Commentary #77: “There’s a severe shortage of mental health professionals in rural areas. Here’s why that’s a serious problem.”

Mental Health - Quotefancy

Image Credit: Quotefancy

I recently read another CNN article that I felt was worthy of sharing. It was published on June 20, 2018.

Here’s the link to the article:


For years, I’ve been fascinated with the Appalachian region of the United States. Part of it is because my grandmother (Mom’s mom) was raised in West Virginia, and other extended family members have lived in West Virginia and Kentucky, to name a few states.

The mountains are beautiful. Grandma Grace was raised during The Great Depression, and they survived. I have vague memories of visiting Great-Grandma Laura Bethany (whom I’m named after) on her farm in Ripley, and seeing Mom’s aunt’s and cousins in Beckley. These two areas aren’t deep in the mountains, but you can definitely see and feel the hills and valleys.

With all that said, Ripley and Beckley are small, but mighty. Other areas of West Virginia, and other states in the Appalachian region, have certainly struggled with the volatility of the coal mining industry, among other issues. The limited amount of research I’ve done shows years of struggles with poverty, unemployment, access to health care, and more. However, the Appalachian people are steadfast. I don’t want to be prejudicial, but research-based.

Along with difficulties accessing quality health care, and affording that care, mental health care is somewhat tied to that. It’s fascinating, as well as immensely frightening.

When I was diagnosed with Generalized Anxiety Disorder (GAD) in the summer of 2015, I started taking a bigger interest in mental health, including news articles about the topic. I’m grateful that I have a stable job, with good health insurance, and access to good mental health resources and services.

I’ve seen several counselors since I was in college, for a variety of reasons, but the counselor who diagnosed me with GAD was a watershed moment for me. She helped me unpack a variety of issues that were causing significant stress, and in turn, contributing to my anxiety. I’ve been able to better understand GAD, and to work to figure out the best ways to limit and control my anxiety. It’s a daily exercise, but I’m proud to say that I’m not taking any medication, and I’m able to live a fairly productive life thanks to a powerful and helpful support system. I realize that my situation is very unique, and I’m grateful for everything!


The article is packed with statistics. I won’t go through all of them, but the main point is a majority of non-metropolitan counties do not have a psychiatrist, and nearly half do not have a psychologist. The best definition of a non-metropolitan county that I could find is one that does not have a Metropolitan Statistical Area (MSA) and has a population of 10,000 or less (Health Resources & Services Administration).

One of the interviewees, a clinical psychologist, pointed out that many rural areas only have generalists, i.e., primary care providers (PCPs), and there’s little to no specialized care. People are left on their own due to a lack of community mental health care, and nearby relevant hospital services.

The services that are available are focused on crisis intervention, not prevention. These services attempt to address the crisis as it’s happening, but nothing is available to prevent the crisis.

In addition to the lack of services and resources, health care funding cuts are exacerbating this problem. Roughly 80 rural hospitals closed between 2010 and 2017. Hundreds more are at risk.

Another problem the rural population faces is isolation. Isolation can spark downward spirals, which can lead to drug addiction, overdoses, depression, and suicide. According to the Centers for Disease Control (CDC), rural areas have a higher suicide rate than non-rural areas, which has been widening since 2001.

This is a significantly complex and challenging problem that can’t be addressed with a single solution. However, there’s one bright spot that is starting to emerge – Telebehavioral health. The article provided the example of a patient in Wyoming “seeing” a psychologist in Pennsylvania via virtual sessions and online portals.

As promising as telebehavioral health appears, the article points out a host of other issues that rural residents face. Access to the Internet is one, being proficient with computers / technology another, and having the financial resources to access these mental health professionals.

To me, there needs to be a series of steps to tackle these issues. I don’t have all the answers, and I try to be as objective as possible.

