Gaps In Local Mental Health Services Exist Despite Recent Additions

Gaps In Care Exist Despite Local Advances

Mental health services are increasing in Northwest Arkansas, but gaps remain, advocates say, and people in need of help fall into them.

The system worked for 8-year-old Hannah. Her mother said she constantly complained of stomach aches and thought it would pass, but the ailment began affecting her school work.

At A Glance (w/logo)

Mental Health First Aid

Ozark Guidance is hosting Mental Health First Aid in May as part of its Mental Health Awareness Month events.

The event is from 7:30 a.m. to 5:15 p.m. May 21 in Rooms 221, 226, 227 and 228 at The Jones Center, 922 E. Emma Ave., Springdale.

The class costs $50 and includes eight hours of training, Mental Health First Aid manual, certificate of completion, breakfast and box lunch and a T-shirt.

Four classes will be held concurrently: three for adults and one for adults who work with young people ages 12 to 18.

The class teaches signs and symptoms of common mental health disorders and risk factors and crisis situations associated with mental illness.

Register online at www.ozarkguidance.o….

Source: Staff Report

By The Numbers

Client Age

Below is the number of clients in different age groups Ozark Guidance served between April 1, 2013, and March 31.

• 5 and younger: 550

• 6-8: 1,183

• 9-11: 1,194

• 12-14: 1,094

• 15-17: 890

• 18-20: 379

• 21-30: 977

• 31-40: 996

• 41-50: 867

• 51-60: 740

• 61 and older: 287

Source: Ozark Guidance

Hannah's pediatrician found no physical cause for the pain. The doctor suggested the problem could be stress-related and referred the family to a child psychiatrist Mercy Health System of Northwest Arkansas hired last year. Therapy and a short-term medication regiment is helping Hannah.

The outlook isn't so certain for 25-year-old Craig, according to Washington County Sheriff Tim Helder. Craig has been in and out of the Washington County jail on misdemeanor charges over the years. In jail, he talks to people who aren't there, pounds his fists and head on the walls and spits and throws feces at jailers.

When he's not in jail, there's no system to ensure Craig is getting mental health services.

Ozark Guidance lists John among its success stories. He fought depression and anxiety his whole life and was able to function. His life started slipping when he went through a divorce in his late 40s. His family moved him to Northwest Arkansas. Ozark Guidance placed him in one of its residential facilities where he received a high level of support. He learned to manage his life and stabilize his manic episodes over nearly a decade of therapy, according to Ozark Guidance officials.

Today, John is a strong mental health advocate and helps with community meals and the homeless population.

Nearly a quarter of Americans suffer from mental health issues each year, but only 40 percent of those seek treatment, according to the National Alliance on Mental Illness. Severe mental disorders affect 20 percent of children ages 13-18, and 13 percent of children ages 8-15. Only half receive treatment, according to the alliance.

Local mental health advocates said Northwest Arkansas follows that national trend. They expect that gap to grow.

Ozark Guidance, a nonprofit mental health center that serves Benton, Carroll, Madison and Washington counties, saw 9,157 clients between April 1, 2013, and March 31.

The center provides outpatient services at the main campus in Springdale and satellite campuses in Bentonville, Berryville, Huntsville, Fayetteville, Rogers and Siloam Springs. Its Washington County school-based program had the most clients in the past 12 months, serving 2,273 students. The next largest program, with 2,075 clients, was its adult outpatient service.

"The demand for services just outnumbers available resources," said David Williams, mental health advocate and former chief executive officer of Ozark Guidance.

Nancy Ewing, crisis services program coordinator at Ozark Guidance, said it averages eight to 10 new clients each week.

Benton County recently ranked No. 1 in the state on the County Health Rankings, released by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. But the county fell well below the state average when it came to mental health providers. It has one provider for every 1,070 residents. The state average is one for every 715 people.

Washington County ranked second overall in the report and had one of the state's best mental health provider ratios at one for every 353 residents.

"We have a lot of services from prevention to long-term care, but throughout the continuum there are major gaps," Williams said. He pointed to mental health services in the criminal justice system and long-term acute residential offerings as areas of need.

Filling those gaps will require people to work together, Williams said. He was part of a group of mental health professionals who created the Northwest Arkansas Adult Acute Care Mental Health Plan in 2010. That report called for a system of coordinated behavioral health care.

