By Trista Bowser at Kent State University
Broadcast version by Mary Schuermann reporting for the Kent State-Ohio News Connection Collaboration.

When she sees clients who are struggling with depression, Vicki Montesano often tells them to walk outside for 10 minutes each day.

"That connection to a natural environment can enhance wellbeing," said Montesano, the bureau chief of mental health treatment with the Ohio Department of Mental Health and Addiction Services Office of Community Treatment Services. "If you look at different experiments, people who have been exposed to natural environments improved working memory, cognitive flexibility, and attention control."

May is Mental Health Awareness Month. To encourage more people to benefit from spending time in nature, the Ohio Departments of Natural Resources (ODNR) and the Mental Health and Addictions Services (OhioMHAS) have created the Thrive Outside campaign.

According to a Kaiser Family Foundation poll, 4 in 10 adults claimed they had symptoms of anxiety or depressive disorder during the pandemic. From January to June 2019, only 1 in 10 reported those symptoms.

"There were studies that had shown a decline in people's mental health because of more isolation, of course," said Staci Tessmer, the president-elect of the Ohio Counseling Association.

Just stepping outside for a few minutes allows us to soak up some Vitamin D from the sun which is known to repel symptoms of depression and improve our mood.

"There has been a lot of research on nature therapy and [it] doesn't necessarily have to be therapy-associated, but just being outside in general can boost our physical and mental health," said Tessmer, who has been a licensed professional clinical counselor supervisor for more than nine years.

Going on walks can help mental health tremendously, Tessmer said. When you do spend any time outside, make sure to be present and not focus on anything that can cause stress or distract from the peacefulness of what is going on around in the moment, she explained.

"Being outside is one thing, but being outside mindfully is really the key," Tessmer said.

Because of COVID-19, many have been utilizing the parks that Ohio offers. The number of visitors that go to these parks have been rising in recent years. Amy Bowman-Moore, president of the Ohio Parks and Recreation Association, has noticed this firsthand.

"In the last two years, the parks have seen their visitation grow and grow," Bowman-Moore said. "And I know there's statistics out there that let people know how being out in nature affects in a positive way, your physical and your mental state ..., if you haven't tried it, try it."

For more information and help, consider contacting one of the following for free, 24/7 help:

Ohio CareLine - 1.800.720.9616 to confidentially connect with trained counselors for support and Ohio Crisis Text Line - Text the keyword 4HOPE to 741 741 to connect with a trained counselor. Any additional help and/or details, please go to https://mha.ohio.gov/get-help/get-help-now.

This collaboration is produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.


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Health disparities in Texas are not only making some people sick, but affecting the state's economy.

A new study shows Texas is losing $7 billion a year because it does not adequately address quality-of-life issues and the health care needs of its lower-income residents.

The research was sponsored by the Episcopal Health Foundation, Methodist Healthcare Ministries of South Texas, and St. David's Foundation.

Brian Sasser, chief communications officer for the Episcopal Health Foundation, said health care includes more than doctors' visits and medication.

"Everything from increasing access to affordable health insurance to investing in under-resourced neighborhoods to give them more options, whether that's exercise options or food options," Sasser outlined. "Look at policy changes that expand health insurance coverage for new moms."

The report breaks down the economic costs of preventable health differences for every Texas county. It found Bexar, Dallas, Harris, Tarrant and Travis counties are losing the most money annually because of health disparities.

The amount of the economic impact depends on the racial and ethnic makeup of the county and the size of its working-age population. Sasser added the report shows Black and Hispanic children are more likely to grow up in neighborhoods with high poverty levels, and higher rates of diabetes and obesity.

"What can we do to work to make sure that the rate of diabetes isn't dramatically different between white households and Black households?" Sasser asked. "That we can make sure the food insecurity isn't dramatically different between someone who makes over $100,000 and someone who makes less than $30,000?"

The Texas Legislature has passed laws to address some of the disparities, including House Bill 12. It extends Medicaid health coverage for 12 months for new mothers, and pays for maternal health services for community health workers and doulas.

There is light at the end of the tunnel for Tennesseans struggling with opioid addiction, as a bill has been passed to increase access to treatment for opioid use disorder at Community Health Centers.

More than 3,800 lives were lost to overdose in the state in 2021, according to the Tennessee Department of Health.

Emily Waitt, policy and advocacy manager for the Tennessee Primary Care Association, said the original bill limited the number of patients nurse practitioners and physician assistants could treat with buprenorphine. The update removes the limitations, allowing more Tennesseans to access medication assisted treatment in their communities.

"It allows NPs and PAs to prescribe to 100 patients at a time, versus 50," Waitt explained. "Basically doubling the number of patients that they can prescribe to."

Community Health Centers serve more than 423,000 patients across Tennessee, regardless of their insurance status or ability to pay. About 7.7% of Tennesseans do not have health insurance.

Libby Thurman, CEO of the Tennessee Primary Care Association, said bringing the treatment to rural health centers expands access to a crucial service for patients who otherwise could not afford it. She noted it is important because people in remote areas often face challenges finding specialists and treatment facilities.

"We really wanted to work on this issue, because we know our Community Health Centers are where patients go for care," Thurman emphasized. "We really believe in an integrated model. So we want to treat the whole person, including if they are struggling with an addiction issue or a substance abuse disorder issue."

Health Centers offer behavioral health care, including counseling, along with treatment. The clinics also focus on creating a supportive network to help patients with family resources, job assistance and community connections.

While Black Maternal Health Week is wrapping up, health disparities for pregnant Black women continues to be an issue.

From April 11-17 this year, the high death rate of Black mothers is in the spotlight. Black women are three times more likely to die from pregnancy-related causes than their white counterparts.

Dr. Patricia Egwuatu, a family practice physician at Kaiser Permanente in Seattle, said racism is at the root of the disparities, which create barriers to health care access. She pointed out lack of access can lead to problems during pregnancy that are preventable or treatable.

"They may exist prior to pregnancy and then it gets worse during pregnancy if it's not managed as part of that maternity care," Egwuatu emphasized. "There are more pregnant women that have chronic conditions such as hypertension, diabetes and heart disease that are amplified during pregnancy."

The White House released a proclamation recognizing Black Maternal Health Week. The Biden administration began recognizing the week in 2021.

Egwuatu noted there are some warning signs any pregnant woman should be aware of and check in with their physician if they develop.

"You might get some changes in your vision that is not your normal. So, like, fuzziness, you can't see as well, or an excruciating headache," Egwuatu outlined. "You could also develop new swelling in your lower extremities that's making it difficult to get around or even new shortness of breath."

Egwuatu stressed physicians also need to recognize the role of racism in medicine. She argued continuous medical education is important for learning how to confront biases, and it is important for doctors to understand how they can provide people with resources.

"Asking the questions about personal barriers," Egwuatu suggested. "Does a patient have issues with getting to work, child care, transportation? What's their education, what's their cultural background and language? And do they even have a cell phone so we can connect with them?"