There needs to be consistent investment in mental health services across the U.S. Every rural area that does not have a psychiatrist or psychologist should probably have at least one of each. The currently practicing doctors should be linked up to the existing mental health services, as well as be / become advocates for improving those services. Continued work to reduce the stigma of mental illness, addiction, and other mental health issues will also be beneficial.

Those support systems that people turn to in the event of a crisis – Family, friends, ministers, chaplains, and even first responders – should also have connections to mental health services. More mental health training for these support systems, specialized if possible, is also a good idea.

Throughout the network of ideas and potential solutions, the idea of making and sustaining connections and cooperation appears to be a common theme. In order to help the neediest residents, everyone involved with helping them should be educated, connected, and cooperative.

Example: Someone in a rural area is struggling with isolation and drug addiction, and overdoses. When the family member calls for an ambulance, the first responders take the resident to the local or nearest hospital. While recovering in the hospital, a series of people work behind the scenes to quickly identify others that can help – Family members, the hospital chaplain, the resident’s pastor, the resident’s primary care physician, and anyone else. Together, this network of resources work together to locate the nearest psychiatrist or psychologist, or even the nearest behavioral health center. The idea is to build a strong support system to get the resident the best mental health services possible.

This is strictly an example, but ideally, there needs to multiple levels of support and accountability for this to work. Every situation is different – Sometimes there’s no family, no primary care physician, difficulty accessing a behavioral health center, among other things. Regardless, if we invest in building these networks and support systems, maybe there can be a shift in crisis prevention, and less crisis intervention.


For more information, check out these resources. Several of these were also cited in the article.


Until the next headline, Laura Beth 🙂

Commentary #75: “The war on drugs failed. It’s time for a war on abuse.”

Honor Blackman

Image Credit: AZ Quotes

The headline grabbed me instantly. It spoke to me.

Here’s the link to the opinion that CNN published on their website on Friday, June 15, 2018:


Full disclosure: This was published under CNN’s Opinion section.

CNN also published this Editor’s Note at the top of the page: Natalie Schreyer is a reporter at the Fuller Project for International Reporting, a nonprofit news organization that covers issues impacting women and girls globally. She is working on “Abused in America,” a Fuller Project initiative to cover domestic violence in the United States. Jessica Klein is a journalist and co-author of the book “Abetting Batterers: What Police, Prosecutors, and Courts Aren’t Doing to Protect America’s Women.” The views expressed here are solely those of the authors.


I read this opinion. And then I re-read it. It stuck with me all weekend long. It’s still with me as I finish writing this post.

The comparisons that Schreyer and Klein make are staggering. After reading it several times, it makes complete sense to me.

Sure, I’m definitely biased here. I am a domestic violence survivor. I am an abuse survivor. Neither of these are ever okay. I’ve read several powerful memoirs and accounts of survivors (Tornado Warning), and stories of those who tragically lost their lives (If I Am Missing Or Dead: A Sister’s Story of Love, Murder, and Liberation) over the years. I don’t want to read new ones, if I’m being perfectly honest.

There must be harsher punishments for habitual offenders. The opening story for this opinion both broke my heart and made my blood boil – An alleged abuser has never been convicted of a crime, despite 160 encounters with police in 15 years. Quick math – That’s an average of 11 encounters per year. That’s too many.

One encounter is too many.

It took way too long for the current stalking laws to be enacted, and even now, those laws aren’t necessarily the same in every one of the 50 states (although it absolutely should be). The problem here is there’s a lack of consistency. The power is usually left up to the states, and that’s where many problems lie. Where you live is a huge factor, and it absolutely shouldn’t be that way!

But, what about all these non-violent offenders, in prison for decades on drug charges?

I could write a proverbial book. What the Nixon administration started in 1971 was a so-called “war” that will never be won. Presidents Reagan and H.W. Bush kept fueling the fire. I myself was in the D.A.R.E. program in fifth grade. I vowed to never smoke cigarettes after watching my grandmother, my dad’s mom. She lived with emphysema for more than 20 years. She also had COPD, and was on oxygen since I was a child.

