Wednesday, October 25, 2017

Mental-health help scarce in Appalachian coalfield

A story from Kaiser Health News highlights the difficulty many rural Appalachians face in trying to get mental-health care. The story zeroes in on Wyoming County, West Virginia, where a visit to the nearest psychiatrist can be time-consuming and expensive, and lengthy wait times between appointments are the norm. "There are no psychiatrists in Wyoming County. A handful of small, general medical practices, a small telemedicine program and a few behavioral health specialists handle services for the 21,763 residents. Patients’ issues — ranging from depression, anxiety, addiction and other mental health concerns — are aggravated by the local economic downturn," Vickie Connor reports.

Local general practitioner Joanna Bailey told Connor that about 30 percent of her caseload is mental health care, which is "way more" psychiatry than she's comfortable with, but does send patients who need specialized help to the closest psychiatrist in Beckley, W.Va.  But many patients don't drive and must rely on a van service or relatives to ferry them, and it can take more than a month to get an appointment.

A Wyoming native, Bailey says the economic downturn from the collapse of the Central Appalachian coal industry has caused a lot of the trauma her patients face. “We haven’t had growth, and a lot of people are unemployed right now," she told Connor. "That’s traumatic to families on every level."

Untreated mental health issues can cause a "vicious cycle" for parents and children. "Those children grow up with the same mental-health issues because they’ve watched the same unhealthy relationships their whole life," Bailey said. "It’s just a cycle of abuse and trauma." It can also contribute to other health issues such as chronic pain and substance abuse.

To help general practitioners treat mental health patients, West Virginia University has a program called the Extension for Community Healthcare Outcomes, which provides specialists from the college for rural health care providers to consult with. The university recently received a federal grant to provide psychiatric services through video conferences to residents in Wyoming and McDowell counties.

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