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Columbus mental health gap not unique

Columbus Telegram - 11/27/2020

Nov. 27--Editor's note: This is the first part of a two part series on mental health needs and services in the Columbus area.

Efforts to strengthen and improve access to critical mental health resources are ongoing and everywhere, including in and around Columbus.

A May 2018U.S. News & World Report article, titled 'What's the Answer to the Shortage of Mental Health Care Providers?' illustrates the many challenges facing the mental health field.

Across the United States, the number of psychiatrists falls short of growing demand even as the stigma surrounding mental illness decreases, the article states. At the same time, mental health professionals flock to urban locations, leaving people in rural areas to struggle for access.

In the Columbus area, members of law enforcement, health care workers and community response personnel are all working together to support those struggling with their mental health, but it's an uphill battle without a simple conclusion.

"There definitely is a shortage of mental health providers," Columbus Family Practice Social Worker Lynette Klug said. "We do the best we can in serving people."

Klug said it's not uncommon for people struggling with their mental health to start seeking help from their family doctor.

Part of Klug's job is to meet with people who are experiencing challenges in life and connect them to resources that will help them. Sometimes, those resources include mental health services.

"We would recommend that they would first see their family doctor," Klug said. "Really, it's in the hopes of trying to help not overwhelm our psychiatrists."

The lone psychiatrist in the Columbus area works at Columbus Community Hospital, not Columbus Family Practice, but Klug said primary care doctors may treat for things like anxiety and depression.

If needed, primary care doctors can then refer people for therapy or to a licensed mental health practitioner, psychologist or psychiatrist.

There are also many programs and agencies that someone may be connected to for help.

An upwards of a dozen people from various agencies may be included on a given person's care team. However, navigating the intricacies of those agencies can be difficult for people experiencing mental illness.

Region 4 Behavioral Health System Director of Emergency Services/Disaster Coordinator Bill Price is responsible for coordinating programs and services offered in communities across 22 northern Nebraska counties, including Platte County.

Region 4 receives funding from the state and subcontracts with numerous agencies to provide and coordinate services for people who need them. The programs help address basic needs including housing, food and mental health.

"I hook them up with our contracted services, the crisis line, whatever, trying to get them mental health services," Price said.

More than a decade ago, then-Gov. David Heineman eliminated regional mental health centers across the state in favor of transitioning to community-based mental health resources. It was a cost-effective measure taken due to funding issues, Price said.

Data from the Agency for Healthcare Research and Quality with the U.S. Department of Health and Human Services shows that providing inpatient psychiatric care is among the most expensive service cost to hospitals.

The only regional center that's still open, he said, is in Lincoln.

The number of in-patient psychiatric beds in the state dropped when the regional centers closed, but the need for them has not gone away.

"So what happened is a number of the hospitals opened up psychiatric units," Price said.

Price said Region 4 partners with many of those units in its 22 county area, including facilities in Norfolk, Kearney, Omaha, Hastings and North Platte.

There are no in-patient psychiatric beds in Columbus, so people who need intensive treatment are often sent elsewhere in the state.

"If we were to have maybe a suicidal ideation patient, they can triage them in our hospital. But sometimes we're referring them to Bryan in Lincoln, sometimes we're referring them on to Omaha. ... Sometimes to Norfolk," Klug said.

Columbus Community Hospital (CCH) Vice President of Physician Relations/Business Development Amy Blaser said the hospital has identified a need for additional psychiatric services.

The Columbus Psychiatry Clinic was created to help meet outpatient needs. Blaser said the clinic has a psychiatrist and two licensed independent mental health practitioners.

The clinic draws from a service area of approximately 40,000. From January through October, it served over 1,700 patients.

Blaser said CCH has implemented telehealth technology to address gaps in its ability to treat mental health in the hospital setting.

CCH has plans to continue adding services, too, as the hospital grows.

"We look at access to care and that's a big part of what's important with mental health services. If someone has to wait a month to get in, that's really not meeting the needs of our community," Blaser said.

Molly Hunter is a reporter for The Columbus Telegram. Reach her via email at molly.hunter@lee.net.

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