Officials and state lawmakers heard of a mental health system that is not working, lacks resources and sets people up for failure, according to providers.
Last Thursday Dr. Elizabeth Williams, a clinical psychologist with Hendersonville Pediatrics, was one of many behavioral health professionals and concerned community members who addressed N.C. Department of Health and Human Services Secretary Kody Kinsley, N.C. State Senators Jim Burgin (R) and Kevin Corbin (R) and Transylvania County Health Director Elaine Russell.
Williams was taking part in a town hall meeting at Brevard College focused on mental health and which allowed the public to provide critical feedback to government officials.
The mental health system is “very piecemeal,” said Williams. “We’re individual people trying to put it together however we can.”
“We miss having a strong community mental health center,” said Williams, who serves children and youth. “We miss the days of having a place where we knew where to go.”
Williams accepts Medicaid, the health coverage program jointly funded by state and federal government for eligible low-income adults, children, pregnant women, elderly adults and people with disabilities.
“Those of us who continue to take Medicaid are just inundated and the wait lists are just unmanageable,” she said.
The rates are not competitive when compared to privately insured individuals, and Williams described her experience as “really punishing” and not “provider-friendly.”
“We are not the enemy,” she said. “Partner with providers.”
This was the 10th town hall meeting organized so far across the state over the past couple of months to better understand what North Carolinians need to improve their community’s mental health and resiliency across the state.
“Our system isn’t working,” said a 26-year-old social work case manager from Buncombe County, through tears. “It’s causing harm to the people it should protect.”
“We set our people up for failure,” she explained. “The barriers, the inequity and the red tape try to disguise themselves as reform but the results speak for themselves.”
“I’m trying so hard to get them resources and I am just spinning my wheels day after day after day,” she said. “The few resources that we do have are clogged.”
Kinsley, Burgin and Corbin discussed the $1 billion investment in North Carolina’s behavioral health system they support over the next few years.
“In my eight-county district right now there’s an 11-year-old boy that’s in the hospital and he is in the emergency room — he killed their family pet and he also tried to kill his mom and dad,” said Corbin, who represents District 50, which includes Transylvania County.
“He has been in that hospital’s emergency room for 50-some days and that’s unacceptable,” he said. “If you had a heart problem or you had cancer, and your doctor said to you, ‘Well, I’m sorry ma’am or sir but we just don’t have room to treat you,’ we would be outraged, would we not?”
Mental health has been “such a stigma,” said Corbin. “This is a view from 30,000 feet — we’ve all been guilty as a society of not recognizing mental health as an illness just like cancer or diabetes or heart disease.”
Corbin and Burgin are both chairs on the N.C. Senate Health Care Committee.
“I saw a long time ago that we have mental health issues in the state and the only way to get ahead of an issue is to go back as early as you can and try to fix it,” said Burgin, who represents District 12. “We’ve really dedicated a lot of time and effort into trying to identify and treat children and young people.”
“The statistics on our children are horrendous right now, especially young women 16 and under,” he said. “We’re seeing a big rise in suicides and attempted suicides.”
Kinsey said the state is working on addressing the issues.
“There is no health without behavioral health; it is essential,” he said. “We have had too many people with behavioral health needs, and let me just be clear: poverty and serious mental illness are often co-occurring. The baseline of giving people access to safe housing, transportation, employment support so they can be employed, and healthy food is transformational for health — plain and simple. We are trying to invest our resources … A big part of our strategy is how do we buy health, not just buy health care.”
Russell said for many years Transylvania Public Health has “seen in our community health assessments that mental health needs and behavioral health needs were a growing concern.”
Transylvania County “values the upstream work of prevention,” she said, citing the Get Set and TC Strong programs.
“We want to work with our families, our communities, our children, our youth, our teens to give them the coping tools and mechanisms to improve and respond to their own health crisis in conjunction with the adults in their lives,” she said.
Russell is working to find money to support peer-to-peer training so youth can support other youth with evidence-based practice and guidance.
“To give them the skills to help each other because they will frequently turn to one another before they will turn to others,” said Russell.
Church and nonprofit organization leaders, concerned parents and individuals brought up other concerns.
Lack of local pharmacists and doctors, the need for funding boys and girls clubs, focusing on health education and healthy food options in surrounding food deserts, and unproportionally high substance use disorders and mental health issues among incarcerated individuals were discussed.
Dr. Don Buckner, a child psychiatrist who works for Meridian/Blue Ridge Health and grew up in the area, said there are a lot of barriers and antiquated systems that prevent health care professionals from being innovative.
“Let us do preventative services,” he said. “Don’t make us wait until somebody has a diagnosis to justify treatment. We have got to take responsibility for keeping children safe in our communities. It’s going to take more than the system to fix this; it’s going to have to come from the community.”
According to the NCDHHS website, the $1 billion proposed state funding will be broken down as follows:
•Raising Medicaid reimbursement rates for behavioral health services ($225 million)
•Improving access to routine, integrated care in communities and schools ($175 million)
•Addressing the intersection of the behavioral health and justice systems ($150 million)
•Building a strong statewide behavioral health crisis system ($200 million)
•Transforming child welfare and family well-being ($100 million)
•Creating sustainable hospitalization and step-down options ($100 million)
•Enabling better health access and outcomes with data and technology ($50 million).
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