Finding the help we need: the state of mental health care in rural communities
The Methow Valley is located in one of the most rural counties in Washington State. Most of us revere the beautiful peaks and fertile valleys of our mountain home, but many of our neighbors struggle precisely because of our isolated location. When faced with depression, anxiety, bipolar disorder, or other mental health issues, the resources they need are just not available.
In Rural Health People (2010), state offices of rural health identified “access to mental health care and concerns for suicide, stress, depression, and anxiety disorders…as major rural health concerns.” Suicide rates in rural counties are as much as 54 percent higher than in their urban counterparts. The presence of more than one mental disorder—depression, bipolar disorder, anxiety, and others—especially left untreated, is a major risk factor for suicide. Inadequate access to mental health services in rural areas leaves many without proper care.
What do mental health services in Okanogan County look like?
Three-quarters of rural counties do not have access to a psychiatrist—a mental health doctor who can prescribe medication. Okanogan County has one psychiatrist specializing in geriatric psychiatry, located an hour away from the Methow in Omak. As in most rural counties, there is no child psychiatrist in Okanogan.
In addition, free or low-cost mental health care is alarmingly limited in rural areas. While Room One, with the help of valuable partnerships, is able to provide free-of-charge mental health counseling twice monthly, we can only accept adult clients who have no insurance.
Unfortunately, many clients in need of these services may fall into a growing group of people who are underinsured. They have insurance, but it does not adequately cover mental health care. Funding cuts have caused Okanogan Behavioral Healthcare, our county’s primary mental health care provider for low-income residents, to reduce services and limit free or sliding scale payment opportunities. Medicaid (federal health insurance for adults living far below the poverty line and low-income children) reimburses mental health care providers at a fraction of the true costs for services; as a result, many providers cannot accept Medicaid insurance.
What does this mean for the Methow Valley?
At Room One we partner with our clients to mitigate the consequences of limited mental health services. Burdened with a debilitating mental health issue, a person’s well-being, relationships, employment, and ability to contribute to the greater community suffer. Inadequate mental health care is an intractable problem across rural counties; the Methow Valley is no exception.
What can we do as a community?
Room One has initiated quarterly meetings of local mental health providers to strategize ways to address the pressing mental health needs in our community. Together we are assessing virtual technologies to support those affected by substance abuse, improving communication to reach those most at-risk in our community, and developing support groups to touch as many as possible. Many of these providers accept Medicaid, despite the low reimbursement rate. These collaborative efforts have helped Room One start to fill a critical gap in mental health resources to low-income residents.
Fortunately, most mental health disorders are treatable. Through the support of friends, family, counseling, and medical services, most people can find relief from debilitating disorders.
As we pursue critical policy-level changes we can get a start in our own community. We can help to de-stigmatize mental health disorders and treatments by accepting our own struggles and those of our friends and families. We can support each other in finding the help we need.
To read more about rural mental health issues, check the High Country News, a literary journal of the West. Ray Ring’s article about his brother provides a compelling account of how limited rural mental health care can affect each and every one of us. Read it at: http://www.hcn.org/issues/367/17608