CHARLESTON, W.Va. - Along with expanding Medicaid to the working poor, West Virginia will change billing rules to provide more behavioral health services though the program.

The Department of Health and Human Resources is preparing to accept Medicaid billing from independent, licensed, masters-level clinical social workers. The West Virginia Center on Budget and Policy studied the availability of these services, and health-policy analyst Erin Snyder said the change should help ease a problem.

"There's a limited number of psychiatrists and psychologists as it is, and most areas of the state are considered mental-health professional shortage areas," she said. "With Medicaid expansion, there's an additional 150,000 individuals who will need access to health care."

According to the DHHR, the details are still being worked out but the change should be in effect for the next fiscal year, which begins July 1, and should result in a very limited increase in costs for the program. Providers point out that behavioral health care saves money in the long run by reducing a lot of other costs.

Snyder said it should be a boost for the state's physical health and economy.

"Having effective behavioral-health treatment will increase productivity, decrease the burden on the criminal justice system and decrease health costs," she said. "It's a real benefit to the state."

Snyder said the billing rules had been a barrier to some people getting the care they need, adding that most neighboring states already have removed similar barriers. In many cases in West Virginia, Snyder said, independent providers have had to have a psychologist or psychiatrist review their treatment notes, which she calls an unnecessary step.

"In reality," she said, "when their supervisors review these notes, it's just cursory, in order to bill Medicaid."

Medicaid covers treatment for behavioral-health issues such as depression and substance abuse, both of which are serious problems in the state. By expanding Medicaid to cover families with incomes up to one-and-one-third of the federal poverty level, behavioral health professionals predict a lot more West Virginians should gain access to the help they need.


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If you find yourself in a less than festive mood this holiday season, you are not alone.

In Wisconsin, the recent school shooting tragedy in Madison can compound feelings of loneliness and grief already common this time of year.

Mary Kay Battaglia, executive director of the Wisconsin chapter of the National Alliance on Mental Illness, said seeing others celebrating can also contribute to feelings of stress.

"You see everyone around you -- the commercials -- it's festive, right?" Battaglia observed. "Everyone else is festive and sometimes, you're not feeling as festive as what social media or the commercials you're seeing are telling you, you should feel."

NAMI reported three in five Americans feel the holidays negatively affect their mental health. Battaglia encouraged people to create what she calls a "mental health toolkit" filled with key supportive contacts, things bringing them joy and an action plan to use during the holidays.

Adults are encouraged to pay special attention to the young people in their lives this time of year. State data indicate about one-third of young Wisconsinites reported feelings of sadness and hopelessness nearly every day. Battaglia believes it is another sign local communities need to focus more on how to help people reconnect in meaningful ways.

"We've had social media take us to a place that allows us to think we're connecting, but we're not really. We're not connecting with people," Battaglia pointed out. "I think it's really important that youth feel connected in some way that's real and honest, and in person."

For those who don't have friends or family close, Battaglia said the Uplift Wisconsin hotline is open 10 a.m. to 10 p.m. daily and anyone can call if they need someone to talk with. If you are experiencing a mental health crisis, you can call 988 to reach the National Suicide and Crisis Lifeline.

With Christmas less than a week away, experts are giving advice on how seniors and the community can fight against social isolation.

A United Health Foundation report ranked Maryland 27th in the nation for the risk of social isolation to its seniors. One study by AARP found more than 30% of seniors have felt lonely over the past five years during the holidays.

Lois Meszaros, licensed psychologist and executive council member of AARP Maryland, said there are common signs to warn family, friends or seniors themselves they may be experiencing isolation. One of those, she said, is shrinking social circles.

"They're complaining of their world shrinking," Meszaros observed. "They're no longer working, so they're not doing things with coworkers. Friends have moved away to warmer climates or to be closer to grandchildren."

Meszaros pointed out other signs of loneliness include a lack of interest in previously loved activities and unexplainable physical ailments. One example is a senior complaining of a sore arm or leg, despite doctors not being able to find anything wrong.

For anyone who might acutely feel the loneliness of the holidays, Meszaros noted there are ways to fight isolation. She suggested reaching out to family members and friends on the phone or going for walks in the neighborhood. Even if they don't feel like accepting an invitation, Meszaros advised they should go. Look for events at churches, senior centers and libraries.

Some older adults don't seek out help. For family members, friends or neighbors concerned about a senior in their life, Meszaros emphasized there are a number of ways to help them.

"Providing transportation, providing help with technology, I see these as things that are really needed," Meszaros observed.

She added it is helpful for older adults to have technology and learn how to use it, to keep feeling connected with others.

By Amy Felegy for Arts Midwest.
Broadcast version by Mike Moen for Minnesota News Connection reporting for the Arts Midwest-Public News Service Collaboration

Rocky Casillas Aguirre found himself swimming in panic attacks in 2020. He wasn't sleeping; he saw all kinds of therapists and a couple of sleep doctors.

Then, he found meditation.

What followed has transformed Casillas Aguirre's life and career.

"I took refuge in art and meditation and mindfulness practice, all of which I'm now doing full time," the Northfield, Minnesota-based artist says.

With a full eight hours of sleep checked off each night, Casillas Aguirre now spends his time creating-not what-if scenarios in his mind but comic books, short animations, and art with impact.

He's a self-taught graphic designer, comic book writer, and animator with a master's degree in biology. ROKATURAS is Casillas Aguirre's studio-slash-business.

Its personified stars are unlikely friends Twitch and Weenie (read: a relatable flame and a hot dog, with mystical powers of course). They're silly, sure, but they pack a practical punch.

"Twitch flame, he represents the little spark in all of us, like the inner child that lives in all of us who is curious and sees the world with awe and amazement," Casillas Aguirre says.

His children's book Where Did Anxiety Go addresses anxiety symptoms kids might feel. Inside are meditation exercises that ask readers to "breathe in and... breathe out." Characters reiterate "I am safe, there is no need to be scared" in tricky situations.

The themes manifest throughout ROKATURAS's online presence, which caters to a broader age range.

"What are you doing today after work?" an animated pink brain asks into a lime green telephone in a video about burnout Casillas Aguirre posted to his Instagram account.

"Laying down," Twitch responds gravely. "Laying down..."

Doing his P(art)

Casillas Aguirre is a Latino artist from Tijuana, Mexico, where he visits his grandparents often. He says Mexican cultural traditions like Day of the Dead inspire his artwork and ground his sense of self.

"I'm also an LGBTQ artist, or a transgender artist, so the exploration of identity and mental health are things that are really important to me and core to all of the work that I do and the messages that I try to deliver through my art."

Casillas Aguirre says he sees stigma around mental health in his Latino community. It prevents people of all ages from getting help. So he's doing his (p)art-which includes continuing his self-published comic book series. He's also looking to expand production of his video shorts with an animation team.

"In the process of creating art, I was de-stressing and healing myself while simultaneously creating art that is trying to create safe spaces for people to talk about mental health, especially parents with their kids."



Amy Felegy wrote this story for Arts Midwest.