Lack of mental health services emerges as No. 1 concern among Douglas County residents

Vicki Collie-Akers talks about the results of Community Health Assessment report during a public forum Thursday, May 17, 2012, at the Community Health Facility. Collie-Akers, of Kansas University's Kansas Work Group for Community Health and Development, was a key researcher for the assessment which was released earlier this month by the Lawrence-Douglas County Health Department.

Vicki Collie-Akers talks about the results of Community Health Assessment report during a public forum Thursday, May 17, 2012, at the Community Health Facility. Collie-Akers, of Kansas University's Kansas Work Group for Community Health and Development, was a key researcher for the assessment which was released earlier this month by the Lawrence-Douglas County Health Department. by Karrey Britt

Inadequate mental health services emerged as the top concern at a public health forum Thursday evening in Lawrence that was attended by about 50 people.

Among the messages: “Lack of psychiatrists in area,” “our hospital does not do enough for residents who are in mental health crisis,” and “lack of mental health services delivered in the home.”

Melissa Hoffman, a community education specialist at Lawrence Memorial Hospital, said she offers a perinatal mood support group for women who are suffering either in pregnancy or after pregnancy.

“I often find that they have a hard time accessing health care outside that group whether it be a therapist or psychiatrist or doctor. There’s not a network of providers in place,” she said.

The Lawrence-Douglas County Health Department hosted the forum to present the results of its 38-page Community Health Assessment, which identified 13 areas that were of concern to residents. Then, attendees were asked to help narrow down the list. Here’s how: There were 13 poster boards that had an area of concern written on them and there was a glass jar nearby. Participants were given two pennies and then asked to place them in the jars of most concern.

Here’s their list from the highest priority to the least followed by the number of votes each received, and the second number is the total votes from all four public forums:

• Inadequate access to mental health services: 19, 36

• Poverty and few job opportunities (tied for second): 11, 20

• Disparities in health outcomes and quality of life: 6, 12

• Insufficient access to health care and other services: 5, 16

• Lack of physical activity: 5, 13

• Limited knowledge of available health and other services: 4, 12

• Limited access to safe and affordable housing: 3, 9

• Inadequate transportation linking people to services, jobs and recreation: 3, 8

• Limited access to dental services: 3, 6

• Lack of access to health insurance coverage: 2, 13

• Inadequate access to affordable, nutritious food: 2, 11

• Abuse of alcohol: 0, 8

• Prevalence of abuse and intimate partner violence: 0, 2

Lawrence resident Bob Oakes said his top concerns were few job opportunities and lack of health insurance coverage, which he said are closely tied together and wonders if they should be.

"Employment often can get you health insurance but is that the right model to deal with?" he asked. "There have been a lot of people railing, 'Obamacare, Obamacare, Obamacare,' but what other options do people have other than working or going without?"

His wife, Diane, voted for the same issues.

"I think poverty is a key driver in most of the difficulties that folks face in trying to live a healthy lifestyle," she said. "My other concern is access to insurance which goes right along with that."

Christina Holt, of Kansas University's Work Group For Community Health and Development, was a key researcher for the assessment. While collecting information for the report, she spoke to residents in one-on-one interviews and small focus groups about the challenges they face.

"There's a lot of disparity in health outcomes and in quality of life here among different groups of people," she said. "Even though statistics tell one story when you hear personal stories from people in their daily experiences, it tells another story."

Holt said there were several that stood out. Among them:

• A Haskell Indian Nations University student, who worked in downtown Lawrence until late at night, said she had to walk home to campus because there was no bus available. She said there are no sidewalks on part of the route home and some areas have poor lighting. She described the walk home as very scary.

• Several East Lawrence residents said the only way they could get to the city pool was by taking the bus, and the only route available was 90 minutes.

• A North Lawrence resident, who didn't have a vehicle, said she used the Dollar General for her grocery store. She knows it's not ideal but she doesn't have the means to go elsewhere.

"I think the assessment underscored community members' concerns about a number of issues ranging from access to affordable and healthy food to things that we don't necessarily even think about every day like walkability and bikeability or infrastructure of our community and whether it supports health," Holt said.

At Thursday's forum, she listened to residents' concerns about mental health services. She said they included lack of services for people in mental health crisis and a lack of in-patient care.

"There's been some tragic outcomes of that recently in our community and I learned about that," she said.

If you were unable to attend a forum, the health department is accepting comments at Continue-the-Conversation.org.

Residents weighed in on their top health concerns during a public forum Thursday, May 19, 2012, by placing votes and messages on poster boards. The forum was hosted by the Lawrence-Douglas County Health Department.

