Nebraska was ranked forty-fourth overall in the 2023 Mental Health in America report, and twenty-ninth for access to care. But a change as of January 1 should improve access for Nebraskans eligible for Medicare.

Licensed Marriage and Family Therapists - LMFTs - and other Licensed Mental Health Counselors can now be approved for Medicare reimbursement for their services.

Anne Buettner, legislative chair for the Nebraska Association for Marriage and Family Therapy, said the state and national organization have lobbied for this change for many years.

Buettner said their title can be misleading - Licensed Marriage and Family Therapists do not just help people who are married and raising children.

"As a matter of fact, there are more conflicts in adult life among extended families than when the children are younger," said Buettner. "You can still use the systemic approach to how to use family therapy to resolve conflicts."

Buettner said as trained mental-health clinicians, LMFTs deal with depression, anxiety and other mood or thinking disorders.

She said they must work in collaboration with a physician or clinical psychologist, whereas an LIMFT - Licensed Independent Marriage and Family Therapist - can diagnose and treat without such a collaboration.

According to the Centers for Disease Control and Prevention, although depression is not a normal part of aging, older adults are at increased risk. And the risk is greater for people living with a disability.

Buettner said depression often accompanies the loss of independence people face related to aging and/or living with a disability.

"You need some assisted living, or skilled people to help you or maybe even talk about, not necessarily a nursing home, but just losing some independence," said Buettner, "then it's already a depressing subject. "

She added that not all depressed people seem sad or withdrawn. Some will appear irritable, fearful or suspicious.

Buettner said one fourth of Nebraska's 93 counties lack a single Licensed Mental Health Practitioner. Many practitioners, however, are willing and able to provide services remotely.

Buettner encouraged people expecting Medicare coverage for their mental-health care to confirm the practitioner has successfully completed the Medicare enrollment process.



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May is Family Wellness Month, and Minnesota households are encouraged to work on goals beyond the surface level of success.

One expert said family members can explore dimensions that go a long way in shaping wellbeing.

In a post-pandemic world, University of Minnesota Extension Department of Family, Health, and Wellbeing Educator Sharon Powell acknowledged that society isn't as laser focused on career or academic success in defining how well a person or family is doing.

Physical health should be near the top. But Powell added that with mental health a bigger priority these days, it's one way in which households can get a sense of whether or not loved ones are thriving.

She said a good frame of mind opens more doors.

"You feel happy and content and like you're contributing to your family's wellbeing," said Powell, "and to your community and even beyond."

Powell said if you notice sudden mood changes or a family member becomes withdrawn, it might be good to inquire about their emotional state, and whether it needs to be addressed.

On the topic of money, Powell said amassing wealth isn't the key, but financial stability is important. She said financial literacy guidance from nonprofits is a good place to start.

She said when families get ahead of the situation by setting spending goals aligned with their income, they have better sense of autonomy in this area.

"People feel better about their finances," said Powell, "when they feel that they have some choice in where their money's coming and going from."

Lastly, Powell said family members can't take daily communication for granted.

Saying hello to each other every day, or occasionally asking how things are going can help, but Powell said there's more you can do. That includes the often shared pieced of advice of being an active listener.

"Being an attentive and curious communicator," said Powell, "is a great way to show love for people."




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Mental health counselors focused on Nebraska's high rate of binge drinking during Alcohol Awareness Month, which just wrapped up.

Alcohol abuse is often associated with other addictions. Nebraska's binge drinking rate is among the highest in the nation and the number of alcohol-related deaths is on the rise. Alcohol was blamed for at least 720 fatalities in 2020, the latest year data were available.

Aileen Brady, CEO of the Community Alliance in Omaha, said alcohol abuse and addiction affects families and friendships but can also lead to safety issues among employees who may be alcohol dependent.

"If their reactions are not as sharp, if they're not sleeping well and if they're distracted with the sense of needing to have that drink, it's going to affect our workplaces, as well," Brady explained.

Brady adds alcohol and other substance abuse disorders affect at least 65% of Nebraskans seeking mental health treatment at Community Alliance. Nationwide, the National Survey on Drug Use and Health said more than 224-million people 12 and older report having consumed alcohol during their lifetime.

Brady added it is common among alcohol addicted people or those who abuse it to assume drinking will improve their mood, which she said can happen temporarily, but long-term, has the opposite effect.

"That might last for a period of hours, and then once they stop the drinking and they are coming down off of that use of alcohol, then the depressant sets in," Brady observed.

Brady added Community Alliance continues to dispel myths about the effects of alcohol and raise awareness about the negative physical and mental health outcomes of drinking too much.


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Budding flowers, warmer temperatures and longer days are welcome signs to many in Maryland after the long, dark months of winter. Some people might believe warmer weather improves mental health after seasonal depression in the winter months, but that's not always the case. Many people experience increased mental-health struggles as spring rolls around.

When people's feeling in the springtime doesn't meet their expectations, said Cynthia Cubbage, director of family and post-adopt service for the Barker Adoption Foundation, it can make mental-health issues worse.

"When people are looking forward to spring because it's a time of renewal, and those expectations don't happen, and then nothing gets better for them because it's deeper than that," she said, "then they get really stressed and depression can really set in. And it's because of the expectations."

Suicide rates rise in the spring and not winter, according to Johns Hopkins Medicine. Researchers find that seasonal allergies play a role. A person with rhinitis, which causes allergy symptoms, is more than 40% more likely to be depressed.

Cubbage said there are many ways people can combat those feelings: Get outdoors as much as possible and get out socially as well. But she reminded folks that sleep is vital.

"Definitely prioritize sleep, even though we're having more daylight," she said. "It makes people want to stay up longer - that they should be doing things - and to remember that's a big transition for your body. They should still prioritize their sleep. If they were still going to sleep at eight or they were putting their kids down at eight, that should continue."

Cubbage added that, if you continue to feel depressed or down even after trying those suggestions, it's best to seek out professional mental-health help.