With an increasing number of mental illness cases, community mental health care providers are struggling to keep up with patient demand.
The January 2016 Butler County Mental Health & Addiction Recovery Services Board’s Strategic Plan estimates that 67,724 adults and 3,386 children ages 10 to 14 in the county experience mental illness annually.
The federal government has identified Butler County as an area with deep needs. The Health Resources and Services Administrations named it a Health Professional Shortage Area, meaning that it doesn’t have the resources to serve the number of patients seeking care for mental illness.
What is mental health?
The term “health” encompasses more than just physical well-being; it also includes mental wellness. Just like asthma or diabetes, mental illness is a medical condition that can be diagnosed and treated. It is a widely discussed topic in healthcare, and millions of Americans experience mental health issues every year.
Mental health includes emotional, psychological, and social well-being, per the Centers for Disease Control (CDC). Mental illnesses don’t discriminate, and can affect anyone regardless of demographic characteristics. Examples of mental illnesses include anxiety, depression, bipolar disorder and obsessive-compulsive disorder.
Dr. Barbara Brewer, clinical psychologist, works in the Oxford area and sees both Miami University students and Oxford residents. Like many practices in the area, Dr. Brewer’s office faces a lengthy waiting list of patients seeking care.
“I hate to see people getting turned away, but it unfortunately happens,” Brewer said.
She hopes to see an increase in the amount of medical staff, especially in a college town like Oxford.
“I do see an increase in stress, especially from the Miami students,” Brewer said. “There is more demand than resources. We could use more providers.”
Michael Ranney serves as the Executive Director of the Ohio Psychological Association which seeks to advocate for public policies that promote psychological services, provide the public with resources, and support the professional lives of psychologists. Ranney said that insufficient funding towards psychiatric care creates a roadblock in the battle against mental illness.
“A lack of funding for mental health care is really not helping the problem right now in Ohio," Ranney said.
The non-profit executive also mentioned several other barriers that affect the treatment of mental health in our state.
“Those with mental illnesses are constantly battling stigma and many people are afraid to seek treatment because of this,” Ranney said. “It’s also hard to find services.”
According to the Treatment Advocacy Center, approximately 299,000 Ohio residents were experiencing a serious mental illness in 2017; yet, the state only maintained 1,121 public psychiatric beds in 2016. Residents also face high deductibles and copays for visits to some providers.
“The workforce is pretty limited in terms of providers,” Ranney said. “And a lot of providers don’t take Medicaid, which limits access to care.”
Mental health issues can also lead to even more adverse health problems, therefore increasing demand for other medical services. Butler County Health Department commissioner Jennifer Bailer says that she sees a strong connection between psychological condition and other illnesses. In fact the CDC reported that in the U.S., depression is found to co-occur in 17 percent of cardiovascular cases, 23 percent of cerebrovascular cases, 27 percent of diabetes patients and 42 percent of patients with cancer.
“Mental health needs underlie a lot of other disease states like heart disease, obesity and substance abuse disorder,” Bailer said.
Drug use and mental illness often coexist. Mentalhealth.gov states more than one if four adults living with a serious mental health problem also have a substance abuse problem.
“We are in the middle of a Hepatitis-A outbreak in Ohio and 90 percent of the cases are associated with drug use,” Bailer said. “That correlates to mental health.”
One group seeking to improve mental well-being is the Coalition for A Healthy Community-Oxford Area. The coalition utilized a needs assessment conducted by McCullough-Hyde Memorial Hospital and identified mental health as a key priority area for this community. Through training and workshops sponsored by the Coalition, over 600 citizens of the town are now Mental Health First Aid certified.
“It’s just like CPR, but for mental health,” said Amy Macechko, a representative of the Coalition and the wellness coordinator for the Talawanda School District. “Those who are trained can address the problem and provide help before a professional is available.”
Those with the certification know how to identify individuals facing a crisis, reach out to offer support, and encourage those individuals to seek professional guidance.
“With the prevalence of mental illness, it’s very important to have Mental Health First Aid and get certified,” Macechko said.
Dr. Scott Rasmus serves as the Executive Director of the Butler County Mental Health & Addiction Recovery Services Board. The Board aims to provide comprehensive recovery care and prevention, while improving addiction and mental health recovery services in the county. He recognizes that as the population of Butler County increases, so do the number of mental illness cases. Rasmus said the county is treating more cases than ever before.
“The Board has over 50 specialized programs,” Rasmus said. “They are specially targeted to things like trauma and eating disorders.”
Rasmus identified the importance of time in treating these illnesses. He said the county needs to provide services when they’re needed, but a critical component in the battle against mental illness is patients’ fear of getting help. Less than 50 percent of those in the county with mental illness seek care.
“When a person needs help, they should reach out to the board and seek assessment,” Rasmus said. “There are professionals who can treat you.”
On Miami’s campus, Steve Large hails as the Assistant Vice President of Health and Wellness. He oversees the student counseling services, student health services, and the office of student wellness. Large says the biggest health challenge facing the University right now is mental health.
“There is a huge increase in students seeking care for emotional difficulties,” Large said. “The beautiful thing is that students are reaching out. There is less stigma than previous generations.”
According to Dr. Jennifer Young, psychologist at the Student Counseling Service, the on-campus practice maintains a staff of 10 psychologists, two clinical social workers, one professional clinical counselor and ten counselors-in-training.
However, this number of staff still can’t always accommodate the number of student appointments. Large says that the campus has times during a semester when the volume of students seeking mental help outweighs the amount of counselors. TIME reported that the average university has one mental health counselor for every 1,737 students. Large hopes to combat this issue on Miami’s campus by using a proactive stance towards helping others.
“We need to help students recognize their own reservoir and strength,” Large said. “We need to help students to find a way to tune in.”
He discussed the importance of looking at mental health from a holistic perspective and that sometimes, multiple factors can play a role.
“My best advice would be to strive for balance in all that you’re doing, practice self-care in ways meaningful to you, create realistic expectations and be kind to yourself,” Large said.
Mental health at Talawanda
At Talawanda High School, Health and Wellness Coordinator, Amy Macechko, reflects on the importance of new school social workers, who were hired in response to widespread student need.
“The Board has invested in a social worker at each elementary school and it’s been tremendous,” Macechko said. “We can identify child needs at those critical early stages.”
At the Feb. 25 Board of Education meeting, data was revealed showing that during the period of August 2018 through February 2019, school social workers had 1,771 contacts with students and families. Of these contacts, 55.4 percent pertained to mental health.
Macechko also said that the district used professional development days to learn more about student mental health. Faculty and staff have been trained to recognize when a student may be in distress or exhibiting concerning behavior. After this, their job is to make a referral or reach out to a professional.
“Every year I reiterate to the teachers to be a caring adult,” Macechko said. “Your job is to make sure anyone struggling sees a professional. We have very talented social workers, counselors and psychologists they can see.”