Mental Health

Pride week in Juneau included a pub crawl, Pride prom and queer trivia. But it also featured something new this year: a party just for teens.

On the morning of the youth Pride party, Callum Marks didn’t know what to expect.

“I’m hoping that people show up. I think people will,” he said.

Besides just showing up at the Zach Gordon Youth Center, Marks hoped the middle and high school students at the party would find a safe space “to talk about the stuff that they don’t get to talk about in everyday life,” he said. “Because, you know, queer youth really are going through a time. High school is hard.”

Marks would know — the 18-year-old just graduated from Thunder Mountain High School last month.

As far as he and the other organizers can tell, the party was the first of its kind in Juneau.

Stephanie Luther is an education specialist at AWARE, a domestic violence shelter in Juneau. She got involved in the planning after asking friends and folks in the nonprofit world what programs were available for queer teens in Juneau.

“And the answer I got from everybody was, ‘There aren’t any, but there should be,'” she said. “And so I was like, ‘OK, well then let’s try.’”

Soon, Luther hopes to see more programming for queer youth, maybe even a club. But first: a party. Luther said it fills a gap for teens during Pride. Many of the big events take place at bars or have age restrictions. And while family-friendly events like kickball and picnics are great, teens might not necessarily want to hang out with little kids.

“And some teenagers don’t necessarily have families that they want to bring to those events or who would want to go to those events,” Luther said.

Organizer Tayler Shae said the party was planned in the spirit — and history — of Pride, which began as a protest against discrimination and has since evolved into something more like a festival.

“We want to encourage connection, raise awareness in the community that, like, this is a need, that there’s kids out there that need this connection, and then using it as a time to just, like, celebrate and be with each other and have a ton of fun,” Shae said.

That meant tie-dye, plenty of food and a drag performance were all in order. Even some live music, courtesy of 19-year-old Theo “FySH” Houck.

“As a queer person, as a trans non-binary person, I kind of like to imagine that anytime I like anyone, it’s queer. And that means that every time I write a love song, it’s a queer love song. And I write a lot of those. So I guess I’m a bit of a hopeless romantic,” Houck said.

Houck graduated last year from Juneau-Douglas High School: Yadaa.at Kalé and now attends college out of state. He was excited when he heard about the youth Pride event in his hometown.

But beyond Pride week or Pride month, Houck said adults can support the youth in their lives year-round by just being there for them.

“Be open and compassionate. Listen to what they have to say,” he said. “I think that one of the best things adults ever did for me was just allow me to figure things out. And really, like, believe me when I said I felt a certain way.”

About 50 teens turned up for the party. They had cake and entered a raffle for various, mostly-rainbow-colored prizes by filling out a survey about the kinds of services and activities they’d like to see for queer youth in Juneau.

As the party wound down, a handful of remaining teens and a few adults gathered around the fire pit out back. There’d been talk of starting a fire, but it was a warm night, and, with the summer solstice the next day, still plenty sunny around 8:30 p.m. All eyes were on Houck and his guitar as he played a few queer love songs — plus one breakup song, because, as Houck said: “Love isn’t always happy endings.”

The party, however, ended happily. Houck finished his set, and it was time for the Zach to close. Youth center manager Jorden Nigro apologized for wrapping things up and thanked everyone for being there. The remaining door prizes were handed out. Someone asked if they could take home an extra piece of rainbow cake.

Nigro said many people and organizations came together to make the party happen, because young people saw something missing.

“This gets at the core of the importance of listening to our kids,” she said, “and at working together to create a healthy and equitable community for all our kids.”

Nigro hopes the Zach Gordon Youth Center and community partners will soon offer more programming specifically for queer youth in Juneau.

A proposal to more than double the monthly costs for most residents in Alaska Pioneer Homes met with stiff opposition during recent public testimony on the issue.

Family members — and residents themselves — warned the Division of Alaska Pioneer Homes that rate increases could likely backfire. And rather than balancing the budget of Alaska’s subsidized senior care, it could instead send many elder Alaskans out of state.