One group pulling community members together is Judicial Equality for Mental Illness. The group formed in late 2012 and rotates monthly meetings between the Washington and Benton county jails. The coalition's goals include providing adequate medical treatment for inmates with mental illness, redirecting some individuals out of the judicial system and into the mental health system and ensuring timely evaluations for inmates.

About 150 people attended a panel discussion Wednesday on the issue of mental illness and jails.

Helder was on the panel and said the jail changed its intake questions following a study by the University of Arkansas in 2008 that found 25 percent of inmates reported having a mental condition.

"This is an issue we are honestly ill-equipped to deal with," he said.

The easiest path is to "kick the can down the road" and hope a mentally ill inmate will be caught in a net by someone else, he said.

Inmates needing a mental evaluation are sent to Little Rock and the wait for an open bed there can take weeks or months. Helder said he would like to see a forensic evaluation site with 40 to 50 beds open in Northwest Arkansas.

Williams said Northwest Arkansas is in a unique position to have such a system grow over time.

The problem is money. State Sen. Uvalde Lindsey told group members to create a short pitch to present to legislators clearly spelling out what the problem and solution are and to be able to sell it to everyone.

"It needs to be a statewide project, but you could get Northwest Arkansas to be a pilot program," he said. "If we build a plan, we can do it."

More progress has been made in the number of beds available locally for inpatient treatment.

"There is not on entity in Northwest Arkansas that is going to solve the whole mental health problem alone," said Dr. Steve Goss, president of Mercy Clinic Northwest Arkansas. "What we would at least like to do is be a catalyst for change and do our part."

Mercy opened an 18-bed Senior Behavioral Health Program in June 2013. The unit started off slow, but has been near capacity in the past two months, Goss said.

Mercy is developing an after-care program for patients released from the Behavioral Health Program. Goss said a licensed social worker will run the program based in its Lowell clinic.

The area is gaining another 59 beds dedicated to patients with Alzheimer's and other forms of dementia. Clarity Pointe officially opens Monday and will admit three patients, said Doug Oliver, the facility's executive director.

"We can partner with other care providers to help people find the right level of care," he said.

Vantage Point in Fayetteville, formerly Vista Health, also is adding eight beds to its geriatric psychiatric unit later this month.

Joy Figarsky, director of the Division of Behavioral Health Services at the Arkansas Department of Human Services, is developing a program for the state's Medicaid recipients that would create a program called Behavioral Health Home.

Behavioral Health Home isn't a physical location, but has one entity that oversees a patient's entire spectrum of care. The idea is to give patients care and treatment that addresses physical and mental health and outlines long-term services and support systems.

Figarsky said the current system is fragmented and patients often don't know how or where to get services. The system doesn't reward providers who work as a team to coordinate care for patients, she said.

Figarsky said she's revising the plan as she meets with providers, consumers and family members across the state. The plan has to be submitted to the Centers for Medicare & Medicaid Services and be passed by the Legislature before it can be implemented. She hopes to start implementing the plan early next year.

The bulk of the money for the program would come from Medicaid. Figarsky said there are also ways to access additional federal money. Medicaid only pays for inpatient psychiatric care for people ages 22 to 64 if they are in a general hospital setting.

Mercy's 18 Senior Behavioral Health beds and 28 mental health beds at Northwest Medical Center-Springdale qualify for Medicaid funding. The University of Arkansas for Medical Sciences Psychiatric Research Institute provides patient care at Northwest. The unit opened in 2005, and most patients stay between seven and 14 days.

"We need additional inpatient beds and services," said Dan McKay, Northwest Health System chief executive officer. "We also need more psychiatric physicians, and the funding to offset the cost of the services."

Vantage Point will have 100 licensed beds after expanding its geriatric unit. There are 16 adult beds and 62 beds for children and adolescents.

Springwoods Behavioral Health in Fayetteville has 80 licensed psychiatric beds.

Cynthia A. Curatalo said it's important for the community to learn about mental health needs. She became chief executive officer of Ozark Guidance earlier this year.

"Without knowledge there can not be understanding," she said.

Ozark Guidance is hosting a Mental Health First Aid Day on May 21 as part of its Mental Health Awareness events next month. Mental Health first aid is a national certification course designed to give community members a better understanding of mental illness and the recovery process.

"There is still a lot of stigma attached to mental health and a lot of access issues," Curatalo said. "Education is key."

NW News on 04/20/2014

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