Mental-health disorders are commonplace; experts say more resources needed

Mental illness ultimately affects us all. It is found in every facet of our society -- at home, in school, in the workplace and on the street.

One in four people suffers from mental illness during a given year. One in 17 lives with a serious mental illness such as schizophrenia, major depression or bipolar disorder, according to the National Alliance on Mental Illness website.

The alliance estimates more than 61 million Americans experience mental illness a year. said John Hudak, executive director of the Community Counseling Center.

The center, based in Cape Girardeau, largely is funded by tax dollars. In addition to some property-tax money, the center receives funding from the Missouri Department of Mental Health and the federal government's Medicaid program.

Hudak said there are more than 400 mental-illness diagnoses, adding to the complexity of the issue.

In addition to the human cost, there is an economic cost to mental illness. Serious mental illness costs the United States more than $317 billion annually in productivity losses, health-care expenses and disability payments, according to the Missouri Department of Mental Health. In Missouri, the annual cost is estimated at $6.8 billion.

Violent acts in recent years have raised public awareness of mental illness and made it a part of the national conversation.

But violent episodes are a small part of the overall issue of mental illness.

"Most people with mental illness are not violent," Hudak said.

He said mentally ill people often find themselves victims of violence rather than being the perpetrators.

Case in point, one area resident with mental illness was robbed three times during the Christmas season, he said.

In Missouri, state and local officials increasingly have pushed for more resources to better address mental illness. The Cape Girardeau City Council has approved a plan to spend $92,000 annually on adding mental-health services to the police department if voters approve a use tax in April.

City manager Scott Meyer said, "We ultimately want to get folks help so they can have a better life."

Cape Girardeau police routinely encounter mentally ill people. The department regularly receives 911 calls from people reaching out for help, Meyer said.

Area law-enforcement officers received extensive training last week on all aspects of mental illness. The training at the Cape Girardeau police station dealt with everything from the effect of mental illness on people and families to suicide intervention and assessing need for treatment.

The Community Counseling Center treats about 7,500 clients with mental illness -- everything from depressive disorders to schizophrenia -- who live in the five counties of Cape Girardeau, Perry, Ste. Genevieve, Bollinger and Madison.

But those numbers don't tell the whole story.

"Many people may not know they have a mental illness," Hudak said. Others, he said, often are in denial.

The center's five counties have a population of more than 137,000. Based on the 1-in-4 ratio, the region would have more than 34,000 people who would experience some type of mental illness per year.

Hudak said many of the center's clients are walk-ins. Others are referred by doctors, family members, friends or current clients.

"Mental health is definitely a public health issue," said Jane Wernsman, director of the Cape Girardeau County Public Health Center. Wernsman said people with mental illness often have substance-abuse problems, too, that can lead to physical-health issues such as heart disease.

Wernsman said mental illness not always is visible to the general public.

"It is not as obvious as a rash or sneezing," she said. "It is kind of one of those hidden things."

Mental health was identified as a top priority in the 2015 Cape Girardeau County health assessment, she said.

According to the report, 1,880 Cape Girardeau County residents received treatment for serious mental illness at publicly funded facilities in 2013. That same year, the vast majority of mentally ill patients treated in hospital emergency rooms in the county ranged in age from 15 to 64. Nearly 30 percent were in the 25-to-44 age range.

Mental-health experts contend there is a shortage of resources to serve the mentally ill. According to the 2015 health assessment, Cape Girardeau County has one mental-health provider for every 413 residents, based on the county's total population. In Missouri, the ratio is one provider for every 632. Nationally, the ratio is one provider for every 386 people. Mental-health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists and advanced-practice nurses specializing in mental-health care.

The Community Counseling Center has a staff of about 350 people. Still, Hudak said the region would benefit from more mental-health professionals.

"The system needs more resources for everybody," he said.

