More mental health resources, medication-assisted treatment and more peer specialist follow-ups after overdoses or mental health crises were among the recommendations made Friday by the Health Care Advisory Board Subcommittee on Mental Health and Outreach Subcommittee. and Case Management.
Data collection by the subcommittees found higher emergency room use by residents living in the 32609 and 32641 ZIP codes, which spread from the northeastern and central parts of the county. Emergency room use is twice the state average in the 32609 zip code area and three times the state average in the 32641 area. Many of these emergency room visits are health or substance use related mental. The committee decided to draft three action items to present to the county: education, treatment, and follow-up.
Mental health among children is of particular concern. Children experience post-traumatic stress disorder and chronic stress disorder, said James Reiser, a member of the Board of Directors of the National Alliance on Mental Illness. Mental health education needs to be more accessible to providers, families, and teachers.
“A lot of what’s going on is not recognized in the community, and I think there are real barriers to getting help,” Reiser said.
The biggest barriers to mental health services are cost and provider availability, said Karen Billings, an advisory board member and deputy director of administrative services for the Department of Health and Clinical Psychology at the University of Florida.
“A lot of the data from the ER will point to alcohol abuse versus traditional mental health, such as depression, anxiety and grief,” Billings said. “We have this whole other population that needs counseling and therapy that is not driven by substance abuse.”
During crises, law enforcement is primarily called in to help with anxiety, depression, bipolar disorders, schizophrenia and substance abuse, said Kamelia Klejc, coordinator of the Gainesville Fire Community Resource Paramedicine Program. Substance abuse cases are some of the most common calls the program receives.
Hospital staff encounter many patients whose conditions are related to substance abuse, said Wendy Resnick, a retired UF Health administrator and volunteer at GNV4ALL, an initiative of the Gainesville Sun that aims to address racial and economic disparities. But others who struggle with traditional mental health issues never make it to the emergency room or hospital and don’t get help.
Identifying the different needs of people with traditional mental health problems and those with substance abuse problems will create an opportunity to improve access and well-being by expanding providers, Resnick said.
People cope with their mental illness by self-medicating with various substances, said Cathy Cook, a member of the advisory board.
“These are two big looming categories that are so intertwined, and separating them can be tricky,” he said.
Other members, including Ali Martinez, said they believe an important component to improving mental health issues is establishing an educational foundation in communities, including Hawthorne and around the 32609 zip code. People dealing with traditional mental health issues are not counted in the data due to limited resources. and interaction with law enforcement.
Until there is a network that can provide continuity of care and treatment for people without insurance or on Medicaid, Klejc said people will continue to rely on 911 and the emergency room.
Follow-up services are necessary, but it would be expensive to contract with more providers, Reiser said. Instead, he suggested that certified peer specialists, people with credentials who volunteer to help patients, offer follow-up services.
In surveys administered, communities in zip codes 32609 and 32641 ranked certified peer specialists at the bottom of the list of needed mental health services. But Reiser said he thinks the service would be profitable for heavy emergency room users, who may not be aware of other resources.
Billings said he believes the community needs more than certified peer specialists.
“Just like we have urgent care centers for physical health, there should be options for mental health treatment,” he said. “We would place articles, as support for the 988 Program [a nationwide suicide prevention hotline]under education and mapping of mental health services and identification of gaps under treatment.”
Martinez suggested establishing mental health clinics throughout the county to build relationships and trust with communities.
“Many people in poor communities call 911 … because they have historically felt that the systems did not take their concerns seriously,” he said. “[Setting up clinics] It would be an immediate way for people to feel that someone will attend to their crisis.”
Deep social and cultural issues still deter residents from seeking treatment for mental health problems, Martinez said. Mental health it is still stigmatized throughout the county.
“Mental illness is a label, and that label disgusts people,” he said. “I think education and removing that stigma in a culturally relevant way will solve a lot of these problems.”
