May is Mental Health Awareness Month
~by Mary Weaver
Recently the Greene County board of supervisors issued a proclamation, encouraging Greene County citizens to increase their understanding of mental health. An internet search for a definition of mental health was found from the Centers for Disease Control. Mental health is…. “emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we manage stress, relate to others, and make healthy choices.”
We can all have a bad hair day, a flat tire, a speeding ticket, or try to combine a rock during soybean harvest. We intuitively know those are not the days to purchase a lottery ticket. Those unexpected events can be identified as mental health concerns, but those blips may become a mental illness if stressors keep piling on, and the ability to cope is lacking. Continued signs and symptoms may result in so much stress that it begins to impact a person’s ability to function. Mental illness is not the same as feeling sad, unhappy, or stressed because of difficult situations. J. P., a good friend, when discussing mental health, said a hard day’s work when he is sad always helps him. This is an example of a person who does not have a mental illness.
Determinants of mental health – A 30,000 feet view from the World Health Organization recognizes that individual, social, and structural culture may combine to protect or to undermine our mental health.
Individual psychological and biological factors such as emotional skills, substance use, and genetics may make people more vulnerable to mental illness.
Exposure to unfavorable social, economic, geopolitical, and environmental circumstances – including poverty, violence, inequality, and environmental deprivation – also increases people’s risk of experiencing mental illness.
Iowa mental health data seems alarming, as one in five adults, or 600,000 Iowans, live with some form of mental illness. About 37,000 grapple with serious mental illness daily.
Too often, without a treatment-focused setting, these individuals end up in jails, prisons, and emergency departments, where they do not get the help, they deserve. The State of Iowa closed the treatment facilities at Mount Pleasant and Clarinda in 2015, and Glenwood was closed in 2018.
Based on Iowa’s population there should be 1,265 inpatient psychiatric beds, but only 566 are available.
No Iowan should be jailed because they are ill and unable to receive medical treatment.
Assistance-Services available in Greene County
Mental Health First Aid
ISU Greene County extension will have a course available on June 5 from 8 am to 5 pm at their Jefferson office. This will focus on how to identify, understand, and respond to signs of mental illness and substance use disorders. This training will provide the skills needed to reach out and provide initial support to someone who may be developing a mental health or substance use problem and help connect them to the appropriate care.
Greene County Medical Center
GCMC offers two staff persons for behavioral counseling:
Heather Wilson, DNP, PMHNP-BC – Heather graduated from Mercy College of Health Sciences as registered surse. She received her master’s degree from Maryville University and is a board certified psychiatric mental health nurse practitioner (PMHNP-BC)
Bonnie Riphagen, LMSW – Bonnie graduated from Iowa State University with a Child and Family Services degree. She obtained her licensed master’s degree from the University of Iowa in social work (LMSW).
These therapists’ work is described as behavioral counseling. They do not prescribe medications, though they counsel people who are receiving drug treatment therapy. At this time there is a six week wait for an appointment to see Heather or Bonnie. Bonnie states, “If an individual or a family is in crisis, the local emergency room becomes the necessary option.”
CICS
Central Iowa Community Services (CICS) is a 15-county area that was mandated and receives funds from the State of Iowa. Previously each County provided mental health services. This mandate was implemented to assure uniform mental health and disability services. Supervisor Dawn Rudolph represents Greene County on this board. She informed me all counties in the region have the same available services, but some come from other counties. Services are to include a crisis line, youth, and adult inpatient and outpatient services, and even jail diversion are included. The system is currently overwhelmed by persons with mental health issues, and mental illness. Dawn informed me, “There are never enough beds.”
Medicaid services
Molina Health Care is a Managed Care Organization under contract with the State of Iowa to provide services to Medicaid clients. Case manager Mackenzie Juergensen of rural Rippey is employed to serve as an advocate and to coordinate services for individuals receiving a Medicaid waiver. Those waivers include intellectual disability, elderly, or brain injury.
In two more semesters at Upper Iowa University, she will be classified as a clinical mental health counselor. This is a critical certification as it encompasses the co-occurring disorders of mental health and substance abuse.
E-counseling
If you are driving and listening to the radio, you will frequently hear about online counseling services. I googled online services and BetterHelp was the first pop up. It is described as the world’s largest online counseling, the cost ranges from $60-80 per week, and includes video, phone, live chat, and unlimited messaging.
Since Googling this service for information, I have received at least 20 pop-ups on my Facebook page offering me several e counseling sites in the last 24 hours.
Leslie Carpenter, a serious and chronic mental illness advocate, stresses the seemingly obvious, that a person feeling suicidal should not have access to guns. She is not opposed to the Second Amendment and does not suggest eliminating all guns from our society. Rather, she encourages removal of means when someone is suicidal. When someone attempts suicide with a gun it is fatal 90 percent of the time.
She also advocates for common sense gun legislation. This includes background checks, banning assault weapons, and ERPO (Extreme Risk Protection Orders), commonly known as Red Flag Laws.
She describes the inadequacy of inpatient services; waiting lists, short inpatient stays, and location so distant that family is unable to be physically supportive to a patient. A recent example is an individual from Dubuque that took his son who was in a crisis to the emergency room, was told the only open bed was in Sioux City.
Concluding thoughts
All counselors interviewed for this column expressed regret and dissatisfaction regarding the closure of the mental health facilities by the State of Iowa. Persons with ongoing mental health issues need a safe harbor to receive adequate and if necessary long-term treatment.
When those interviewed concluded their thoughts, they generalized that mental illness is less stigmatized and persons discuss concerns more openly, and thus mental illness seems more prevalent.
Finally, Bonnie Riphagen describes the importance of life balance for all of us in today’s overly scheduled lives. Take time to exercise, eat properly, maintain a sense of humor, and use nature and the outdoors for self therapy.
Good advice for all of us.