Sharon Braun, director of public relations for the center, said a shortage of psychiatrists has led the organization to rely on tele-psychiatry at times. Clients, in some cases, talk to a psychiatrist in St. Louis, she said.

"It works very well. We have had that in place for several years now," Braun said.

A significant number of mental-health patients are hospitalized or incarcerated. Over 50 percent of inmates in the nation's jails and prisons and about 65 percent of juveniles involved in the criminal justice system have a mental-health condition, the National Alliance on Mental Illness reported in 2015.

Cape Girardeau Sheriff John Jordan said, "Jails have become a dumping ground for the mentally ill."

Jordan's department plans to add a part-time mental-health coordinator to the staff this year in an effort to assess which inmates have mental illnesses that would be better addressed in mental-health facilities.

"The more mentally ill folks you put in jail, the risk of suicides goes up," Jordan said.

Hudak said it is less costly to treat the mentally ill in outpatient settings than with hospitalization or imprisonment.

Hospitalizing the mentally ill depends in large part on bed space. Cape Girardeau police "often have a hard time finding a place to put them," Meyer said.

Across Missouri, only 50 hospitals have psychiatric units, including five in Southeast Missouri. Statewide, there are nearly 2,100 psych beds, but only 152 of them are in Southeast Missouri, the Missouri Department of Mental Health reported.

In Cape Girardeau, Southeast Hospital operates a 15-bed psych unit. Saint Francis Medical Center doesn't have such a unit. The bulk of the region's psych beds -- 125 in all -- are in hospitals in Hayti, Kennett and Poplar Bluff. The Missouri Delta Medical Center in Sikeston, Missouri, has 12 psych beds.

Hudak said the Counseling Center staff works to secure safe, affordable housing for mentally ill clients.

"We have a big focus on housing," he said, explaining their clients tend to do better when they are in individual housing. "It is very hard to treat people if they are bumping around all over the place."

Homeless people often suffer from mental illness, Hudak said. Nationwide, 46 percent of all homeless adults live with mental illness and/or substance-abuse disorders, the National Alliance on Mental Illness reported.

But while the statistics can seem dismal, Hudak said the news isn't all bad.

"It is not this deep, dark dungeon," he said. Hudak said there are a variety of medications and counseling programs available to help people cope. Hudak said his staff repeatedly reminds clients to take their medications. Many people can function well as long as they take their medicine, he said.

Hudak and other mental-health professionals said they welcome the growing public interest in finding ways to help the mentally ill.

Hudak said his Counseling Center continues to reach out to the mentally ill.

"We encourage people to seek help," he said.

mbliss@semissourian.com

(573) 388-3641

Pertinent address:

Community Counseling Center, 406 S. Silver Springs Road, Cape Girardeau, Mo.

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Mental illness by the numbers

• 1 out of 4 people in the United States suffers from mental illness
• 1 in 17 live with a serious mental illness

Source: National Alliance on Mental Illness

Community Counseling Center treats some 7,500 clients with mental illness who live in the five counties of Cape Girardeau, Perry, Ste. Genevieve, Bollinger and Madison.

In 2015, the top five mental disorders treated by the center based on number of clients:

• Depressive disorders, 1,965
• Bipolar disorder, 1,069
• Attention deficit/hyperactivity disorder, 638
• Anxiety disorders, 544
• Schizophrenia, 495

Source: Community Counseling Center

• Licensed psych beds in Missouri: 2,097
• Total psych hospitals in Missouri: 50
• Psych hospitals in Southeast Missouri: 5
• Psych beds in Southeast Missouri: 152
• Breakdown of beds in Southeast Missouri:
• Southeast Hospital in Cape Girardeau, 15
• Pemiscot County Memorial Hospital in Hayti, 52
• Twin Rivers Regional Medical Center in Kennett, 33
• Poplar Bluff Regional Medical Center, 40
• Missouri Delta Medical Center in Sikeston, 12

Source: Missouri Department of Mental Health