Let’s address mental health catastrophe

Editorial by Emerson Lynn in the weekend edition of The St. Albans Messenger

Vermont’s mental health system is reportedly on the edge of a “catastrophe”, according to a Vermont Public Radio story this week.

The problem, as with many businesses in Vermont, is a workforce shortage Our mental health agencies can’t find enough people to staff their operations, meaning that Vermonters who depend on the organizations for mental health services and substance abuse treatments can’t get help and are essentially at the tail end of the health care system in terms of their needs being met.

That shortcoming affects one out of every five Vermonters according to state and national statistics. It’s also a circumstance made more intense by COVID-19 and the accompanying isolation and stress. What we’re experiencing is a lot of people waiting in emergency rooms for help, yet there are few places where those beds are available, compounding the sense of urgency.

This is playing out right here in Franklin County; Northwestern Counseling and Support Services is down between 30-40 positions. Our mental health provider has never been over-staffed, so being down that many positions puts additional pressure on the existing staff, and it means that it’s more difficult to meet their patients’ needs.

According to the VPR story, Mary Moulton, executive director of Washington County Mental Health, says she is down 80 positions and that the waitlist for outpatient therapy services stands at 120 people, almost double the highest number she’s experienced in her 30 years in the business.

So what’s the issue? Pay. Mental health agencies are tied to Medicaid reimbursement levels and it’s not enough. Employees are leaving for better pay elsewhere. COVID has accelerated the exodus.

There are a variety of options, including things like helping with tuition reimbursement, loan repayments, child care subsidies, etc. But they amount to the same thing which is to increase the disposable income of our mental health workers and operations.

To be successful will require a rebalancing of the public’s health care needs. The public’s mental health care needs should be funded on par with what we pay for our physical health. That make sense for two reasons: first, one’s mental health is no less critical than one’s physical health and second, people with mental health conditions are at high risk for experiencing chronic physical conditions. In other words, properly funding our mental health needs also reduces the pressure on the rest of our health care system. Our mental and physical health are fundamentally and inextricably linked.

As the research shows, poor mental health is a risk factor for chronic physical conditions and 84 cents out of every health care dollar goes to treating chronic disease. Obviously, it makes complete sense to spend money where it does the most good, which means dealing with our mental health care needs in a way that also reduces the pressure on people’s physical health.

The fundamental exercise here is to publicly connect the link between mind and body, accepting that one is as important as the other. We’ve been late to this conversation. It’s cost us dearly. It’s time to correct the imbalance.

Before the “catastrophe.”