Now, in 2018, our country has been facing the “opioid crisis” for several years. Like the authors argue, “addicts who need medical treatment more than criminal punishment,” is so true. And, sadly, not likely to happen. There is a lack of investment in mental health treatment and addiction treatment. Addicts need resources such as medical intervention, quality treatment facilities, quality therapy and/or counseling, and continued support for as long as necessary to keep them sober, stable, and functional.

Why? We have more people in prison for drug possession than mental health treatment facilities. These men and women (not all, mind you), unfortunately, re-offend and get sent back to prison because they can’t get a good, steady job after being released. Struggling to support themselves and their families, they turn to what they’ve known as their source of income. And they’re stuck in this vicious cycle that doesn’t seem to end.

When I think of an “addict,” I think of someone involved with drugs such as heroin, methamphetamine, or crack. The harder, more dangerous drugs.

To think of how many people (many are people of color, too) are in jail or prison for non-violent marijuana offenses makes me incredibly angry. I’ve been supportive of the interest to legalize / de-criminalize marijuana. But, that’s another story altogether.

There needs to be far more accountability on the domestic violence and abuser side, however. The authors pointed to a fascinating report from The University of North Carolina at Greensboro, which focused on High Point, North Carolina. When the focus was shifted toward cracking down on intimate partner violence, the number of intimate partner murders dropped from 17 (between 2004-2011) to just one (between 2012-2014).

Numbers are powerful. Seventeen murders dropped to one? Wow.

As I mentioned earlier, the current stalking laws took way too long to pass. Now, there really should be domestic violence courts in every state. The script should be flipped – Turn the thousands of drug courts (3,100 quoted in the opinion) into domestic violence courts. Problem solved? Maybe.

I’m not saying to get rid of drug courts altogether. What I’m saying is to shift the balance. Shift the balance of the number of courts, and maybe that will also shift the balance of power.

I certainly don’t have all the answers. I just feel strongly about the issues presented in this opinion. I hope more is done for all victims of domestic violence and abuse. No one deserves to go through the horror, shame, and terror. And this includes women, men, and children. There’s a lot of focus on women, but men and children are abused and violated every single day.


For more information, check out these resources. Many of these were also cited in the opinion.


Until the next headline, Laura Beth 🙂

Commentary #74: The “New Science of Psychedelics”

The New Science of Psychedelics

Image Credit: NPR

Many of you know that I enjoy listening to podcasts. One that I listen to regularly is NPR’s Fresh Air podcast.

This week, Terry Gross interviewed Michael Pollan, a world-renowned author. His books have typically focused on food and agriculture.

However, his new book, titled How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence, discusses the history of psychedelics, and the “new” uses of them to help treat anxiety, depression, and helping cancer patients face their mortality.

There have been two phases of clinical trials up until now, and the Food and Drug Administration (FDA) just approved Phase III, which is “testing of drug on patients to assess efficacy, effectiveness and safety.”

In researching for the book, Pollan himself became a “reluctant psychonaut” with LSD and psilocybin (magic mushroom) to see if these effects were real.

I won’t tell you Pollan’s results, but it’s a really interesting process. I recommend listening to the podcast version of the show, as it’s an extended edition, where Pollan and Gross discuss the history of psychedelics, which is so fascinating to learn. It’s amazing to learn how LSD was first synthesized, and how it has had a turbulent history. Pollan also discusses psilocybin to an extent, which is another interesting part of the story.

For me, I was definitely more than a little skeptical. I’ve never used any drugs or psychedelics in my life. I’ve seen counselors and therapists.

However, Pollan lessened my skepticism a bit during his interview with Gross. One of his interview subjects was a woman who had survived ovarian cancer. She was absolutely terrified of it recurring, and she was paralyzed with fear. She found a guide, a therapist who administered small doses of one of these psychedelics, and helped her along her trip. She discovered this “black mass” underneath her rib cage during the trip, and originally though it was her cancer. The guide helped her understand that it wasn’t cancer, but in reality it was her fear and anxiety. During the trip, she commanded the black mass to leave her body, and it did.

