Access to Care -- Assessing barriers to mental health care in Putnam County

Wednesday, March 14, 2018

The recent tragedy in Florida has brought the issue of mental illness, violence and the need for treatment into daily conversations. Mental Health America of Putnam County believes this horrible event provides an opportunity to review issues related to mental health and treatment.

Unfortunately, it appears necessary to remind ourselves that the connection between mental illness and violence is weak. To quote Dr. Louis Kraus of Rush University Medical College "the concept that mental illness is a precursor to violent behavior is nonsense." In fact, repeated studies show that persons with "mental illness" are less likely to commit acts of violence than the general population but are more likely to suffer from acts of violence. However, there are real costs such as personal suffering, disrupted relationships and impaired work and academic performance when people do not receive needed mental health services. Some of these costs may not come with a dollar sign, but the estimated cost to the U.S. economy due to mental illness is around $193 billion /year. Another practical cost is incarceration: 20 percent of adults in prison/local jails have a recent history of mental illness and 70 percent of youths in the juvenile justice system have at least one diagnosable mental health condition. Statistics show it cost about $32,000/year to incarcerate someone in the Federal system, while it cost about $18,000/year in the Indiana system. While it is not possible to know how many people would not have been incarcerated with adequate mental health care, mental health and law enforcement professionals believe the numbers would be significantly reduced at great savings in money and pain for individuals and society as a whole. With regards to Putnam County, statistics suggest more than 7,000 adults and 1,000 teenagers in Putnam County will deal with significant mental health issues each year. All of these individuals -- our neighbors, co-workers, friends and family members -- are vulnerable to all these costs. Even if we as a larger community do not care about the subjective costs for our neighbors, the community faces the financial burden previously described. It is obviously in everyone's best interests for humanitarian and financial reasons to provide mental health treatment.

The first step in getting mental health treatment is being able to access it. According to Mental Health of America's 2018 State of Mental Health in America report Indiana ranked 48th of the 50 states in general need for mental health services and 45th in the number of adults with unmet mental health care needs. According to these data, Indiana has the highest rate of youth among all states with a major depressive episode (14.6 percent) and 37 percent of Hoosier adolescents with depression (about 37,000 teenagers) do not receive treatment. Why don't people get mental health treatment? While it is difficult to know why any individual does not obtain treatment general barriers to care have been identified. Studies identify the top two barriers as cost and limited numbers of mental health professionals. How do these barriers impact Indiana? Data show over 250,000 Hoosier adults could not afford to see a doctor for their mental health needs. A related finding shows Indiana was 38th in the number of adults with health care insurance. Access to care is limited by the number of providers: Across the U.S. as a whole there is one mental health professional for every 529 residents but only one per 730 in Indiana (44nd of 50). These data show significant challenges for Indiana residents on the two primary barriers for accessing mental health care. There is reason to believe the problems are worse in a rural community like Putnam County where services are concentrated in the larger communities so that our neighbors in smaller towns face longer travel times, greater fuel costs and more disruption to work or school to attend treatments. What can be done to address these issues? Mental Health America of Putnam County is working in partnership with Cummins Behavioral Health Center, Hamilton Center, Putnam County Department of Child Services, Family Support Services and Beyond Homeless to try to identify the barriers specific to our community to that we can develop and implement plans to make it easier and more affordable to obtain treatment. We invite interested residents to partner with us by sharing thoughts and suggestions or personal information regarding problems accessing care. By gathering information, we can target the most significant barriers in our community and identify the steps we as a community are able to take. If you have information or experiences to share, please communicate with us either by phone 653-3310 or email ( Only by actually knowing what the problems are can we make effective change.

Mental Health America of Putnam County Board of Directors

Bill Nunn, President

Jan Hodges, Vice President

Pam Lage, Treasurer

Mary Zerkel, Secretary

Austin Malayer

Dan McMurtry

Diana Meo

Harriet Moore

Christina Wagner

Carl Waterman

Lucy Wieland

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    Dr. Louis Kraus's burden-of-proof persists: Go ahead and believe his Ivory Tower calculation that mental health illnesses are agnostic of violence. While you're at it, give me a few minutes to fill you in on a contract sale I've whipped up on this here napkin concerning a parcel of land I own down in the Bahamas...

    Keeping in mind that this guy isn't a Psy.D. (or even a Ph.D.), I his numbers even count people with sporadic breakdowns that resulted in a mortality? Probably not... It might explain his perception of lacking correlation, but whatever...

    Good mental health services are hard to come by, especially when you need a couch for the catharsis sandcastles some shrink charges you $300+ per-hour to build from your broken brain...but a lot of today's issues have nothing to do with that. Rather, it's more of an "everyday life stress in general" issue: Peoples' bucket of emotional-psychological capacity has reached the rim and now they're finally starting to cap things off (no pun intended).

    Adding to this, I also think there's an as-yet misunderstood byproduct of peoples' current symbiosis with technology that nobody wants to admit exists or else is just too deluded with to appreciate (or, maybe even too overwhelmed from to even have a vague idea about how to approach).

    -- Posted by DouglasQuaid on Wed, Mar 14, 2018, at 10:28 PM
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