RALEIGH, N.C. – While the Affordable Care Act hangs in limbo, one sector of the population stands to be significantly impacted. Over the last eight years, access to mental-health care for those who need it has increased, through the availability of policies and safeguards to ensure access to that care.

Jack Register with the National Alliance on Mental Illness - North Carolina, says reducing the accessibility for folks who need care would have a community-wide impact.

"We see folks unable to maintain their employment," he said. "They're unable to continue to go to school and the disconnect is that the cost to the community when we sort of ignore these ongoing issues is they end up in homeless shelters, they end up in jail."

Register says it can take as many as 10 years to establish a successful treatment plan for people in need of mental-health care, and a disruption of treatment can instigate behavior that would make it impossible for them to function in society.

Register says if the state and federal governments don't support regular mental-health care for those who need it, it ultimately will cost more down the line.

"We see that people don't ask for help at the stages in their life when they could be more preventive versus more crisis-oriented, and we end up in a very different conversation," he added.

In spite of the progress made in the availability of care, millions of people still live in areas with a shortage of mental-health care, particularly in rural and economically disadvantaged communities.


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New York's 2025 budget improves access to mental-health services.

Budget legislation stipulates commercial insurers have to pay rates similar to Medicaid for in- and-out-of-network behavioral health services.

While many New York adults can access care, younger people can't because of insurance coverage.

Matthew Shapiro - senior director of government affairs for the National Alliance on Mental Illness-New York State - said people are glad this broadens access to often limited mental health services.

"We hear from people all the time that they can't access care, they can't find a psychiatrist, they can't find a social worker, they can't find someone who'll prescribe medication," said Shapiro. "It can be very, very difficult, especially in parts of Upstate New York where these services just aren't readily available."

Some insurance companies pushed back, saying it would raise customers' rates. Shapiro noted that this will hopefully resolve long-standing issues in obtaining mental-health care.

A state Attorney General's office report finds 86% of the listed, in-network mental-health providers were either unreachable, not in-network, or not accepting new patients.

The budget allocates millions of dollars to other programs that establish new inpatient psychiatric beds statewide, and increase mental health support for first responders.

But, Shapiro noted that other insurance companies' barriers prevent New Yorkers from getting the best mental-health care they can.

"It's so important those people get the medications their doctor believes are best for them, and their individual set of symptoms as quickly as possible," said Shapiro. "So, eliminating things like fail-first procedures and what they call step-up procedures."

He added that these policies can significantly set back a person's recovery.

A 2024 survey finds 1 in 5 adults required to fail first had to visit the emergency room or be admitted to a hospital as a result of the policy.




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As Children's Mental Health Awareness Week kicks off in Arkansas, an expert said parents can help their children have a healthy brain to thrive.

Charles Fay, child psychologist and president of the Love and Logic Institute, said national data show roughly 42% of adolescents aged 12-17 in Arkansas, mirroring national trends, receive services for severe depression.

He argued a healthy brain is the foundation of good parenting and Arkansas parents could foster children's ability to become mentally strong, responsible and successful.

"Parents creating a home where kids are really expected to take good care of themselves and show them how to do it, with the eating, the diet, with sleep," Fay outlined. "We're seeing more young people getting hardly any sleep and one of the biggest reasons is they have their phones or other devices in their bedrooms."

For children struggling with depression, anxiety or adjusting to challenging situations, the state program ARKids provides mental health resources online.

Fay stressed it is important for parents to identify signs of mental health struggles in their children. One indicator he suggested is a child's lack of interest in activities they normally enjoy. He added it is important for parents to consistently be firm and caring with their children.

"Firm means healthy limits and accountability," Fay emphasized. "There's been a number of studies recently that show that when kids do not have consistent limits, when they are not held accountable, they are far more likely to suffer from anxiety, depression, and a whole host of other mental health disorders."

Fay noted the importance of guiding children to translate their natural talents into fulfilling careers. He believes the path leads to greater happiness. His book, "Raising Mentally Strong Kids," features a strategy combining brain science with practical tools to cultivate resilient minds in children.

Studies show suicide is a serious public health problem, claiming more than 48,000 lives each year in the nation.

A new initiative from the Zero Suicide Institute aims to change it and demonstrate how a diverse group of hospitals in South Carolina and elsewhere can improve their suicide prevention practices.

Allyson Sipes, director of clinical initiatives at G. Werber Bryan Psychiatric Hospital in Columbia, said the Institute worked with her staff to develop best practices.

"The Zero Suicide Institute brought in a group of individuals that we could learn from," Sipes recounted. "Then having an expert faculty with a change package that we used to set our facility and what to look at and address."

Sipes explained the program was developed by the Pew Charitable Trusts to test evidence-informed methods to detect suicide risk and connect patients to treatment.

Nearly 27% of U.S. hospitals do not practice recommended suicide prevention practices, including safety planning, warm handoffs to outpatient care, patient follow-up and lethal-means counseling.

Laurin Jozlin, senior project associate for the institute, said studies show half the people who die by suicide saw a health care professional in the month before their death but were never referred to a mental health professional.

"We know that there's an opportunity in health and behavioral health care systems to intervene," Jozlin acknowledged. "They are being seen by health and behavioral health care professionals but they're often not identified as someone who is at risk of suicide."

Sara Voelker, improvement adviser for the Education Development Center, said they take ideas proven successful elsewhere and develop them into best practices.

"We put it together into a change package," Voelker noted. "Then teams pulled out ideas that had worked in other places and then, essentially, figured out a way of, 'How do I adapt this to make it work in my organization?'"

If you are struggling with mental health, help is available by calling or texting 988, the Suicide and Crisis Lifeline.

Support for this reporting was provided by The Pew Charitable Trusts.


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