A 2024 study showed almost 26% of Nebraskans reported having a mental-health illness in the past year -- nearly 3% higher than the national average.
Providers and stakeholders of Nebraska's behavioral health care system face uncertainty as more budget cuts loom. In the last legislative session, $15 million was cut from the state's behavioral health services budget and the heads of state government divisions are now being asked to find more cuts.
Tiffany Gressley, regional administrator for Region 3 Behavioral Health Services, questioned how cuts to behavioral health align with Nebraska's conservative values.
"We're being fiscally conservative by serving these people early; as early as we can," Gressley pointed out. "We're saving money and we're saving, on top of that, the human cost that goes along with untreated mental health conditions. "
Gressley explained last year's cut brought the total budget reductions to Nebraska's behavioral health system to nearly $50 million over the past six years, much of it from unfunded provider rate increases. She stressed budget cuts mean fewer Nebraskans receive services.
Among Nebraska counties, 88 of 93 had a shortage of behavioral health providers in 2023, and 29 had none at all. Many rural Nebraskans face considerable challenges accessing behavioral health care, which advocates said further budget cuts will only exacerbate.
Sadie Thompson, chief innovation officer for the Lincoln-based Wellbeing Initiative, an organization providing services for mental health, substance use and chronic physical health conditions, said after a nearly 12% cut to its budget this fiscal year, the organization had to close satellite locations in Fairbury and Geneva and was unable to open one planned for Seward.
"All of these rural communities that we were really starting to see lots of engagement with and impact basically got the rug pulled out and weren't able to continue to have these services," Thompson noted. "These communities don't have services anyway."
Bob Shueey, CEO of South Central Behavioral Services in Hastings and Kearney, said they are constantly looking for qualified therapists and frequently have to turn patients away as a result. Shueey added the state's low provider rate combined with retirements has depleted the state's behavioral health workforce. He argued without attention, the situation will only worsen.
"Even if we raise the rates to a sustainable rate today, it's a multiyear pipeline before someone's even able to start working," Shueey emphasized. "Then that information has to be out there to new students and to young people. 'I'll be able to make my house payment and pay my student loans if I do this; I'm not going to be poor my whole life.'"
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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.
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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.
Disclosure: Inseparable contributes to our fund for reporting on Criminal Justice, Health Issues, Mental Health, Social Justice. If you would like to help support news in the public interest,
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