Gaps in mental health care are a common research topic right now and for Minnesota youth in rural areas, a new report showed their families face big obstacles in navigating the care system if their child displays symptoms.

In its analysis, the Center for Rural Policy and Development said long travel distances and a lack of information make it hard for parents in these settings to put a concrete plan together.

Marnie Werner, vice president of research and operations at the center, said other factors are at play.

"There's a desire for anonymity," Werner pointed out. "People don't necessarily want all their neighbors to know that their kids are seeing a therapist. And in rural areas, especially, there are just getting to be fewer and fewer people in the mental health field."

Because of a fragmented system, the authors say in a crisis, parents -- especially in rural areas -- often end up taking their child to the emergency room, which can create a host of other problems. As long-term solutions take shape, parents are encouraged to educate themselves about early warning signs and the basics of mental health. And if their child reaches a crisis point, the 988 Suicide and Crisis Lifeline is a resource to lean on.

Werner noted there is also an evolving approach to integrate mental health care with primary care.

"Having a therapist in the regular clinic," Werner explained. "Mental health has often been siloed off to the specialty clinic. And so, with behavioral health integration, the doctor can bring the therapist in to meet you and your child while you're there at your appointment."

The authors said it is not a perfect solution but school-linked mental health services are increasingly becoming more dynamic, which can make it easier to seek assessments and schedule treatment on campus.

Meanwhile, the American Heart Association is raising awareness about establishing healthy routines like physical activity, which help improve mental health while preventing such conditions as anxiety and depression.

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.

A bill headed to the Montana governor's desk would qualify post-traumatic stress disorder under workers' compensation for the state's first responders.

PTSD is a mental-health condition that someone may develop after a traumatic event. It can result in a range of symptoms from a negative mood and reactivity to flashbacks and difficulty sleeping. First responders report experiencing PTSD at about five times the rate of the general population, according to Relief Mental Health.

George Richards, who serves as president of both the Montana State Firefighters' Association and the Montana State Council of Professional Firefighters, said suicide is one of the top two leading causes of death among firefighters.

"Firefighters, police officers, paramedics, EMTs, experience - working on a gunshot victim or a fatality wreck or a kid death - major trauma-critical calls that really affect the brain," he said.

Richards said the bill had bipartisan support, although some opponents were concerned with the costs. The bill passed a House vote Friday, just before today's observance of Workers Memorial Day.

Until now, Montana was one of roughly a dozen states without a PTSD-related workers comp policy for first responders. Richards said treatment for PTSD will also help with worker retention.

"We want it recognized so they can get the treatment and return to work as a healthy individual with a clear mind," he said.

Treatment can take different forms, Richards noted, from peer-to-peer support to residential treatment programs.


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A new report finds that Maryland has made progress in providing school mental health services to its students but work still remains. The report by the national mental health advocacy organization, Inseparable, measures states based on 13 policy targets.

Maryland has improved its ratio of social workers to students. There is one social worker for every 620 students - a decline from more than 2,300 students in previous years. But the state has not implemented, or only partially implemented, five policies, such as expanding Medicaid coverage to include school-based mental health services.

Caitlin Hochul, vice president of public policy with Inseparable, said providing mental health services in schools has major impacts on students and parents alike.

"You're reducing the financial strain on parents," she explained. "You're reducing the need for reliable transportation. You don't need to be taking a lot of time off of school to go travel to an appointment, so it really helps give kids the resources and tools they need to get back in the classroom and learn."

Maryland also lacks mental health screenings of students, a tool that advocates say is critical to identify potential mental health issues.

The Maryland state legislature recently passed laws geared toward bolstering the behavioral health workforce. One law made school mental health professionals eligible for the state's loan repayment plan, and another created a state workforce development program for mental health professionals.

Sen. Malcolm Augustine, D-Prince George's County, said a focus of the state legislature has been working to bring - and keep - mental health professionals in the state.

"It's challenging right now for us to attract and retain these folks," he said. "It's a global issue, so we are trying to do our very best to create opportunities for them to have their loans repaid, opportunities for them to grow professionally, in the hopes that we'll be able to retain and grow our own."

Maryland lawmakers also passed laws requiring education and health agencies to provide guidelines for student telehealth appointments on school days.