Jackson County mental health forum May 24, 2016

SYLVA — Marsha Crites asked those in the Jackson County library auditorium Tuesday evening to raise their hands if they or a family member had any experience with mental illness. With more than 30 present, everyone in the room held up a hand.

The Mental Health Panel, which Crites moderated, explored regional challenges in access to care for those with mental illness, as well as related issues.

“This event is really a first,” Kate Glance, community specialist for the Smoky Mountain Managed Care Organization, told Carolina Public Press after the event. “Ten years ago, people with mental health problems were just kind of hidden away, especially out here (in WNC).”

Representatives from six organizations appeared on the panel, organized by the Jackson County library after a survey of library users showed that discussion of mental illness was one of their top priorities. Organizations participating included the National Alliance on Mental Illness, or NAMI; Appalachian Community Services, Children’s Developmental Services Agency of WNC, Meridian Behavioral Health Services, Western Carolina University’s Counseling and Psychological Services, and Smoky Mountain MCO.

Each mentioned different logistical tactics that they had found helpful in treating patients in a region that is typically rural and frequently economically disadvantaged with communities isolated by the rugged terrain and lack of roads, along with a general shortage of licensed mental-health practitioners.

“We’ve been using telepsychiatry,” said Tabatha Brafford, of Appalachian Community Services. The method allows patients to video chat with a psychiatrist. “It took us from having people wait for an appointment for months to, in some cases, same-day appointments.”

Katie Goetz, of Meridian Behavioral Health Services, talked about her organization’s unique take on outpatient services.

“They’re called Recovery Education Centers,” Goetz said. “It’s really set up like a community college, where people come to take classes … to learn skills and tools that will help them with their wellness.”

Panelists agreed that their most important role is to be available when someone is in a crisis.

“And crisis is defined by the person,” Brafford said, “not by some definition in a book.”

Depending on the nature of a patient’s mental illness, crises could be spurred by many things — a missing dog, an event that triggers a painful memory, a family conflict. And they can happen at any time.

That’s one of the reasons that many organizations, including Smoky Mountain, have an emergency phone line that’s available 24 hours a day, seven days a week.

“It can connect you to the right organization, (which) will support you at the moment that you need help,” Glance said.

Brafford added that around-the-clock availability of care becomes especially important for treating people with mental illness. In addition to being available in acute times of need, centers often need to deal with the reality that patients can find it difficult to ask for help when they’re already feeling overwhelmed.

“We’ve had much more success with a walk-in model than scheduling regular appointments,” Brafford said, “(because) then we’re there when someone is actually feeling up to (talking).”

The stigma surrounding mental illness often discourages patients from seeking help, according to Glance. “But every one of you sitting here has the ability to work on that stigma and to quit making it such a big deal to walk through that door,” Glance said. “If (someone) had cancer, people would be pushing him to the door to get the help that he needed.”

As a follow-up to the May 24 event, the library, in partnership with Smoky Mountain MCO, will host a Mental Health First Aid workshop on June 7. The workshop will aim to help community members prepare for when someone they know experiences distress due to mental illness or substance abuse.

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