'We're sinking': More anxiety, more violence and a shortage of healthcare workers in North Carolina

‘We’re sinking’: More anxiety, more violence and a shortage of healthcare workers in North Carolina

NC Health and Human Services Sec. Kody Kinsley discusses the mental health landscape.

State lawmakers speak out at town hall on mental health

“My friends, we have a massive mental health issue,” Sen. Jim Burgin (R-Harnett) told a packed room at a Kannapolis town hall last week.

Sharing the stage with North Carolina Health and Human Services Secretary Kody Kinsley and three other Republican lawmakers, Sen. Burgin said lawmakers want to hear directly from the public about mental health and addiction issues before the next legislative session.

The percentage of American adults with symptoms of anxiety or depression has nearly quadrupled during the pandemic.

“Usually, in any given week, one in nine people would say, ‘I feel lonely, depressed or a little anxious.’ Over that time, that number has risen to one in three, disproportionately among younger people,” Kinsley told the audience.

The 2022 Mental Health America report ranked the state 21st for adult mental health, but 42nd for youth mental health and 38th for access to care.

More than half (51.6%) of North Carolina adults with mental illness receive no treatment.

Trauma as a common denominator

Gwen Bartley, executive director of Amazing Grace Advocacy, said the county’s mental health task force recently focused on the threat of mass shootings.

“We recognize that trauma has been a common denominator in many national tragedies. So we wonder if North Carolina is conducting research or providing information to communities to do preventative work with regards to mass shootings that focuses on trauma and behavioral health aspects? »

Second. Kinsley agreed that gun violence was more common. Five North Carolina residents die each day from gun-related deaths, up from more than 1,700 in 2020.

He recounted the October 13 mass shooting in the Hedingham neighborhood of Raleigh that left five people dead. The Chief Medical Examiner’s Office worked through the weekend to perform autopsies on the victims.

“And then two days later a two-year-old crawled into the back seat of their dad’s truck and shot a gun and killed himself, and we had to take that body as well.”

Kinsley said that in addition to discussing trauma, the state needs to focus on the safe storage of guns.

“Everyone wants to protect their family, if you need quicker access to a gun then there is a gun safe. 4-H staff talk about safe shooting training – it’s as much about knowing how to respect a firearm as it is about leadership and civic duty.

Kinsley believes that a multi-level public health approach can improve community safety.

“Thinking [of it] similar to how we think of traffic accidents. There is no one-size-fits-all solution to trying to reduce road traffic injuries. In 30 years, we have been able to really reduce the number of people who have had accidents and people who have been injured thanks to a multi-level approach. We didn’t say one size fits all, we met people where they were and tried to change behavior over time. There were seat belts, speed limit signs and airbags for people who weren’t wearing seat belts, an array of different things. And I believe we can do the same around violence.

The NCDHHS has just released a ten-page white paper on approaches to reducing gun misuse and mitigating violence. It is estimated that 32% of youth firearm suicides and accidental firearm deaths could be prevented through safe storage.

“Who comes to work for us and does this kind of work?

Next, a veteran health care provider from Winston-Salem raised concerns that residential facilities that care for people with behavioral needs are increasingly closing due to low wages and onerous demands. .

“We talk about the kids and how we want to support them, but the state isn’t helping third-level residential providers to keep the kids and stay open.”

Pam Phillips explained how a little-known law passed by lawmakers in 2015 required her establishment to hire workers with at least a year of experience, even for the most entry-level jobs.

“People who have experience, they don’t come to work for us for what we can pay. They’re not,” Phillips said firmly.

“I got into this because I was sick of seeing these misdiagnosed kids being sent to county jail, so this is real to me.”

Phillips, 65, said she has been trying to find out where this law came from for four years in hopes of getting it changed. Until that happens, she cannot accommodate any more patients at the Triad Home which provides care for young men.

“We need help. We’re sinking. We’re at the bottom of this sanity structure and we can’t hire anyone.

Phillips said when Arby’s can offer a starting salary between $17 and $22 an hour, his behavioral health facility can’t compete.

“Who comes to work for us and does this kind of work? Philip asked. “I was spat on and everything. But I keep praying and moving forward.

Opioids wreak havoc

Dr. Russell Suda, an obstetrician in Kannapolis, told lawmakers the state needed to do more to help pregnant women who are also drug addicts.

The opioid epidemic began in the 1990s primarily as a male issue.

“But by 2010, we’ll have more women coming to the ER for overdoses. More and more women are coming to rehab,” Suda explained. “Men still outrank women in successfully committing suicide, but women do it more often.”

“What I am pleading here is to provide care to pregnant women as a priority.”

Too often, Suda said, doctors are unwilling to treat pregnant patients with addictions, fearing possible malpractice lawsuits against them.

Programs like the Cabarrus Health Alliance (CHA) SUN Project provide prenatal care and clinical services to women with substance use disorders.

Suda said trying to keep mothers and babies together can be one of the best strategies for breaking the cycle of addiction and keeping families together.

“Every dollar you spend saves you seven dollars on criminal justice work, on health care work, on social services, on all these other expensive related services,” Suda reminded the panel.

Do it right, not fast

Addiction was also on the mind of Mary Beth Poplin, nurse manager of behavioral health services at Atrium Health Cabarrus.

“I have a front row seat in the emergency department, and I can tell you I have ten kids there right now.”

With nearly forty years in the medical field, Poplin says she’s learned what works and what doesn’t.

“You’re not going to fix anything in five days. I can’t get someone sober in five days. If you want to get someone off drugs and alcohol I need a 30 day inpatient treatment center where they go through stages one, two and three and they get a temporary sponsor and then they don’t come back to my ER,” Poplin explained.

She told lawmakers that when it comes to programming, you can’t put a band-aid on a hemorrhage.

Patients need time to recover from mental health and addiction issues, not to be discharged after a few days hoping that will result in a better outcome.

“Take time to do it right, not quickly.”

The elephant in the room

Keshia Sandidge, a clinical social worker and member of the Cabarrus County school board, asked the question that was on the minds of many in the room.

“When are we going to expand Medicaid here in North Carolina?”

The North Carolina Senate passed a bill to expand Medicaid in June, only to have the legislation bottlenecked at the State House. That night, Sen. Paul Newton (R-Cabarrus) seemed content to let House members have the upper hand.

“We recognized the financial benefits for the state. We recognized that this is a window for those financial benefits that could close. We also recognized that the population we are talking about are not scoundrels, they are people who work, but earn too much money to qualify for Medicaid.

“Long story short, we’ve decided it’s in the best interest of the people of North Carolina to grow. Our colleagues in the House had a different take on that. I’ll let them respond,” Newton said. with a smile.

Rep. Kristin Baker, MD (R-Cabarrus) said Medicaid Transformation has finally put the state in a position to consider Medicaid expansion, but it has to be a bill of its own.

“If it’s not just Medicaid expansion, we have to look at everything else in this bill, and we have to make a trade-off between risk and benefit,” said Baker, a practicing psychiatrist. “It’s complicated, we have to do the right thing for our citizens in health and fiscal terms. We have to make sure it’s a good bill throughout the process.

Sandidge held firm.

“I appreciate that we have a lot of problems. I totally agree with that,” Sandidge replied. “But you are the ones we have appointed to answer it. So we expect you to do that.

Lawmakers will have another chance to tackle Medicaid expansion in January. Every month that passes without expansion, the state misses $521 million in federal funding according to Kinsley.

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