 beds from a historical average of over 100. The way this is supposed to happen is that hospital stays are to be substituted with less restrictive services in the community, including designated mental health beds in local hospitals. The twin pillars of this plan are (a) a Single Point of Entry, which would be an evaluation program that would allow many people to be sent to community based services and avoid hospitalizations, and (b) the availability of these community based services. In my 1999 article I expressed grave concerns that the promised community based services would not materialize. Now, I am the last person to suggest that placement at API is a good thing for people, but realistically, under present conditions, if people don't get sent to API, they end up in jail or worse.

At the last Mental Health Board meeting in January of 2000, we were told that no one had even submitted a bid on the Single Point of Entry contract (it seems that there was actually one bidder who said it could not open before the fall of 2001, rather than April 1, 2000 as required by the RFP). We were also informed that the purchase of the new facility was on track. When I expressed concern that the API downsizing was going to happen without the Community Services/Single Point of Entry components being implemented, I was assured that the Division is committed to making sure that Single Point of Entry and community service components come into being. I have no doubt that this statement was made sincerely, earnestly and in complete good faith. However, I have been around enough to realize that the way things go, if Charter North is purchased and remodeled to the 54 beds, that the current API will be closed and we will have a 54 bed hospital. If the Community Services/Single Point of Entry are not in place at that time it will be a disaster, albeit a disaster that only people with mental illness and their families will know about. In other words we will have even more people inappropriately jailed, homeless, and worse.

It seems to me that it is time, at this critical juncture when an essential component of the plan is not coming into place to reconsider the wisdom of the API 2000 plan. First, while I do not understand all of the thinking, does it really make sense, if Charter North is purchased, to spend more money to reduce the capacity? More importantly, shouldn't the whole effort to reduce API capacity be stopped until the Community Services/Single Point of Entry components are in place?

Finally, has the implication for children's mental health services really been thought through with the purchase of Charter North? Charter North currently provides a great deal of children's mental health services in the city. What is going to happen when this capacity disappears? At the last Mental Health Board Meeting, one person brought out that she had heard that Charter North was going to build a new facility. Does this really make sense? I don't think so. It seems to me that the sale of the Charter North facility indicates that Charter is substantially pulling out of Anchorage. Of course, if Charter North wants to terminate its children's services, there is not much we can do about it, but purchasing their building certainly makes it easier for them.

Let me know what you think by emailing me at jimgotts@touchngo.com.
And, for another view see the Response by Loren Jones, CMH/API 2000 Project Director

Jim Gottstein grew up in Anchorage, Alaska, graduating from West High School in 1971, the University of Oregon 1974 and Harvard Law School in 1978. He has practiced law in Anchorage since then, including representation of Alaskans with mental illness in the Mental Health Trust Land Litigation from 1986 through its conclusion in 1997. Mr. Gottstein is a co-founder of Touch N' Go Systems, a software developer and home to the AlaskaCam and the Alaska Legal Resource Center on the World Wide Web. As a recovered mental health consumer, he co-founded Mental Health Consumers of Alaska with Andrea Schmook and Barbara Greene in 1986, and the Alaska Mental Health Consumer Web with Katsumi Kenaston in 1998. In December of 1998, Mr. Gottstein was appointed to the Alaska Mental Health Board, largely, he believes on the strength of his views on the mental health system as described in his article, The Mental Health System; Recovery Should be the Goal. Mr. Gottstein has published a number of other articles on the Alaska Mental Health Consumer Website, including his own personal recovery story:

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