On paper it sounds really simple. The state director of the Alaska Pioneer Homes, Clinton Lasley, explained the rationale behind the increased rates.

“The rates being proposed in regulation are reflective of the division charging what it costs to provide services,” Lasley said. “Currently, the state has been paying those rates to provide services, but we have not been charging them to the general public.”

In a letter sent to all Pioneer Home residents on Feb. 25, Lasley explained that the state subsidizes their care at a cost of more than $30 million a year.

But the state’s Pioneer Homes — although subsidized — aren’t free. Currently there are three levels of care, ranging in cost from around $2,600 a month to almost $7,000 a month, from residents who can live independently to those who need 24-hour nursing services.

Broadly speaking, the proposal from Gov. Mike Dunleavy’s administration would push rates up by 40% to over 120%, topping out at $15,000 a month for residents with so-called “complex behaviors” like dementia.

During a public hearing held on May 28, simultaneously in all six of the state’s Pioneer Homes, there was significant backlash.

Resident Carol Scott has lived in Alaska for 59 years — the last four in constant worry about meeting her rent at the Anchorage Pioneer Home.

“And then this year, the governor’s proposed budget knocked our twice-mended socks off,” Scott said. “We already were wearing clothes from when we retired 10 to 15 years ago, and our allowance is only $200 a month.”

Scott is referring to a payment assistance strategy used by the Pioneer Homes to ensure residents that their bills are paid as much as possible through personal income — with at least $200 left over each month. She went on to call the proposed rate structure preposterous and unaffordable for Alaskans.

Ninety-four-year-old Nancy Ricketts, a resident in the Sitka Pioneer Home, testified that the proposed rate structure undermined her plans to remain self-sufficient.

“I sold my house to be able to afford the rates as much as possible here at the Pioneer Home,” Ricketts explained. “I planned carefully so that I could remain in control of expenses. I remain in the best health possible to maintain these goals for the rest of my life.”

Ricketts said that the added stress of paying higher bills would likely force her health — and that of many of her neighbors — into decline.

Aves Thompson, whose wife is in the memory care unit of the Anchorage Pioneer Home, said he paid 100% of her bill out-of-pocket. The proposed rate increase, in his family’s case, could end up costing the state more.

“The cost increase will drive my wife out of the Pioneer Home,” Thompson said. “This means that this private payer will no longer be paying the entire amount of the fee. The replacement will, more than likely, receive state or federal subsidy to pay the bill, as they will be about the only ones who can afford to be in the Pioneer Home.”

The Division of Alaska Pioneer Homes took testimony from its facilities in Anchorage, Fairbanks, Palmer, Juneau, Ketchikan, Sitka and from people calling in over the phone. Much of the testimony focused on the ramifications of the dramatic increases, but some focused on the timeline.

Lauren Wilde’s mother is a “Level III” resident of the Sitka Pioneer Home who pays $6,800 per month for care. Under the administration’s proposal, her mother would be at “Level V” care and pay $15,000 a month — according to Wilde, that’s more than the combined income of her parents when they were working.

Wilde understands that costs are going to rise, but these changes were coming too fast.

“People need time to figure out how they’re going to adapt to increasing costs,” Wilde argued. “Instead of increasing incrementally over time, you’ve put forward a plan to more than double the costs for my mom within about four month’s time. You’re not giving us enough time to figure out how to cope with these changes. And obviously these are not small changes. We’re talking about $160,000 a year.”

Wilde’s mother, along with Thompson’s wife, are in the majority in Alaska Pioneer Homes, where 56% of residents are currently in “Level III” care.

The Alaska Legislature has also weighed in on the timing of increases. On May 28 — the same day as the public hearing — 19 members of the House of Representatives sent a letter to Clinton Lasley and his boss, Commissioner Adam Crum of the state’s Department of Health and Social Services, urging the department to use House Bill 96 as a guideline for setting rates in the Pioneer Homes.

HB 96 allows for a one-time reset of the basic rate structure in the Pioneer Homes, and then “reasonable and regular rate increases” keyed to the Social Security cost-of-living benchmark.

