‘broken’: mental health availability, funding ‘not enough’

LIBERTY, Texas (KTRK) — At least a few times a week, a patient arrives at Liberty Dayton Regional Medical Center suffering from a mental health crisis.

But the 25-bed hospital about 50 miles northeast of Houston isn’t designed to provide long-term mental health care to patients, so nurses and doctors are starting to look for providers.

A few hours pass and then a day.

Kristine Gerlich, chief nursing officer at the Medical Center in Liberty, said it usually takes at least 24 hours and sometimes up to 72 hours before they can connect a patient to mental health services.

However, once the patient has stabilized, they often come back to the hospital for another mental health crisis, according to Gerlich.

“The mental health system is broken,” she said. “In rural districts, the supply is not available. Something is missing. You don’t have enough providers per population. They end up going to the ER for mental health help.”

Texas Gov. Greg Abbott has not addressed access to guns after Tuesday’s mass shooting that killed 19 children and two teachers at Robb Elementary School. Instead, he said community leaders and MPs in Uvalde had told him that mental health was their focus.

“(They said, ‘We have a mental health issue in this community,’ and then they elaborated on the magnitude of the mental health challenges they face in the community and the need for greater support to the mental health region,” said Abbott.

But the shooting, like the one before it, has sparked a nationwide debate over access to guns.

13 Research found that 3.8 million people live in Texas counties with more access to guns than to mental health services. According to an analysis of federal data by ABC Owned Television Stations, there are more gun dealers than mental health providers in at least 1,500 counties across the United States.

ALSO SEE: More gun dealers than psychotherapists in Uvalde

In Texas, 173 of the state’s 254 counties have more gun dealers than mental health providers, including Uvalde County.

“It is very sad that it takes this tragedy, this terrible evil, to bring this to the fore in the public eye, but I have to say there are a lot of people working behind the scenes to try to improve it,” said Larry MacNeil, Community and partnership association at Liberty Dayton Regional Medical Center said. “It just feels like it’s one of those guys that takes one step forward and two steps back when it comes to making this system work.”

INTERACTIVE: Search the map below to see how many providers are in your county. Red indicates that there are more gun dealers than mental health providers in that county. On mobile? Click here for a full screen experience.

There are nearly four times as many gun dealers in Liberty County as there are mental health providers.

Hope Brown of New Home New Liberty Counseling said the lack of providers is making it harder for residents to get mental health treatment.

“To attend an in-person therapy session, one often has to leave Liberty County for a 30 to 45 minute drive each way. This means that someone has to devote about three hours of their day to an appointment. Not many can set aside a lot of time to do the work on a regular basis,” Brown said. “While telemedicine options are increasing, many in rural areas still prefer face-to-face contact, or they may have trouble accessing online options.”

She said Medicare also only pays for patients to see a licensed social worker or psychologist, not a licensed counselor, making it even more difficult to seek help.

“While there are very few licensed counselors in Liberty County, I don’t know of any licensed psychologists,” she said. “As a licensed professional counselor, I’ve had to turn away many seniors because their insurance doesn’t allow them to see me and they can’t afford to pay out of pocket.”

To become a licensed professional counselor in Texas, an individual must complete a minimum of 1,500 hours of supervised direct counseling practice, a minimum of 3,000 hours of supervised practice, completion of a Texas state law exam, and filing of paperwork and an application fee on the Texas State Board of Examiners of Professional Counselors.

Obtaining a license to sell firearms requires only an interview, a background check, and a $200 fee.

This week, when the legislature reconvenes, Texas Speaker of the House Dade Phelan said lawmakers will have a “very robust discussion about mental health, as we always have, and will continue to support mental health in this state and in particular.” support rural mental health”.

But MacNeil said funding was drying up in both rural and urban areas, creating a “broken” system.

“If you have a mental health facility in your county, it’s not just serving your county. They also serve adjacent counties and they just don’t have the space, they don’t have the people, they don’t have the funding,” he said. “They have closed places because they don’t have the staff. You don’t have the funding and you have the same if not more people diagnosed with mental health issues every day.”

Gerlich said her center relies on the government-funded Tri-County Behavioral Healthcare, which serves Montgomery, Walker and Liberty Counties, to help find places for patients who need mental health care.

But Evan Roberson, executive director of Tri-County Behavioral Healthcare, said that despite government investment in mental health funding, it’s still difficult to keep up with the region’s growth and the need for more services amid the pandemic.

He said about 30% of Tri-County’s 460 positions are vacant. All but a few of the 147 vacancies are healthcare jobs.

Tri-County sees approximately 5,000 adults and children annually at the Conroe Psychiatric Emergency Treatment Center.

“This year, nearly 30% of the people we studied were children and adolescents,” Roberson said.

In the rural town of Liberty, Gerlich said she will continue to work to connect patients with mental health crises to providers but worries about what could happen if the “broken” system isn’t fixed.

“Although we can treat them, (mental health) isn’t our specialty, so we do what we can for them, but it’s not enough,” she said. “It’s hard to put that into words. It’s really because our hearts are breaking. We are humans. Our hearts are breaking for this patient, his family, but there is only so much we can do because this system is fair – it’s not a good system right now.”

John Kelly and Maggie Green contributed to this report.

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https://abc13.com/rural-mental-health-access-provider-gov-greg-abbott-school-shooter/11898209/ ‘broken’: mental health availability, funding ‘not enough’

Dais Johnston

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