Report: Alarming deficiencies in mental health care in rural America

From The Independent in Grand Island, Nebraska. A full copy of the Center for Rural Affairs report can be viewed and downloaded at http://files.cfra.org/pdf/Mental-Health-Overlooked-and-Disregarded-in-Rural-America.pdf.

LYONS, Neb. — A new report from the Center for Rural Affairs released May 29 found that there were “alarming deficiencies in the mental health care system in rural America.”

The center’s report is titled “Mental Health: Overlooked and Disregarded in Rural America.”

According to Kim Preston, rural research assistant for the Center for Rural Affairs, rural Americans remain underserved in terms of mental health care providers and health insurance coverage for mental health services, despite the fact rural Americans suffer just as much from mental illness.

She said the report “further demonstrates that rural America’s economic dependence on small business and self-employment calls for health care reform that includes an affordable, meaningful public health insurance option.”

“And that any such reform should also ensure that all Americans, rural and urban, have reasonable access to quality mental health care,” Preston said.

The Center for Rural Affairs, in collaboration with Dr. Dianne Travers Gustafson of Creighton University, recently evaluated rural Americans’ access to crucial mental health care services.

Preston said this is the fourth in a series of Center for Rural Affairs reports examining crucial health care issues in rural America. Previous reports can be found on the front page of the center’s Web site (www.cfra.org).

Findings from the report include:

— Depression: Major depression rates in some rural areas significantly exceed those in urban areas. Teens and older adults in rural areas have significantly higher suicide rates than their urban counter-parts.

— Stress: Stress is associated with increased mental health disorders and rural people experience stress with cyclical farm crises, natural disasters and social isolation.

— Barriers of availability: More than 85 percent of the 1,669 federally designated mental health professional shortage areas are rural.

— Lack of accessibility: Only in rural America did the National Advisory Committee on Rural Health (1993) find entire counties with no practicing psychiatrists, psychologists or social workers.

— Social stigma: The social stigma attached to mental health problems, in combination with a general lack of anonymity in many small communities, leads some people to forego treatment.

— Lack of affordable, meaningful health insurance coverage: Rural Americans are less likely than urban Americans to have health insurance that covers mental or behavioral health services.

According to the Nebraska Department of Health and Human Services, there are approximately 71,000 adults in Nebraska who have a serious mental illness.

Mental illness, according to DHHS officials, is often misunderstood but is a common health condition that causes changes in a person’s thinking, mood and behavior.

“It’s important to remember that people can and do recover from mental illness and lead productive lives with the support of our friends in the community,” said Carol Coussons de Reyes, Office of Consumer Affairs administrator in the Department of Health and Human Services.

Friends make a difference

There are more treatments and community support systems than ever before, but recovery does not happen in isolation, said Scot Adams, director of the Division of Behavioral Health in DHHS.

He said friendship is one of the most important factors in recovery.

“My friends and family have made a difference just by understanding and assisting throughout the course of my mental illness,” Coussons de Reyes said. “You can do a lot by simply listening to someone. For example, when a friend tells you they were diagnosed with a mental illness, ask them to tell you about their experience and feelings.”

Here are some tips from DHHS on how to respond if a friend tells you he or she has a mental illness:

— Express your concern and sympathy.

— Make sure your friend understands that you honestly care. Ask for more details about how he or she is managing and really listen.

— Remind your friend that a mental illness is treatable. Find out if the friend is getting the care he or she needs and wants.

— Ask what you can do to assist. Rides to medical appointments or keeping the person company in the waiting room can ease some of the anxiety and reluctance that people feel when faced with a life-changing diagnosis.

— Be sure to include your friend in everyday plans, such as going out to eat or catching a movie. If your friend resists these overtures, reassure and re-invite without being overbearing.

“You can make a difference in your community just by being present and available to your friend who is living with a mental illness,” Coussons de Reyes said.

The new Network of Care Web site is an easy-to-use, comprehensive Web site that provides vital information about treatment resources and diagnoses, insurance, advocacy and other pertinent behavioral health Web sites. The Network of Care Web for Behavioral Health can be accessed at www.dhhs.ne.gov/networkofcare/.