HB 96 passed overwhelmingly in the House by a 35-4 vote on May 10. The bill is now parked in the Senate Health and Social Services Committee.

The Department of Health and Social Services is taking public comment on the proposed changes to the Pioneer Home rates through June 28. After that, the department could implement the new regulations at any time.

Late last month, U.S. Attorney General William Barr spent three days touring Alaska with the congressional delegation to hear about and see for himself the lack of public safety in rural Alaska. He spent a day in Bethel and the nearby village of Napaskiak.

Barr’s security detail outnumbered the number of village public safety officers in the Yukon-Kuskokwim Delta, a region roughly the geographic size of Oregon.

Western Alaska has a public safety crisis, one that’s been there for decades.

A recent Anchorage Daily News article highlighted just how bad it is: At one point this year, at least 1 in 3 rural Alaska villages had no law enforcement. Western Alaska also has some of the highest rates of domestic violence and sexual assault in the nation, and ranks high in the number of murdered and missing Indigenous women.

With U.S. Sen. Lisa Murkowski, R-Alaska, by his side, the attorney general made his first visit to the Yukon-Kuskokwim Delta.

“You have to see it to understand it,” Barr said.

Barr said that it’s hard for him to imagine a “more vulnerable population.” And he said that even the bare minimum of basic safety standards is lacking in the Y-K Delta.

Barr and Murkowski first visited Bethel’s Tundra Women’s Coalition, one of two women’s shelters in the region. Staff there told them that they were over capacity and struggling to make room for families coming in. Ina Marie Chaney, a shelter manager, said that a case has to be pretty serious before the shelter can even consider it.

“Right now we’re screening on lethality cases,” Chaney told Murkowski and Barr.

And then Barr heard from the Association of Village Council Presidents about the public safety crisis and their ideas about fixing it. Reporters were not allowed in that meeting.

AVCP CEO Vivian Korthuis told KYUK later that they presented Barr with a plan to build seven public safety centers in the region, and she hopes that they will get the resources they need to build them.

Then it was time to visit Napaskiak. People lined the banks as the boats carrying Barr and Murkowski pulled up to shore.

Their first stop was the jail. Inside the large red building are cells made of wood, with wooden doors.

Napaskiak has two tribal police officers and two village police officers. All of them are working part-time; they work one week on and one week off. Napaskiak used to have two state-trained village public safety officers, but they left.

Barr also visited the school. There, Native Village of Napaskiak President Stephen Maxie Jr. begged him to declare an emergency because of how many alcohol-related deaths happened in the village over the past two years.

“The poor suffer the most, and they don’t got the most. They’re hurt the most because we’re always overlooked and always put aside,” Maxie said.

Barr said that he sees that the criminal justice system isn’t working for Alaska Native tribes. And as for the types of solutions, he said “everything is on the table.”

Meanwhile, another tribal police officer is set to leave after only a couple of months on the job: Harry Williams said that he plans to go to building maintenance. The reason? Better pay and benefits.

Barr has said he plans to return to the Y-K Delta. At an Anchorage meeting, he told leaders that he would schedule a followup meeting. So far, no date has been set.

Since January, Southeast Alaska’s largest hospital has quietly rolled out a new program to close a big gap in behavioral health services for minors.

So far, 13 young people in the midst of a crisis — like a suicide attempt — have been able to receive care. It’s addressing a growing need so patients can stabilize a little closer to home.

Bradley Grigg used to work at the emergency department at Bartlett Regional Hospital, and he saw dozens of patients come through the door.

But he wasn’t treating them for an injury, like a broken leg. He did mental health assessments when parents would come in with their child asking for help.

“My frustration in working in those scenarios was talking with the family, building a quick rapport with the family … only to find out, we can’t help you here,” he said.

The hospital does have in-patient mental health services for adults.

But up until recently, there was nowhere in the region for a minor to stay after a mental health crisis, stabilize, see a psychiatrist and receive ongoing care. The closest place in Alaska was Anchorage.

