Mental-health provider shortages compound problems getting care

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Clik here to view.For many area residents struggling with mental illness, insurance problems are just one barrier to getting the help they need. Another is finding professionals to treat them.

“We have a huge shortage of mental health providers,” said Sheila Schuster, who heads the Kentucky Mental Health Coalition. “You might have the benefit, but not be able to find anybody. The community mental health centers are struggling to stay open” and funded.

A state-commissioned health workforce report from Deloitte Consulting said the current supply of mental health providers totaled 8,538, and 1,638 more providers were needed just to meet current demand. And this shortage is expected to grow as health reform begins in earnest in 2014, and more people gain insurance.

The Deloitte report found:

• More than 80 percent of Kentucky counties need more mental health providers, with 10 percent of counties needing at least 25 more.

• Seventy percent of the current need is in rural counties. Jefferson County, the state’s most urban and populous county, was not listed as needing more mental health providers.

• The need is greatest for people who are uninsured or on Medicaid.

That shortage comes against a backdrop of years of stagnant funding in Kentucky for mental health services. The state ranks well below the U.S. average in per capita funding.

Tony Zipple, president and chief executive officer of Seven Counties Services, said the need is particularly acute for certain types of professionals, such as psychiatrists in rural areas.

April Blevins of Bardstown, Ky., who has battled severe mental illness in recent years, said there are few psychiatrists in her town with open appointments, and she has often had to drive to Louisville or elsewhere for inpatient care.

“It’s hard to find proper care,” she said.

That’s particularly true when someone needs inpatient or residential treatment.

Statistics from the U.S. Substance Abuse and Mental Health Services Administration show that Kentucky has 179 mental health facilities, with only 32 providing inpatient care and 40 providing residential care. Indiana has 227 mental health facilities, the agency shows, including 48 offering inpatient care and 54 providing residential care.

But officials said they realize they need to improve access to care with more set to join the ranks of the insured through health exchanges and expanded Medicaid in Kentucky.

Larry Kissner, Kentucky’s Medicaid commissioner, said outpatient mental health is currently provided at designated community mental health centers, which can subcontract to master’s level health care providers.

But in light of the Affordable Care Act, he said there’s a possibility that Medicaid will open up the network to allow direct access to master’s level providers, and expand telemedicine, which allows mental health professionals to treat people from a distant location.

That possibility, coupled with the promise of greater parity in mental health insurance, could go a long way in improving care for the mentally ill, Blevins said.

“That’s the biggest problem everyone has — if you can find (mental health care), you can’t afford it or you have to travel for miles,” she said. “I’m really hoping all this helps.”