Emily Nelson wrapped up her in-person work with patients Monday at Providence Alaska’s Crisis Recovery Center in Anchorage. Later this month, the program will close permanently.
Nelson is a mental health counselor who’s worked there for five years, and she said she’s seen young people experiencing mental health crises transform during their time at the center.
“I've had kids who were night and day from the day they arrive to the day they leave, and I have a whole file of notes from kids who let me know how important I was to their journey or how I changed — and my coworkers changed — their view of inpatient treatment,” Nelson said. “And so, I knew that we were doing safe, ethical, compassionate work.”
She said the center filled an important niche in the state, offering short-term inpatient care for young people in crisis, sometimes with depression, intense anxiety or suicidal ideation.
The center has been serving Alaskans ages 12 to 17 in mental health crises for almost two decades. It typically housed about seven to 13 patients at once, and it reached kids at a crucial time. Many mental illnesses, like schizophrenia, anxiety, depression, bipolar disorder and eating disorders, first emerge during adolescence. Experts say those disorders are often treatable and manageable, but if young people don’t get care during that time, issues with mental health can snowball.
The program was for kids who didn’t necessarily need the intense security measures of longer residential treatment, and Nelson said that allowed “kids to be kids” even as they were healing.
“We're taking the kids outside every day, and we're going on walks, and we're allowing them to learn how to crochet in a safe environment, or to use markers and pencils, things that a kiddo who is more unsafe to themselves or others might not have the opportunity to,” Nelson said.
She said the closure of the Crisis Recovery Center, or CRC, is heartbreaking, and she’s not the only one who feels that way.
Mister Patton, who worked for the Office of Children’s Services for many years, said he sent several of the kids he worked with through the program and it changed their lives.
“It's gonna be hard to replace the CRC. It’s gonna be really hard,” Patton said. “The other programs that I know about that are available just aren't as supportive, [don’t] have as many resources and connections, and they have it. They're just a more loving environment, if I can use that word, from what I've experienced with the kiddos.”
Providence Alaska declined an interview on the topic but a representative wrote that the program suddenly lost a $1.2 million federal grant, which meant the already-subsidized center would likely lose about $2 million annually. That’s a relatively small amount compared to Providence Alaska’s total operating expenses last year, which were about $1 billion, but the hospital operated at a loss last year.
The Providence representative wrote the nonprofit faces an array of financial challenges including potential Medicaid cuts. Almost 60% of the center’s patients were on Medicaid, they said, and not all private health insurance covered the program.
Amanda Nalewaja, clinical manager with Alaska Behavioral Health, a community behavioral health clinic which also treats kids in crisis, said some of her patients have been through the program.
“The crisis recovery center shutting down, absolutely, is something that we feel ripple through our community,” Nalewaja said. “It served a lot of kids.”
But she said the state has been working to offer alternatives to residential treatment, partly because the Department of Justice reprimanded the state in 2022 for failing to provide enough community-based options for youth.
Nalewaja said the statewide trend to move away from residential care is a good thing for many Alaskans.
“I am a very big proponent of ‘healing happens in community,’” she said. “Being isolated from your family, from your support network, your friends, your school, that is tough, and some kids, sure, do make progress when they are in inpatient settings or out-of-state settings, but that's a really controlled environment.”
Alaska Behavioral Health runs a partial-hospitalization program for kids in Anchorage and recently opened one in Fairbanks. Both allow kids who live nearby to stay at home while they attend the 30-hour-a-week program. Or, if they’re from outside those areas, Nalewaja said they can stay at a hotel with family. She said she hopes more Alaska kids in crisis try a partial hospitalization program like their's.
But Emily Nelson, who works for the closing crisis center, said some kids do need a temporary separation from family and community to heal, and she worries they’ll end up in residential programs outside Alaska. She said for some kids in the program, this was their first time in a big city like Anchorage and it was a culture shock. Some didn’t know how to use a washer and dryer, or a microwave.
“It was already hard for them to be away from their family, to be sleeping alone in a room, rather than nearby their family and friends,” Nelson said. “So, I can't imagine the shock it would be for them to go out of state.”
Although the Providence Crisis Recovery Center is closing, Nelson said she hopes another organization can provide a similar program. She said that may require the state to provide more funding for behavioral health.
