CHARLESTON, W. Va. – Lack of behavioral health care for children may be undermining West Virginia's efforts to reduce truancy, cut juvenile incarceration and improve foster care, advocates say.
They pointed to surveys showing that a much higher than average portion of state high school students complained of mental health issues, such as depression or anxiety. And when those young people go untreated, they often end up in trouble, either with the schools or the justice system, said Kelli Caseman, co-founder and chair of Mental Health Matters West Virginia.
According to Caseman, the state is putting more effort into spotting young people in crisis.
"But once we identify that child who needs help, where do we send them?" Caseman asked. "Even in our metro areas like Charleston, kids are waiting up to two months to get into care.”
The number of young offenders behind bars has dropped sharply across the county. But West Virginia is one of the few states where the number has increased. During the legislative session, Caseman and others will be working with lawmakers trying to reduce it.
The Legislature has been looking at reforming West Virginia's juvenile justice system, reducing truancy, and improving foster care. Caseman said lawmakers are coming to see that investing in young people in crisis pays off in the long run.
"No, you're not going to really see a big financial change within the next two years,” she said. "But within maybe the next five or 10 years, you could be seeing a substantial change in the finance – and then, you're going to see a change in the kids."
Caseman said truancy often is the first sign of serious trouble. She said many young offenders can only get treatment while locked up, possibly after a wait of a year or more. Then when they get out, any treatment they had been receiving might just stop cold.
She described the care as so fragmented, it’s difficult to know where children are falling through the cracks.
"Currently, we don't even know where our major gaps are in care,” she said. "If we collectively don't know where those resources are, how can we go about helping kids?"
Caseman said one suggestion she plans to make to the Legislature is better data gathering and a global look at care across schools, communities and the justice system.
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Late last year, Missouri recorded its first significant drop in overdose deaths since 2015 - primarily due to increased access to naloxone, also called the Lazarus drug for its ability to revive a person who has overdosed.
A 2024 report from the Missouri Department of Health and Senior Services shows opioid-related deaths statewide fell from more than 700 to just over 500, a 30% decrease.
DawnElyn Schneider, chief network development and population health officer with Central Ozarks Medical Center, said it's important to carry naloxone for overdose emergencies.
However, she also attributed the decline in overdose deaths to increased community education on factors surrounding substance use.
"On the prevalence, on risk factors, on identifying concerning trends and behavior," said Schneider, "and if you're an individual who is struggling with substance use, or a family member who is struggling with substance use, how do you get help?"
More than 73% of the drug overdose deaths in Missouri in 2023 were opioid-related.
Since 2017, Missouri has had a standing order allowing anyone to get naloxone from pharmacies without a prescription.
That increased access enables more people, including drug users, to use it in emergencies.
Schneider said harm reduction strategies for those who use drugs include carrying naloxone, avoiding use alone, and using clean needles to prevent overdoses and infections.
"Abstinence is not always the only goal," said Schneider. "Sometimes, you have to get someone to a point where they have safer use before they're ready to stop using completely."
Nationwide, opioid deaths dropped from around 84,000 to about 81,000, while cocaine and methamphetamine-related deaths saw a slight increase.
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As the temperatures drop, some Georgians are feeling more than just the winter chill.
Nearly 40% of Americans experience the seasonal mood changes known as seasonal affective disorder. The condition can leave people feeling drained, unmotivated and stuck in a cycle of low energy.
Tami Brown, board vice president of the National Alliance on Mental Illness-Georgia, explained there are factors like where you live, family history and even gender, can increase the risk of developing symptoms.
"It affects more people than we think," Brown pointed out. "Folks that are displaying low energy or fatigue, even after having a full night's sleep, they might have issues with concentrating. Sleeping habits might start to fluctuate. They might start over sleeping, under sleeping. They might be eating too much or undereating."
Brown stressed if you are struggling, seeking help from a mental health professional can often prevent symptoms from worsening. She encouraged reaching out to a primary care doctor or calling the 988 Suicide and Crisis Lifeline for support.
Brown emphasized coping with seasonal affective disorder does not have to be overwhelming. She suggested simple but effective strategies like light therapy, physical activity, maintaining a routine and prioritizing social connections. She highlighted the power of community support, and added her organization offers programs and support at no cost.
"All of our trainings, groups, information, education, they are conducted by folks that have lived experience," Brown stressed. "These individuals have a behavioral health diagnosis that they are living with and working through, and they are helping the community."
Dr. Rhonda Randall, chief medical officer and executive vice president of UnitedHealthcare Employer and Individual, said you can also find support through your health insurance provider. Many now cover virtual care.
"Those telehealth benefits generally include telebehavioral health, which can start through your employee assistance program, or through virtual coaching and digital self-help tools," Randall outlined.
She underscored some insurance plans or workplace wellness programs may also offer extra resources to help with mental health and everyday challenges.
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The Alabama Senate has passed a bill which would give gun owners struggling with mental health challenges the option to voluntarily surrender their firearms.
Sen. Keith Kelley, R-Anniston, sponsored Senate Bill 40, named the "Houston/Hunter Act" in honor of Houston Lee Tumlin and Hunter Chase Whitley, two veterans who died by suicide.
Data from the U.S. Department of Veterans Affairs showed about 86% of veteran suicides in Alabama involve firearms. Kelley said the bill was inspired by their stories, with hopes similar tragedies can be prevented.
"Their mothers feel like that if this bill had been in place and they could have turned in those firearms voluntarily, that it would have likely saved their lives," Kelley explained.
The bill also protects gun dealers and law enforcement from lawsuits if a firearm is returned and later misused. However, if they violate laws while handling a returned firearm, they could still be held accountable. The bill now moves to the House for consideration.
Sen. Merika Coleman Evans, D-Birmingham, voiced her support for the measure on the Senate floor. She also urged fellow lawmakers to consider Senate Bill 170, which she said is an initiative with a more proactive approach to removing firearms from individuals who could harm themselves or someone else.
"My bill is not a 'voluntary,' but it is an opportunity for us to get those firearms away from people who have deemed to be a threat to themselves or others," Coleman Evans outlined.
Under her bill, law enforcement or a person's family members, along with teachers and school staff, would have the ability to petition for a Gun Violence Protective Order.
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