CHARLESTON, W.Va. - West Virginia has the second-fastest-growing prison population in the country, largely because of substance abuse and untreated mental health problems. But, according to some doctors and social workers, the state could get a better handle on those problems by screening and treating people when they get primary care.
Mary Aldred-Crouch, a licensed counselor and a program director with the state Bureau for Behavioral Health, says the trend is for clinics to invest in putting mental health providers on staff, to catch those problems early.
"Jail and prison overcrowding comes from untreated mental health and substance abuse problems. Is it going to add costs to the front end? Yes. Will it save the system money in the long run? Yes."
Aldred-Crouch says that by screening for depression, anxiety and substance abuse, the therapists can catch the problems when they are easier to treat. She spoke about the issue during last week's annual conference of the West Virginia chapter of the National Association of Social Workers.
Adding behavioral health to the treatment at a patient's medical home takes an up-front investment, but Aldred-Crouch says that pays off over and over again in the long run.
"Why would we not routinely screen for that, like we screen for cholesterol problems, and diabetes and breast cancer? It's part of health care."
According to Dr. Dan Doyle with New River Health Associates in Fayette County, counseling can make pain treatment more effective and less likely to lead to permanent disability. Doyle says doctors have to consider more than just the patient's physical ailment.
"Are they receiving mental health care? Are they receiving physical therapy? Do they have a plan for what they're doing with their life? Or are they waiting for the next pill to make them better?"
Studies have repeatedly shown that a huge portion of the problems doctors see are caused by or made worse by substance abuse or mental health issues.
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Residents in the Texas Panhandle are starting to put their lives back together after surviving the largest wildfire in the state's history.
The fires burned for three weeks, destroying homes, barns and livestock. The State of Texas Agriculture Relief Fund is accepting donations for survivors.
Sid Miller, Texas agriculture commissioner, said it is not always enough to help with the physical needs of farmers and ranchers. For mental health concerns, there's the AgriStress Helpline.
"These people have lost everything," Miller pointed out. "We've lost over 500 homes and barns up there. A lot of those ranches have been there over 100 years. They've lost their cattle, their fences, their livelihood, so it's a very stressful time."
Miller noted the Helpline is answered 24 hours a day by professionals who've received more than 300 hours of training. It is part of the University of Texas at Tyler Health Science Center. The Helpline number is 833-897-2474.
Miller explained the mental health of people in the ag industry can be affected by geographic isolation, weather conditions and the fluctuating prices of commodities. He added the helpline professionals are trained to deal with issues related specifically to rural communities.
"We answer that phone within 30 seconds, and we'll call you back the next day, and the next day and the next day," Miller emphasized. "As long as you want us to keep checking on you, until you tell us to not check on you, we're going to keep checking on you."
Farmers and ranchers from across the country have taken feed, hay and fencing materials to the Panhandle to help people rebuild. The fires scorched more than 1 million acres and killed three people, and Miller acknowledged it will be at least two years before the full effects are calculated.
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More parents in Kentucky are switching jobs, delaying major purchases, cutting back on essential needs, and going into debt in order to afford child care, according to a new survey from the Kentucky Center on Economic Policy. Parents, especially mothers, in the Commonwealth say the financial stress and uncertainty around of child care is impacting their mental health.
Keshia, a parent in Knox County, said she struggled with postpartum depression, and notes having access to child care, even just a few days a week, allows her time to focus on her well-being.
"I put him in day care twice a day, twice a week. So that gives me time to focus on my work and to focus on my mental health and to be a better mother for him," she explained.
According to a recent survey of more than 1,300 parents in the Commonwealth, they continue to face anxiety and stress over what might happen if they lose care. More than 70% said they won't be able to find alternative care arrangements, or may have to use less safe care for their children. More than half said that if they lost their child care, they would be forced to leave their job to stay home with their kids, or wouldn't be able to provide for their family.
Lisa Leonard is a grandparent in Daviess County who gained custody of her now 17-year-old grandson when he was a toddler. She saidher grandson qualified for a Head Start program, which allowed her to keep working full-time, adding that many kinship caregivers face financial pressures that can contribute to chronic stress and anxiety.
"If it hadn't been for the availability of Head Start, I truly don't know what I could have done. I lived so far out in the county, and didn't know anybody around me," she said.
Most Kentucky parents shell out hundreds of dollars per week for child care, even with assistance, according to the Kentucky Center for Economic Policy. The state faces a $330 million loss in money for child-care centers when American Rescue Plan Act funding expires this year.
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March is National Criminal Justice Month and advocacy groups are drawing attention to how people with mental illness are overrepresented in jails and prisons.
According to the Prison Policy Initiative, 43% of people in state prisons and 44% of people in local jails have been diagnosed with a mental health disorder. However, placing them behind bars may not be the best solution.
John Mitchell, mental health court judge in Kootenai County, said about half of the people in his caseload have some sort of mental health diagnosis, but noted jail does little to change their behavior.
"Unless you can figure out a way to help those people address their mental health concerns, ideally at the same time they get their chemical dependency treatment, they're just going to keep coming back," Mitchell observed.
Mitchell acknowledged jail can be necessary for a person's safety or the public's safety but it has not often been the case in his 22 years heading the mental health court. He meets with people in the court typically over two years, on a weekly basis to begin with, and said he plays the role of cheerleader and coach.
John Hall, group facilitator for NAMI Idaho, has been incarcerated and said he was living with undiagnosed and untreated mental health issues. He argued diversion programs like Mitchell's are a better alternative to sentencing and added it is important to educate people before they become incarcerated.
"They have an opportunity beforehand to change the course and direction of their life through the management of their diagnosis," Hall emphasized. "Or maybe their life choices or maybe the environment that they have been in for some time."
Hall also noted peer mentor programs within Idaho's jails and prisons are showing promising results for people who are incarcerated.
Mitchell stressed it is powerful to watch the people he works with change.
"To see somebody with those things stacked against them deal with all their issues all at once and succeed, it's one of the coolest things you can do as a judge," Mitchell observed.
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