Residents weighed in on their top health concerns during a public forum Thursday, May 19, 2012, by placing votes and messages on poster boards. The forum was hosted by the Lawrence-Douglas County Health Department. by Karrey Britt

Ann Gabel, left, an employee of Lawrence Memorial Hospital, visits with Kim Ens, director of clinic services at the Lawrence-Dougas County Health Department, during a public health forum Thursday, May 19, 2012, at the Community Health Facility, 200 Maine.

Ann Gabel, left, an employee of Lawrence Memorial Hospital, visits with Kim Ens, director of clinic services at the Lawrence-Dougas County Health Department, during a public health forum Thursday, May 19, 2012, at the Community Health Facility, 200 Maine. by Karrey Britt

Tagged: Lawrence-Douglas County Health Department, mental health

Comments

Starbrite 2 years, 7 months ago

With 1 out of 5 families in the U.S. affected by mental illness and 1 out of 17 individuals suffering a severe mental illness such as bipolar, major depression or schizophrenia, this community definitely needs additional psychiatrists as well as easier access to mental health services.

Urgently needed is the re-opening of an inpatient psychiatric unit at Lawrence Memorial Hospital. Individuals in our community needing in-patient treatment for mental illness should not have to travel out of town to be hospitalized--usually at an overcrowded and understaffed hospital miles away. They need to be cared for in our community hospital close to family and friends.

On a bright note: Douglas county does currently have several mental health support groups for people with mental illness and their families. Two of them are:

NAMI-Douglas County which has monthly support group meetings for people with mental illness and their families. Contact: nami.dgco@gmail.com for more information. [NAMI=National Alliance on Mental Illness]

There is also a Depression and Bipolar support group in Lawrence that meets on a regular basis. Contact: cdotmo@gmail.com for more information.

Let us work together as a community to try to improve and add to mental health services for the mentally ill in our community.

Marilyn Hull 2 years, 7 months ago

Thanks for posting the support group info.

Why aren't there more psychiatrists in Lawrence? Is there anything we can do as citizens to change this?

It is hard enough to admit you need help and seek it out. if you seek it and can't find it (or afford it), that has to be very discouraging.

Belinda Rehmer 2 years, 7 months ago

What a great first step! I attended one forum and have talked to others who attended the others. Personally, I was surprised at the creativity used in getting the audience talking! There was an air of openness at the meeting I attended that facilitated freedom to express yourself without fear of ridicule.

The level of participation required from the Health Assessment team impressed me also. This was not a small group effort and I truly feel some good direction/change could come out of their efforts. I would like to thank EVERYONE who participated, from the Assessment Team to community members who gave their time to answer the surveys, attend focus groups, and these community meetings! I sometimes feel my voice doesn't really matter in most community decisions but I believe our voices do matter here!

I encourage anyone who has not yet participated in some way, to do so now at the link given in this article! Continue-the-Conversation.org. They say the results of this study will make a difference in determining programs and/or future services to focus on. Let's give them some direction!

Jim Williamson 2 years, 7 months ago

I thought all the doctors and lawyers in the world wanted to come back to Lawrence after they got out of law and med school? At least, that's all my Lawrence-resident friends have always told me.

The reason psychiatrists don't come to a city is a simple one: money. They either can't make enough of it in Lawrence, or no one -- say Bert Nash -- is willing to pay them the $160,000 that the average psychiatrist makes. And after being in school for four years of undergrad, four years of med school and four years of residency, psychiatrists have debt enough to choke a pig. They can't afford to work for less than that.

Ron Holzwarth 2 years, 7 months ago

Phogfan86 pointed out one of the biggest reasons why health care in the United States is so expensive, that is, the cost of training a physician is very high for the student.

But that is not the case in all nations. in Cuba, education is free, there is no charge for tuition or books. All that is necessary is the ability to graduate from medical school. So, when a physician is finished with his or her education, there are no student loans to repay. That is why Cuba exports doctors, they have plenty of them.

And, Cuba has a national health system that covers all of the costs of the health care for all of its citizens. So, there are never any doctor bills, hospital bills, or prescription medication bills for anyone to pay.

This is a fact: If you are an infant about to be born, and have your choice of where, you should choose Cuba over the United States of America.

In Cuba, there were 4.83 deaths per 1,000 live births in 2012.

In the United States of America, the same statistic is 5.98 infant deaths.

The United States of America can invade countries on the other side of the world that pose very little threat with the most amazing military that the world has ever seen, and seems to have developed a habit of doing that.

And, if infant mortality is used as a measure of the quality of health care, there are 47 nations whose health care is superior to that in the United States of America.

It's all about priorities, I suppose.

Source for the above statistics: The Central Intelligence Agency of the United States of America (CIA)

https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html

A clip from the above link: "This entry gives the number of deaths of infants under one year old in a given year per 1,000 live births in the same year; included is the total death rate, and deaths by sex, male and female. This rate is often used as an indicator of the level of health in a country."

