Next to gun control and security in schools, access to mental health services is among the biggest issues that has attracted the public’s attention following the Dec. 14 shootings in Newtown, Conn.
The question locally has become whether Elkhart County has enough options to satisfy the demand for mental health services. Candy Yoder, head of Children and Parent Services, said it’s a complicated issue, but in general, the answer is “no.” Yoder said the county has not had much of a problem pulling in dollars for prevention programs on account of the area’s high poverty and unemployment rates, but state funding for other mental health services has been cut drastically.
Oaklawn president Laurie Nafziger said more money would solve a few problems but not all. Nafziger pointed out that there are fewer mental health professionals in the area than there were several years ago, and some of the remaining providers have become more restrictive about the types of insurance they will accept.
“Psychiatrists very scarce, and that’s true also for therapists and master’s level social workers,” Nafziger said. “Generally, this field is not particularly well paid compared to some others, and people aren’t flocking to go to school for this, so it makes it hard to hire.”
Oaklawn grew in clients and staff in 2010 when the facility became the state-designated mental health center for Elkhart and St. Joseph counties. Oaklawn cared for roughly 14,500 clients in 2011 with a staff of about 590 people.
Gregory Hinkle, executive director at the Samaritan Center, said people wanting to meet with a psychiatrist in Elkhart County could be put on a waiting list that goes on for months. The Samaritan Center has six counselors on staff who work with individuals, couples and families.
Just because there are fewer providers does not mean the quality of services has weakened, said Mike Wruble, practice manager at Elkhart General Hospital’s Center for Behavioral Medicine.
“I can’t think of an agency that does not try really hard to do whatever they can to help as many people as they can,” he explained. “I think the help is out there, but accessing it can sometimes be frustratingly slow, but I guess I would want people to know that somewhere out there is treatment for them, and there is treatment that can fit what they can afford.”
Wruble said he does not want people to get discouraged from finding the help they need.
“I think if they just keep at it, they will find something that will help them,” he said. “It’s a frustration that we see in our office routinely, and so we try to fit all of the pieces for people because we really do believe that for some people, that call to us may be the one and only call they intend to make to get help, and that’s what we’re here for.”
FOR THE CHILDREN
All types of mental health programs have been impacted by state budget reductions, but services for children and adolescents seem to be hit the hardest, according to Yoder.
“Neuroscience research is showing us just how critical those very early years of a child’s life are,” she said. “The foundation of mental health begins in childhood.”
Yoder said CAPS has had more demand for its Healthy Families program in recent years. CAPS has about 25 home visitors on staff who work with close to 500 Elkhart County families, she said. The home visitors start with weekly sessions when a baby is born and tapers off over three years as the family becomes stronger and more self-sufficient.
“A lot of the smaller agencies that do a lot of work with kids and teens are reporting that they are struggling with the cuts, but they are doing everything they can to keep these programs going, but the reality that they’re facing is that it’s getting harder and harder to do it on less and less money,” Wruble said.
Oaklawn was forced to shut down its in-patient program for children and teens in 2007 after state funding was cut, though the facility still offers long-term programs for young clients. Since then, Oaklawn has been referring children and adolescents who need immediate attention to other services in the area, including the Epworth Center at Memorial Hospital in South Bend.
A COMMUNITY CONVERSATION
Yoder said there seems to be generally more awareness about mental health issues than there was just a few years ago, but a looming stigma about seeking help remains for some.
“To us as a society, as a Western culture, for some reason it’s a sign of weakness,” Yoder said. “I don’t know how we change that except bit by bit, step by step. I think the more educated we become about how trauma and other circumstances affect us, maybe we’ll get a better understanding of how support and mental health counseling should be a normal part of what we do.”
Mental health should be part of a community conversation, Yoder said.
“We as a community, as neighbors, as fellow church attenders, as people that go to the same gym together, we can all be supportive of each other, and that’s part of strong mental health in a community,” she explained. “There is a role for all of us to play.”
The Elkhart County Health Department will be sponsoring Mental Health First Aid training sessions in February and April to teach people how to identify others who may be in crisis and how to help them find the services they need.
“The sooner you help somebody with a physical injury, the less likely that injury is going to get worse,” said county health promotion specialist Jim Starkey. “It’s the same thing with mental health services. If we can find people earlier in their mental health issue or crisis, the sooner they can get help and the less devastating it tends to be.”