According to information published by Mental Health America in its annual “State of Mental Health in America” report, Kentucky ranks 16th in the nation for access to mental health care.
The report included rankings and findings across multiple mental health domains from all 50 states and the District of Columbia.
This ranking is the highest among southern states, far surpassing regional neighbors Kentucky. The second best in the South is Oklahoma at No. 28, followed by No. 35 Louisiana, No. 37 Virginia, No. 38 North Carolina, No. 40 Arkansas, No. 43 South Carolina, No. 45 Tennessee , #47 Mississippi, #48 Georgia, #49 Florida, #50 Alabama, and #51 Texas.
The ranking includes information such as the percentage of adults with mental illness who have not received treatment, those who report unmet need, those who are uninsured and those with cognitive impairment who do not couldn’t see a doctor because of the costs.
Gretchen Roof is vice president of clinical services at Four Rivers Behavioral Health in Paducah. She said some of the common barriers to mental health care are barriers found in other aspects of daily life.
“One of the barriers I’ve found for people is just the basic barriers,” she said. “Not everyone has a car, so transportation to and from an appointment is a real challenge. Some people have one or two jobs, so they don’t have 9-to-5 schedules. Everyone Not everyone is lucky enough to have a job where they can just say, “I’m going to take two hours off and go on a date.
“One of the things I’ve seen evolve over the years — and I started working here in 2000 and worked in a private psychiatric hospital before that — is the whole idea of having many doors, many paths to care, to make it as easy as possible to get treatment.
Roof said people coming to FRBH can be a walk-in emergency, where they can see a professional as an emergency appointment without having been a client first.
“One of the other good things is if you call and have made an appointment, when we talk to you on the phone, we sort that out from our perspective,” she said. “Do we need to say, ‘Come in today’ or can we just arrange a date that fits your schedule?”
Roof said the stigma surrounding mental health issues seems to be diminishing among the general public, helping to break down this barrier to mental health access.
“It takes a lot of courage for someone to say, ‘I think I’m depressed’ or ‘I think I’m hallucinating,'” she said. “Imagine saying that to your friends or family. It’s even more difficult to walk through the door of a mental health centre.
“…I think (the stigma) is quite reduced now. You have so many celebrities coming out and saying, “I have body dysmorphia issues” or “I have depression” or “I’m a suicide survivor” or “I’ve struggled with addiction all my life.” . So I think when you see people you look up to in the audience and they recognize something, it takes away the shame. I think it’s fantastic that people do that.
Roof said people are now better informed about the symptoms of mental health issues, which helps them determine whether they should see a mental health professional.
“They know what depression probably feels like,” she said. “If you hear or see things, or respond to stimuli that others don’t feel, you know there’s a problem.
“Getting help, I think, sometimes is about a family member or a friend. What I’m saying is: don’t necessarily look for a specific symptom, but look for a change in someone. Someone who is generally calm being more euphoric could be onset of mania or bipolar. Someone, who is generally active, more reclusive and doesn’t go out much, looks sad and doesn’t care how they look – we all see them and know these are signs of a mental health problem, but saying to that person, “It sounds like you’re having trouble. Do you want to talk about it? and not just ‘If you’re having a problem, let me know’ – really communicating ‘I’m I agree with this conversation; I want to help you.’ ”
Four Rivers Behavioral Health has a crisis line that connects people to mental health professionals who can recommend resources to deal with a person’s mental health issues. This toll-free number is 1-800-592-3980.
Roof also referred to the current suicide prevention lifeline, which is 1-800-273-TALK (-8255).
“The best thing coming out – I think it’s July 16 – is a number called 9-8-8,” she said. “You don’t have to know 1-800-LIFELINE or any of those phone numbers anymore. All you have to do is dial 9-8-8, much like we dial 9-1-1 for the police, and it will take you directly to Lifeline or a crisis line.
“It’s fantastic. We’ve been in the planning stages at the state level for probably six months to a year. We’re really anticipating that our call volume – which ranges from about 350 a month – will grow to about 450 This will be around our standard.
Eric Friedlander, Cabinet Secretary for Health and Family Services, said expanding Medicaid was one of the best ways to open up access to mental health care.
“In 2013, there were about 800,000 people who received their health care coverage through Medicaid,” he said. “Today, it’s doubled; it’s about 1.6 million. We have a relatively low uninsured rate for a state of our size and location. I think it’s a big problem (for access to mental health care).
According to that same Mental Health America report, Kentucky ranks second in the nation for uninsured people receiving mental health care, with only 4.2 percent of adults with mental illness who are uninsured. The national average is 11.1%.
“I think that’s what determined our overall ranking (for access to mental health care),” Friedlander said. “If you look at things like people with depression and mental health issues, Kentucky, unfortunately, ranks pretty high there as well. We have a lot of people with behavioral health issues.
“Like recently in western Kentucky, after tornadoes and thunderstorms, it causes anxiety. We’ve seen it too many times.
Friedlander said Medicaid is probably the biggest payer of behavioral health care in Kentucky.
“If it weren’t for Medicaid, we wouldn’t even be close to the mental health system we have now,” he said. “We have a long way to go, but it makes access so much better.”
Friedlander said another factor in having better access to mental health care was the openness of TeleHealth, which allows people to access a mental health care provider by phone, tablet or computer from home. He said it really helped provide access to the heart of the COVID-19 pandemic.
“Often, transportation is a giant problem in Kentucky,” Friedlander said. “Being able to open TeleHealth in the way that we have really helped ourselves and a lot of people access it.
“Also, during the pandemic, we opened up an easier path to getting Medicaid for a little while. This was called presumed admissibility. About 100,000 people signed up. We have reduced it now, but it was important during the pandemic.
Friedlander agreed with Roof that the stigma surrounding mental health care is diminishing.
“There’s no stigma with ‘I have a bad heart’ or there’s no stigma with ‘I need a knee replacement’ – a physical illness,” he said. he declares. “That’s really how we should think about behavioral health. We still have a long way to go, and part of that is that stigma.
“There are more tools available now. We’ve learned a lot on the pitch over the past 20 years, and we’ve made a lot of progress. If you felt physically ill, you would not hesitate to seek medical attention, so if there is a mental health issue, we should not hesitate to consult a mental health professional. It’s the same thing.”
For more information about Four Rivers Behavioral Health in Paducah, visit 4rbh.org or call 270-442-1771 or 1-866-442-1771.
Information about Mental Health America can be found at mhanational.org. Rankings can be found on this site by clicking on the “State of Mental Health in America” link at the top left of the homepage.