Providers work to improve mental health care

After reviewing and discussing needs and programs addressing Hi-Line mental health issues, including an ongoing survey with opinions on major mental health issues, local health care providers reached a consensus on two keys to improving local services on the issue: collaboration and advocacy.

Some 20 health care and mental health professionals met in Havre last week at a mental health needs assessment meeting. The top issue, they said by the end, was health care providers working together to treat the whole patient.

Trent Lear, clinical director of the Center for Mental Health, which sponsored the assessment, said the idea of collaboration was something he saw used successfully especially while working with children, looking at all aspects of the patient's life.

"We got much better traction in terms of breaking the cycle … ," Lear said. "You all have to kind of converge, and not get in each other's way, because you can over-help."

The other main point was that the mental health care community needs to work to increase communication, both to let people in the community know what services exist and to provide agencies the facts on what is the need.

Facing a trend of decreased funding on both the state and national level, the group agreed that the mental health care community needs to speak with one voice when it is requesting funds for its services.

Lear pointed out that next year is a legislative session.

"When agencies can speak as one, the Legislature listens," he said. "If we speak in different voices, they don't hear anything and nothing happens."

Common problems

are identified

The group looked at a survey conducted online and broke into groups to discuss what the people at the meeting believed were some of the top issues in the region. Though there are very few entries so far, meeting facilitator Mark Willmarth of the survey's host Vision West, said it is ongoing and available at http://www.visionwestmt.com/cmh_survey.htm.

The three groups found some common areas of concern with mental health, with some linked to both Hill and Blaine counties and to both children and adults.

Some of the more common included substance abuse; poverty, bullying, a sense of independence and unwillingness — or inability — to communicate and seek help, knowing what services were available; and overcoming the stigma to persuade people to access those services.

Sydney Blair, CEO of Center for Mental Health, said a change is happening nationwide about how people think about how mental health problems affects the nation.

Part of that is from federal initiatives, including in the Patient Protection and Affordable Care Act, she said.

Trends are pushing the medical community to look at the whole person rather than looking at different issues individually, she said.

The health care community also is stressing the need for individualized treatment, rather than trying one-size-fits all treatment, she said.

A key to success, Blair said, is trying to treat mental health problems early — the longer they are untreated, the greater the cost to the patient and to society.

The national push includes taking a view of mental health issues that considers them treatable issues, reducing the stigma of seeking help for mental health issues, increasing awareness of what is available and working to increase collaboration.

Jennifer Durward, psychiatric nurse practitioner at Northern Montana Medical Group, said collaboration is increasing and is much higher than in the past.

The group agreed that more needs to be done to increase collaboration.

And that needs to occur at the same time that funds are being cut, several added.

Blair said that funding for the Center for Mental Health, which serves more than 5,000 people a year in a 13-county region of central and north-central Montana, has dropped — it's former $17-million a year budget is down to $15.5 million — and that the amount of services donated by the Center has increased. The percentage of the cost of services provided that is paid for also is dropping, she said.

Looking at needs of north-central Montana

Blaine County Commissioner Dolores Plumage, also a board member of the Center for Mental Health, said she wants to see the local providers make certain the board understands that this region has different needs than other areas.

The transportation alone, for people in rural areas to get to services, creates problems other parts of Montana don't see, she said. Other issues specific to this part of Montana, as opposed to areas like Helena, create different needs.

"There's no comparison to Great Falls, as far as I can see. That's apples and oranges … ," Plumage said. "We are talking about this area, and there are a lot of challenges here, yet, and I want us to be elevated in our needs here, to get more attention from Center for Mental Health and the dollars. But we have to justify it. Because some things you cannot be satisfied with."

The group members agreed that more outreach is required — both from policy makers and funding agencies, and to the people in the community.

The more that people know what services are available from different groups and agencies, both as mental health care consumers and as providers, the more services can and will be used and the more collaboration can occur, the group agreed. The need to work on the whole person was repeatedly raised during the meeting.

Looking for long-term changes

Lear stressed that changes need to be made over time.

"All of these issues are ones that we can only chip away at over time, because they weren't created yesterday, nor are we going to solve them tomorrow," he said.