One of the largest mental health agencies in Minnesota abruptly shut its doors Monday, potentially stranding thousands of patients with severe mental illnesses and aggravating a statewide shortage of psychiatric care.

Riverwood Centers, which serves some 3,000 clients in five counties of east-central Minnesota, said county funding cuts forced it to shutter five clinics and an emergency home-visiting service for people suffering from psychiatric crises such as severe anxiety or suicidal thoughts.

“I don’t have the words to describe how I feel,” said Bruce Echelberry, 64, a Riverwood client from rural Milaca who is manic depressive. “Astounded? Angry? They decided that money was bigger than our mental health.”

The surprise announcement raises new concerns about gaps in the treatment of Minnesotans with mental illness at a time when communities across the state face an acute shortage of psychiatric services. A legislative report issued last month said hundreds of patients are cycling in and out of hospital emergency rooms and county jails because the state lacks psychiatric beds and mental health professionals, particularly in rural counties like the ones served by Riverwood.

In interviews Monday, clients said Riverwood was often the only resource that prevented them from ending up in a mental hospital or jail — or even committing suicide.

The nonprofit had a team of 20 employees who would visit clients in their homes, providing therapy and helping them adjust to life after being discharged from psychiatric facilities.

An employee left the Riverwood Centers building in Braham, Minn., on Monday — her last day of work after the county closed the mental health treatment center, leaving a gap in care.

It was unclear Monday what steps the affected jurisdictions — including Chisago, Isanti, Kanabec, Mille Lacs and Pine counties — would take to fill the gap left by Riverwood’s closure.

“The big fear is that people will just pull into themselves and not seek help,” said Mary Fehring, a member of the mental health advisory council in Mille Lacs County. “It’s hard enough for these people to reach out and get help, and now we’ve just created another barrier. It’s scary.”

The Minnesota Department of Human Services, which oversees care for the mentally ill and other vulnerable populations, sent out an urgent request for community agencies to provide mobile crisis services in the region affected. The state is also working with county officials to assess the region’s mental health needs.

“We’re so tight in [psychiatric] beds that any change in the delivery system impacts the whole system,” said Assistant Human Services Commissioner David Hartford. “The agencies need to reorganize to get people the care they need.”

A regional mental health agency will take over Riverwood’s emergency phone line for people who may be suicidal or having a mental crisis.

Safety valve

Founded 50 years ago, Riverwood Centers was one of 35 community health centers across Minnesota that emerged in the years after the state began to close many of its large state hospitals. The centers provided services such as group therapy and one-on-one psychiatric counseling in homes and communities where people with severe depression and other mental illnesses lived. In east-central Minnesota, officials said, Riverwood was seen as an essential safety valve as the state moved patients out of large institutions and into settings close to home.

But in recent years, Riverwood’s funding became increasingly tenuous, according to Executive Director Kevin Wojahn. Public subsidies have not been increased for more than 15 years, Wojahn said, and many of Riverwood’s clients were receiving smaller payments from their private insurance providers. When Mille Lacs County finally ended its contract with the center late last year, Riverwood never recovered.

“That was the death knell,” Wojahn said. “This is a true tragedy for our region.”

‘Such bad shape’

Inside his home outside Milaca, Echelberry said he would “probably be in a mental hospital or dead” were it not for Riverwood.

In 1989, after he broke up with his wife and lost his hog farm, Echelberry said, he fell into a severe depression and has been hospitalized at least five times since for attempted suicides. Each time, Echelberry said, he was met in the hospital by a Riverwood therapist who helped him develop a plan for coping. Riverwood also sent people to his house after each episode to help with basic activities, such as stocking his cupboards with food and balancing his checkbook.

Recently, when Echelberry failed to show up for a weekly group therapy session, he could count on a phone call from Riverwood to see if he was all right. He proudly pointed to a needlework project of a deer buck that he made with the help of a Riverwood therapist.

“Sometimes I was in such bad shape that I couldn’t even talk a straight sentence,” he said. “I would get very suicidal. They were always there to help me through.”

Since rumors of Riverwood’s closing began to circulate last week, county governments have been scrambling to find mental health vendors that could offer the sort of emergency crisis services it provided.

In Chisago Couny alone, an estimated 900 people receive mental health services through Riverwood, officials said. The county is preparing for an influx of phone calls once clients discover that Riverwood’s clinic in North Branch is closed and in-home visits have ended.

Bruce Messelt, administrator for Chisago County, said it would be hard to contact clients because Riverwood was an outside provider and the county does not have access to private client information.

“It’s not like a nuclear concern, where everything will collapse,” Messelt said. “But we are expecting there will be a lot of people who may be disrupted by this.”