Grigg says behavioral health specialists in the community recognized it was a problem. Children would sometimes be separated from their parents, which can delay the healing process for everyone.

“Right now, we’re really stuck,” Grigg said. “When a family comes in here, they usually come in here at the time when they cannot handle it anymore.”

That was Erik and Melissa McCormick’s experience with their oldest son.

“Speier Malone McCormick was his full name,” Melissa McCormick said.

The McCormicks remember Speier as an inquisitive kid who enjoyed going on hikes with the family. He played guitar and wrote his own songs. His music tastes were eclectic. He liked Metallica and the Beatles.

“He really liked Elton John,” Erik McCormick said.

But the McCormicks became increasingly concerned about Speier’s behavior around the time he was in 6th grade.

He was a pitcher on a junior league baseball team.

“He would come home and he would be very upset that they lost the game,” Melissa McCormick said. “And we we would explain to him, it’s just a game. But he would take it really hard. He would go hit his head against the wall. ‘I didn’t pitch well enough.'”

Erik McCormick says they thought he was just being a perfectionist.

“He just to needs to learn,” he said. “But we probably underestimated all that was going on in his brain. We didn’t know.”

Speier was later diagnosed with bipolar and borderline personality disorders: treatable mental health conditions.

But at 15, he tried to kill himself. That’s when the McCormicks first tried to navigate a confusing mental health system which made it nearly impossible to keep their son close to home.

Melissa says after Speier was taken to the emergency room in Juneau, “it was like boom, boom, boom and he was gone.”

Speier was flown to a hospital in Anchorage outfitted to help suicidal teens. Then, he was admitted to a youth mental health treatment facility in Palmer for about six months. His parents were able to visit him there and Speier eventually returned home.

When he was 16, the family went through it all over again — after another suicide attempt.

Melissa says in both instances, she would’ve liked to slow down and reflect on the best options for Speier and the family.

“You know, worked on a plan together,” Melissa McCormick said. “Instead of me on the internet at 3 o’clock in the morning trying to figure out what am I going to do with my son? And how am I going to get him out of town, and how am I going to explain this to his siblings?”

The McCormicks felt like they’d exhausted all the mental health services available. So Speier was sent to another treatment program in the Lower 48 while most of the family remained in Alaska.

A little over a year ago, Speier died by suicide.

Bradley Grigg, the counselor who did mental health assessments at the hospital, didn’t treat Speier. But he did know him.

“I was a baseball coach. It’s a small community,” Grigg said.

Grigg is now the Chief Behavioral Health Officer at Bartlett, which is doing things differently than how it’s been done in the past, due to a $2 million dollar grant from the state.

For instance, when a family arrives with a child experiencing a mental health crisis, they aren’t immediately confronted with a flight to Anchorage. Instead, they can receive care at Bartlett’s new youth stabilization room.

Grigg points out the safety features which have been adapted to minimize self-harm.

But it’s more than the redesign of one room. Next year, Bartlett is constructing an entire building that can serve up to four adults and four kids, which they hope to be able to flex based on need.

Grigg says it’s a chance to hit pause for up to week or longer. Patients can meet with a psychiatrist and come up with a treatment plan.

“And as often as possible with the family,” Grigg said. “Because don’t view this as, ‘Oh, we have a kid here who’s having a crisis.’ We view it as a family crisis.

Grigg acknowledges there’s still more work to be done to address the huge need for more mental health services in Alaska.

But for now, he’s able to tell families with kids something he couldn’t before: Yes, we can help you here.

If you or someone you know needs help, call Careline at 1-877-266-HELP (4357), a 24/7 Alaska resource that can provide support, information, and local resources.

The Alaska state government has changed its plans for the Alaska Psychiatric Institute.

Wellpath will not operate API under a controversial no-bid contract for the next five years. Instead, the company will continue to work at the facility through December. The state also has hired a contractor to study whether it makes sense to privatize API. If the state then moves forward with privatization, it will seek bids.

Alaska Department of Health and Social Services Commissioner Adam Crum said Gov. Mike Dunleavy’s administration made the move because it wants to ensure trust in government.

