The need to break barriers to mental health access

There is a mental health crisis in rural America.

Youth are among those hardest hit in this crisis. Parents, teachers, school counselors, and building administrators see it firsthand every day. The crisis is seen firsthand by social workers and those in county human services departments.

It manifests itself in threats and actions of self harm, as well as young people acting out through misbehavior or anti-social activities which disrupt classrooms and can bring harm to other people.

A recent report by reporter Natalie Eilber in the Milwaukee Journal Sentinel highlighted the failure of tele-mental health services — a tool that was viewed as a potential silver bullet to address this mental health crisis particularly in rural areas.

When it comes to mental health services, particularly for youth, there are clear divides between the haves and the have-nots. Urban areas like Dane County, Milwaukee, and Waukesha County have dozens of mental health providers focusing on youth needs. The vast majority of counties in the state have no specialized providers for youth mental health needs. The mental health providers that do serve patients in rural areas such as this portion of the state are stretched thin with their caseloads and face other barriers.

The sales pitch of tele-mental health, and tele-health in general, is that by utilizing technology, people in rural communities could have virtual office visits with providers hundreds of miles away without having to drive to see these specialists.

While technology still brings that promise, it is far from a perfect system and many of the kinks remain to be worked out such as the lack of reliable broadband access in rural communities. Coupled with this is a lack of privacy, especially for young people, to talk about their issues and concerns, when they are in the home where other members of their family can overhear them.

Likewise, the community hubs of schools, libraries, and some businesses that have reliable broadband internet access are very public places that are not suitable for tele-health visits of any sort.

For many, cost is a major barrier, with limited insurance coverage of mental health services, resulting in high out-of-pocket expenses for those seeking help. This is particularly true for those of lower economic levels who rely on Medicaid. Many providers around the state have refused to accept Medicaid patients because the reimbursements were below their costs.

Of all the barriers to mental health services, the largest is the societal stigma attached to mental health. People, particularly young people, don’t seek the help that is available because of the fear of judgment from their peers, their family, and their community.

Mental illness is tearing society apart, exacerbated by growing stress levels people are facing every day. Stress brings to the surface the cracks that are already there.

Communities must work together to tear down these barriers, beginning with removing the stigma attached to mental illness. Lawmakers must write regulations for insurance providers to ensure coverage of vital medical care, and we must be innovative in our communities in creating spaces in public areas where residents can have privacy and security for tele-health visits.

There is too much at risk to not make the effort to break down the barriers to mental health access.

The Tribune Record Gleaner editorial board consists of publisher Kris O’Leary and Star News editor Brian Wilson.