Ron Holzwarth 2 years, 7 months ago

I need to point out that the statistics I transcribed were estimates by the Central Intelligence Agency of the United States of America (CIA), and were not based upon historical data. But, they correspond perfectly with what I have read in the past, and also with the other reference that I looked at. I selected the CIA because I think that is probably an authoritative reference.

Another thing I should have pointed out is the number of nations mentioned. The United States of America rates # 48 out of 222 nations listed for quality of health care. That means, in the top 1/4th, and almost, but not quite, in the top 1/5th.

But, our military is # 1 out of 222.

hannahss 2 years, 7 months ago

If my experience was in any way typical, I would run screaming from anything that Bert Nash had to offer. My daughter had a severe dissociative episode and we came to Lawrence even though we don't live there. I had no previous experience with such an episode and was overwhelmed and unsure what to do or what was happening. I had good reasons for the choice to come to Lawrence, which I would have explained to anyone who asked in a caring manner. Instead, I was treated like an abuser, possible criminal, perpetrating fraud at the least. The hospital staff was very kind, but the "mental health professional" made our situation much worse. The person who brings another in for help----is looking for help! Luckily, I now have other resources, but was alone and very frightened at the time of our Lawrence experience. I hope that others seeking help have not had similar experiences.

Ron Holzwarth 2 years, 7 months ago

SFBayhawk, you can learn what hannahss is taking about here:

The following is all clipped from this website: http://emedicine.medscape.com/article/294508-overview

Overview

Since the 1980s, the concept of dissociative disorders has taken on a new significance. They now receive a large amount of theoretical and clinical attention from persons in the fields of psychiatry and psychology. Dissociative disorders are a group of psychiatric syndromes characterized by disruptions of aspects of consciousness, identity, memory, motor behavior, or environmental awareness. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) includes 4 dissociative disorders and one category for atypical dissociative disorders. These include dissociative amnesia (DA), dissociative identity disorder (DID), dissociative fugue, depersonalization disorder, and dissociative disorder not otherwise specified (DDNOS).

Dissociative Amnesia

The essential feature of dissociative amnesia is an inability to recall important personal information that is more extensive than can be explained by normal forgetfulness. Remembering such information is usually traumatic or produces stress.

DSM-IV-TR diagnostic criteria for dissociative amnesia include a predominant disturbance of one or more episodes of an inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness. Also, the disturbance does not occur exclusively during the course of dissociative identity disorder, dissociative fugue, posttraumatic stress disorder (PTSD), acute stress disorder, or somatization disorder and is not due to the direct physiological effects of a substance or of a neurological or other general medical condition. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Dissociative Identity Disorder

Dissociative identity disorder, formerly referred to as multiple personality disorder, is characterized by the existence of 2 or more identities or personality traits within a single individual. Patients with this disorder demonstrate transfer of behavioral control among alter identities either by state transitions or by inference and overlap of alters who manifest themselves simultaneously. It is observed in 1-3% of the general population.

Dissociative Fugue

Dissociative fugue is characterized by sudden, unexpected travels from the home or workplace with an inability to recall some or all of one's past. Some of these patients assume a new identity or are confused about their own identity. They seem to be running away from something of which they are unaware.

After the fugue episode resolves, patients are unable to remember the events of the state.

hannahss 2 years, 7 months ago

Thanks, Ron! This was her first episode that I was aware of, fugue state and personality change, very alarming!!! I needed comfort and direction, not accusations. She has had several since then, but I am learning what to do and she is learning how to head them off. They are triggered by memories and abuse in early childhood, before she was removed from her birth family.

Ron Holzwarth 2 years, 7 months ago

Many people simply have no concern for the welfare of others. If we were a moral and righteous nation, people like that would be considered to have a mental disorder.

pinecreek 2 years, 7 months ago

'Urgently needed is the re-opening of an inpatient psychiatric unit at Lawrence Memorial Hospital. Individuals in our community needing in-patient treatment for mental illness should not have to travel out of town to be hospitalized--usually at an overcrowded and understaffed hospital miles away. They need to be cared for in our community hospital close to family and friends.'

Please go back in time and review what happened at the time that the unit closed. It was underutilized and, more importantly, did not have local staff to cover the need that was there. If the local psychiatrist community and Bert Nash can not (or will not) provide cover, that pretty much closes the unit.

Another point that people forget about (and is supported in state data) is that mental health care still carries a stigma that often leads people to seek inpatient care in other communities rather than risk seeing their caregivers in other local, non-care situations. So, even if there was a local inpatient unit, chances are most of the patients would be from outside Douglas County. Sad, but true.

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