Rural Mental Health Shortage Reaches Legislators

$righthorizontal$September 16, 2010 -- Kathy Moon never thought she’d become the voice for rural Oregonians suffering from mental illness. But as a nurse practitioner working in the small town of Reedsport, she’s become acutely aware of the lack of services for this vulnerable population.

 

Moon’s taking her concerns to the Oregon Legislature. She’s been invited to testify before the House Interim Human Services Committee on Sept. 22 by Rep. Carolyn Tomei (D-Milwaukie), who chairs that committee.

 

“People in this community can’t get mental health services even if they have insurance or on Medicaid,” said Moon, a nurse practitioner at Dunes Family Health Care. The nearest hospital, Bay Area Hospital in Coos Bay, has shut down its secure bed unit and recently lost its only psychiatrist who resigned.  

 

“The hospital can’t afford another psychiatrist; every time they find one, they burn out really quick,” said Dr. Robbie Law, who praised Moon for speaking up. “She’s become a real advocate.”

 

The lack of access has intensified because there’s not a political constituency for the mentally ill, and most people are unable to advocate for themselves, said Law, who’s worked at the Dunes clinic since 1991.

 

“We’ve gotten used to fending for ourselves, and we feel like a voice in the wilderness, while the county is trying to scramble for the few crumbs that are left," Law said.

 

Even though Reedsport is 90 miles away from the county seat of Roseburg, the need is just as intense, Law said. For example, Roseburg has 50 units of county subsidized housing, while Reedsport falls just shy of that figure, at 48. “But we don’t have the same social services,” he said.

 

The mental health problem became acute when Moon tried to find a bed at Bay Area Hospital for a woman who was actively suicidal. “When I called the hospital, they tried to talk me out of it,” she said. “We have a very broken system.”

 

It’s time to overhaul our mental health system, Moon said. “Our system is designed to take people who are seriously mentally ill, fix them up with a quick fix and stick them on the street with no resources. They can’t get any help unless they’re ready to kill themselves or someone else. There’s absolutely no where to send people who need help when they start cutting themselves and hear voices.”

 

Legislators need to know the acuity of this situation, Moon said. “I intend to let them know how desperately people need help; how it’s affecting the most vulnerable people in this community.”

 

This problem goes beyond Reedsport. It’s impacting the entire Douglas County area, which has among the highest unemployment rates in the state, said Janet Holland, the county’s mental health director.

 

Holland fears that legislators might over react by either dismantling the system or pulling funding.  

 

“We need to engage in solutions rather than finger pointing and identify problems and do what we can to fix things,” she said. “It’s not going to be perfect and everyone’s not going to be happy because our resources are limited.”

 

As a starting point, Holland is looking for a case manager in Reedsport who can help people manage their medications and coordinate their medical appointments.

 

Currently a therapist works in Reedsport two days a week. "We just can’t afford to put a full time therapist in that community,” Holland said. “It’s not in our budget.”

 

With a population of 102,000, GOBHI is responsible for about 11,000 people on the Oregon Health Plan, while the county also sees an average of 2,500 uninsured people each year.

 

“Our biggest concern is what’s happening to people who are indigent and are being cut off services because of budget cuts,” Holland said. “I see this systematically across communities because of the funding crisis. We’re all struggling for how to meet the needs of the community. Once we start cutting and cutting, we no longer will have a viable program and we’ll have diluted services so that nothing will be left.”