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She added that not all depressed people seem sad or withdrawn.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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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.