“There’s so many questions and skepticism surrounding this contract, it’s important for us to resolve those questions, that our process aligns with our intentions. And we just have been working on this, thinking about this decision about what is right,” Crum said.

Wellpath agreed to the change, which the state made public Monday in court, where the union representing API workers was seeking a restraining order against the Wellpath contract. The lawsuit said the no-bid contract violated state labor laws.

Crum said that if the state seeks another contract, it will use the study to determine what it looks for in a contractor. But he expects experience running a psychiatric hospital will be important.

“Our biggest concern throughout this entire process is to make sure there’s stability for the patients,” Crum said. “We want to make sure that they are taken care of.”

The state also announced it hired Matt Dammeyer to be the CEO of API. He has worked as an administrator at Central Peninsula Hospital in Soldotna.

Crum noted that Dammeyer has a doctoral degree in psychology.

“He is a clinician himself, and so both in hospital administration (and) behavioral health and psychiatric care, he’s a very well-experienced guy who’s spent a lot of time in Alaska,” he said. “He understands the kind of unique issues we have up here.”

API has had staffing shortages, reports of mistreated patients, and substandard working conditions for employees. The state hired Wellpath in February, after the federal Centers for Medicare and Medicaid Services said it planned to revoke API’s certification. That could have forced the hospital to close.

Bethel Democratic Rep. Tiffany Zulkosky said she’s glad the state made the change.

“Process is important,” she said. “I think that’s come out in several hearings that we’ve had, both in making sure that we protect state employees, but (also) caring for some of the most vulnerable Alaskans at a very critical institution.”

Anchorage Democratic Rep. Ivy Spohnholz said she hopes Providence Health and Services will be considered if there’s another contract. She said it will be important that the state require quality measurements in its request for bids. That includes making sure patients are appropriately transitioned between care providers, which is called a “warm handoff.”  

“We know you get what you measure when it comes to contracts,” she said. “And if you’re not measuring, you know, health and safety, if you’re not measuring patient readmission rates, you’re not measuring warm handoffs, then you’re not going to get better results.”

She said lawmakers could hold an oversight hearing on API after the legislative session ends.

A union is suing Gov. Mike Dunleavy’s administration to stop the privatization of Alaska’s main psychiatric hospital.

In February, the administration introduced a plan to turn over management of the troubled Alaska Psychiatric Institute to Wellpath, a private company based in Tennessee. The move has been criticized for bypassing the competitive bidding process, and because of the extensive number of federal complaints filed against one of the two companies that merged to form Wellpath.

And now, the Alaska State Employees Association is suing the Dunleavy administration in state Superior Court to halt the change.

“We are facing an emergency situation where we want to save our members’ jobs,” said ASEA Executive Director Jake Metcalfe.

The union represents around 8,000 workers across the state, 211 of whom are employees at API and could eventually see their jobs eliminated under the privatization plan, according to Metcalfe. The organization is pursuing a restraining order to immediate block Wellpath’s management of the facility.

While there are concerns about patient well-being, the union’s actions are based on what Metcalfe said is a breach of labor laws that affect employees.

“The state has gone ahead and signed a contract with a private employer and not given our members the contractual rights that they have, or the opportunity they have, to show they can do the job cheaper and provide a better service,” Metcalfe said. “That’s a violation of contract law. It’s a violation of the state procurement law. And we think it’s a violation of the Alaska Constitution.”

As of noon Tuesday, the state had not responded to the motion in court.

Dunleavy spokesperson Matt Shuckerow said the administration cannot comment on pending litigation.

But he rejects assertions that recent decisions about API are driven by budgetary concerns. The facility has faced a barrage of problems: from working conditions to employee vacancies to patient safety concerns. According to Shuckerow, the administration moved swiftly to transfer control of the hospital to Wellpath, because it was at imminent risk of losing federal funds and even being forced to shut down completely.

“There’s a healthy understanding that this system was broken. And that, without doing something, that we were in a very, very difficult situation,” Shuckerow said.

The union expects the court to hear arguments before the end of the week.