Rural Idahoans lack access to mental health care; expanding Medicaid would have helped

Like many mostly rural states, Idaho suffers from a shortage of doctors. But Idaho's rural residents have limited, or in many cases, no access to mental health professionals, Daniel Walters reports for Boise Weekly. About 33 percent of Idaho residents live in the country, and 25 percent of the state's residents lack access to a psychologist or psychiatrist, meaning residents are forced to hit the road, sometimes driving five hours from home, to get treatment. Others receive treatment from doctors in Boise through telepsychiatry services. (Weekly photo: Dr. William Terry, left, and Dr. William Hazle meet with rural patients via a computer)

Idaho ranks last in the number of psychiatrists per person, according to 2012 Kaiser Family Foundation data, and is also last in mental health funding, Walters writes. "The state is rural and underfunded with a high incidence of mental illness. Despite its sky-high suicide rates, it was the last state in the nation to get a suicide hot line."

Of the 1.5 million Idaho residents, 72,000 suffer from mental illness, including 18,000 children, according to a 2010 report from the National Alliance on Mental Illness. In 2006 the state spent just $46 per capita on mental health agency services, which amounted to only 1.3 percent of state spending that year.

In 2006 the state allotted 59 percent of state mental health spending to community mental health services, well below the national average of 70 percent. The state also spent 33 percent on state hospital care, higher than the national average of 28 percent. The state's public mental health system only provided care to 16 percent of adults who suffer from serious mental illness. (Read more)

Financial problems stem from the recession and from the Republican-led state's decision not to expand Medicaid under federal health reform, Walters writes. From 2008 to 2012 the impact of the recession led state mental health care funding to decrease by more than 28 percent, while federal funding dropped by nearly 50 percent. Meanwhile, if Idaho has expanded Medicaid, the state would have saved more than $400 million across 10 years, according to a report from the Idaho Workgroup.

"Idaho's Health and Welfare department is intended to fill a gap, providing mental health care for those without access to insurance or Medicaid," Walters writes. "To balance the budget, Idaho eliminated redundancy. In the summer of 2010, 451 mentally ill Idahoans were kicked off state coverage and onto Medicaid or private insurance." (Read more)