When Pollan’s fact-checker called to verify her account right before the book’s publication, Pollan’s original words were something to the effect of “this black mass was significantly reduced after her experiences with psychedelics.”

The woman corrected the fact-checker over the phone and said, “No, it wasn’t ‘significantly reduced.’ It was extinguished.”

Again, some of my skepticism remains, but as someone who has a diagnosed anxiety disorder (GAD), hearing the woman’s story gave me hope. I truly believe these psychedelics helped her.


For more information, check out the following links:


Until the next headline, Laura Beth 🙂

Commentary #68: “Support Systems” (Reblogged)

I’ve been following Sara’s blog for quite a while. Her poetry is beautiful. She does fun Questions of the Day every now and then.

She also makes the time to reply to every comment that is posted. She’s so sweet, and incredibly supportive!

I wanted to share this post of hers about support systems. It’s a long one, but she pours her heart out. I know I’m glad I took the time to read it.

Sara, you’re an awesome person!


Until the next headline, Laura Beth 🙂

Sara in LaLaLand

For a large portion of my life, I have felt that I have not had a very strong support system. Growing up, I was not taught how to talk about my feelings, I was encouraged to shut them down. It was not until I was living in “the real world” that I noticed the way I expressed myself was not normal, but it was the only way I knew. I did not have the kind of parents you could talk to about anything and everything.

I first experienced death when I just turned 10 years old and I did not know how to deal with such a thing. I was not talked through loss. I was given the news and then left to my own devices. I even remember some cruel kids mocking how this person died. I was lost at that point and from here is where I started building…

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Commentary #58: “The women who don’t know they’re autistic”

Autism Speaks

Image Credit: Autism Speaks

I stumbled upon this article via Facebook back in July. I thought it was fascinating, and it prompted me to learn more about autism.

Here’s the link to the original post:


The article primarily focuses on what’s known as “high-functioning” autism in women. This means autism without intellectual disability.

According to the American Association on Intellectual and Developmental Disabilities:

Intellectual disability is a disability characterized by significant limitations in both intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. This disability originates before the age of 18.


For years, it’s been studied, and widely publicized, that more boys than girls are diagnosed with autism.

Autism is defined as the following:

a mental condition, present from early childhood, characterized by difficulty in communicating and forming relationships with other people and in using language and abstract concepts.

It’s estimated that 1 out of 68 children in the United States are on the autism spectrum. For boys, it’s around 1 in 42.  For girls, it’s around 1 in 189.

Some of autism’s signs can now be recognized as early as 18 months of age, but are usually identified and diagnosed between the ages of two and three.

Parents are encouraged to seek evaluation of their child without delay. Early intervention can improve outcomes.

In 2013, all autism disorders were merged under one umbrella diagnosis of Autism Spectrum Disorder (ASD). Previously, they were distinct sub-types,  including autistic disorder, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS), and Asperger Syndrome.


Despite more childhood diagnoses, it’s becoming more common for people to be diagnosed as adults.

According to the Madison House Autism Foundation:

  • Those with autism may have exponentially acute senses. Bright or fluorescent lighting can be overwhelming. Loud sounds and crowds of people may be as well.
  • The ability to concentrate for long periods of time on one thing, and their attention to detail is something those without autism find enviable.
  • They are often highly visual people, and many have found ways to communicate through multiple mediums besides with words.
  • Those with autism may avoid eye contact with other people and, because they often take language literally, may have difficulty with metaphors, humor, and sarcasm. Interpreting what others are thinking or feeling is challenging because they have difficulty understanding social cues, such as tone of voice or facial expressions.
  • It is a myth that those with autism are unable to feel empathy.
  • Those with autism think, process, and behave differently than neurotypical individuals.

As renowned animal rights activist and professor Temple Grandin says, they are “Different, but not less.” They can, with support and slight modifications, become assets to every community and the workforce.

The main point I’m trying to get at – Individuals with autism are individuals. They are amazing. They may think and behave a little differently than others, but it’s important to recognize them and appreciate them.


The original article provided and cited a variety of sources:


This article shone a spotlight on women and how we can recognize smaller, less noticeable signs of ASD.

  • Compensating for communication impediments they may not be consciously aware of.
  • Not being good at guessing what people are thinking.
  • Hypersensitivities – Smells, sounds, bright lights, etc.
  • Reduced sensitivity to pain.
  • Misdiagnosed psychological disorders.
  • Taste for solitude.
  • Intensity of passions.
  • Talking about one subject / topic for extended periods of time, longer than normal (i.e., spending hours focusing on one thing in particular and not deviating).
  • Not wearing jewelry because of the way metal feels on the skin.
  • Not wearing certain clothing because of sensitivity to fabrics, tags, buttons, zippers, etc.

Given some of these signs and symptoms, it’s fairly easy to interpret or assume that a woman may be an introvert, be shy, have an undiagnosed anxiety disorder or obsessive-compulsive disorder (OCD), a speech impediment, or some form of a developmental or intellectual disability.

As the article indicates, ideally, a lot of women being diagnosed with autism as adults could have / should have been diagnosed as children. Luckily, these childhood diagnoses are improving every day. Leaps and bounds have been made in the last 20-30 years, and research is ongoing. However, doctors and psychologists alike need to remain vigilant, and keep a close eye on young girls exhibiting similar signs and symptoms, especially since autism symptoms in girls have appeared to be less obtrusive than those in boys.


For more information, here are some more links and resources. Education is so important. Continual learning and studying will help all of us better understand ASD, and start to take away the stigma!

I have immense respect for those who work in special education, work with individuals with ASD, and parents that have children with ASD. My hat goes off to all of you!

 


April is National Autism Awareness Month. The Autism Society encourages everyone to join them in promoting awareness, action, inclusion, acceptance, and appreciation.

World Autism Awareness Day is April 2nd of every year. It’s one of only four official health-specific United Nations (UN) days.

Several movies have been released, featuring prominent characters with autism or ASD behaviors. Children of the Stars is an award-winning documentary about children with autism in China.


What do you think? Do you know someone that is autistic?

Do you have any ideas about how to help those with ASD?


Until the next headline, Laura Beth 🙂

Commentary #46: How The U.S. and Others Work with Mental Health Issues (Follow-Up to “A 700-Year-Old Haven for Mental Health”)

quote-on-mental-health-91-healthyplace

Image Credit: HealthyPlace.com

Back in October (Wow! Where did the time go?) I wrote a post about the amazing town of Geel, Belgium, and their remarkable approach to mental health and helping those in desperate need of care.


In case you missed it, here’s the link to the original post:


In my original post, I mentioned how I wanted to research how the U.S., other countries, and even other continents approach mental health issues, and how they are addressing them.

Are they like Geel? Or completely different?

It’s taken a long time to compile this research, so bear with me. My eyes have certainly been opened!


Through my research, it’s become clear to me that the United States in particular has a long, long way to go before reaching a place like Geel. Stigma is everywhere. However, I found some encouraging articles and resources.

The Washington Post published an article entitled Three innovative ways to address mental health issues in June 2014. This article focused primarily on children’s mental health, but this is as equally important, if not more so, to devote time and resources as adult mental health.

Published through Samford University in Birmingham, Alabama, the web page titled Community Recovery in the United States was intriguing. There are established programs modeled after Geel in the U.S., but only in certain states. This makes me wonder if there could be community recovery programs eventually established in every state, so that anyone can have access? Granted, this page has not been updated since 2009, but still, I like that these resources have been highlighted.

In Philadelphia, Pennsylvania, Temple University has created a unique Rehabilitation Research and Training Center that focuses on helping those with psychiatric difficulties be independent in their communities: Temple University Collaborative on Community Inclusion of Individuals with Psychiatric Disabilities.


Around the world, there are several organizations that have mental health initiatives. However, there is still much work to be done to help those with mental disorders.

In an article from Wake Forest University in North Carolina from November 2009, Addressing mental-health issues around the world discussed the Mental Health Facilitators (MHF) program that started through a request from the World Health Organization (WHO).

From the Huffington Post in April 2016, Addressing Global Mental Health Challenges and Finding Solutions was a blog post about the author’s work with the International Medical Corps and other non-government organizations (NGOs) to help address these crises all over the world. In 2016, it’s incredibly sad that nine out of 10 that have mental disorders do not receive basic treatment.

Published on August 1, 2016 by the BJPsych Bulletin (Royal College of Psychiatrists, a charity registered in England, Wales, and Scotland), this fascinating article entitled Lessons to be learned from the oldest community psychiatric service in the world: Geel in Belgium was an exploration of the family foster care model that’s worked for so long.


On December 14th, I discovered some encouraging news from my own state of Virginia:

This was published by Richmond news station WRIC.

I read and re-read this article, at least three times. This proposal is full of promise, but it’s just a proposal. Thirty-one million dollars is good chunk of change, but I’m a bit skeptical. I hope it will come to fruition, but it’s going to take time.

I plan to keep following this particular story very closely.


In addition, here are other resources that you may be interested in:


Final Thoughts

It was frustrating and a bit disheartening to write this post, hence why it took so long to finally publish. As someone who has Generalized Anxiety Disorder (GAD), it’s hard to read statistics and stories that show so limited resources, historically, being dedicated to mental health.

However, I’m happy that more attention is being given, and that more organizations are working every single day to make changes. I’m glad there are resources available to many, but it would be nice to see equal resources be available to all. That herculean effort takes time, money, and dedication.


Until the next headline, Laura Beth 🙂

Commentary #45: A 700-Year-Old Haven for Mental Health

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An aerial view of Geel, Belgium. Image Credit: Tripwolf

“She made broken look beautiful and strong look invincible. She walked with the universe on her shoulders and made it looks like a pair of wings.”

~Unknown


Thanks to Facebook Memories earlier this week, I was reminded of an exceptional town in Belgium that has adopted a completely different approach on helping those that need help with their mental health.

Here’s the link to the original story:

I shared this story on Facebook in October 2015. I remember reading with great interest at the time, but then I filed it away in my brain.


Then, at the beginning of July, Geel re-entered my life.

Remember my recent post on podcasts?

One of the seasonal ones is NPR’s Invisibilia. I kept hearing about it in promos during other NPR podcasts. I subscribed in the spring of 2016, eager to listen to season 1 and prep for season 2.

Then, on July 1st, they released the episode titled, “The Problem with the Solution.”

The episode focused on Geel, and how the hosts went to Belgium to see this idea for themselves.

I remember being rapt with attention in my car during my work commute, hanging on every word.

I couldn’t get it out my head.


Seeing the article from Upworthy made me curious about how the U.S. helps those with mental health issues. Other countries and continents, too – Not just Europe. I’m thinking about Africa, Asia, and Australia. What about China, or Japan?

Over the next few weeks, I plan to research this and do a follow-up post with my findings.


Final Thoughts:

I find Geel’s approach fascinating. It’s interesting that the boarding population has decreased to due a reduction in the number of host families, but I think that’s part of the cycle. The inference that there’s a decreased need for farmhands makes sense.

It’s hard to believe that this one town has done this giving for 700 years, but i think it’s awesome. I’m excited to do more research, to see how the U.S., Canada, and other countries work with mental health issues.


Until the next headline, Laura Beth 🙂