Needs assessment identifies top 4 priorities for region, including youth substance use, suicide prevention

Southeast Missouri’s largest behavioral health organization has identified youth substance use, youth suicide prevention, community education and primary care/behavioral health integration as the four top behavioral health priorities, following several rounds of research and analysis.

Community Counseling Center revealed the priorities in its recently released 2024 Behavioral Health Community Needs Assessment. The assessment is a 68-page document that includes data derived from several sources, as well as summaries from focus groups held in Bollinger, Cape Girardeau, Madison and Ste. Genevieve counties.

Workforce issues, substance-use treatment, treatment for jail inmates, transportation, housing and homelessness and geriatric services were listed as secondary priorities in the assessment.

Youth and substances

The assessment cited data showing that youth in the five-county area served by CCC consume alcohol at a higher rate than the Missouri average. Madison and Perry counties showed a higher use rate of marijuana. Bollinger County showed high levels of inhalants, over-the-counter drug misuse and tobacco. Madison County showed across-the-board elevated substance use except for the prescription category.

The data was taken from an optional survey given to youth. The survey has been conducted by the Missouri Department of Elementary and Secondary Education and the Missouri Department of Mental Health since 2004.

Wendy Ice, Community Counseling Center CEO, said the region lacks substance-use care for minors.

"Our behavioral health community needs assessment identified youth substance use treatment as a priority need," Ice said. "Although there are prevention services available in our communities, treatment options are very limited for youth. It is important the availability of treatment options exist as once a youth has developed an unhealthy relationship with substances, treatment is often the best course of action to achieve positive outcomes."

Meanwhile, alcohol continues to be abused at a higher rate than the state average in Bollinger, Cape Girardeau, Madison and Perry counties (Ste. Genevieve County schools did not participate in the surveys.) The data presented showed that 17% of Missouri youth consumed alcohol. Youth in Bollinger, Cape Girardeau and Madison counties ranged from 18.8% to 19.84%. But Perry County far exceeded that number, with 25% of students reporting having consumed alcohol.

The assessment stated that CCC has developed three substance-use-only positions. All CCC therapists are qualified to provide substance-use treatment to youth. Solutions for the substance-use problem were listed as applying for grants that could help with early intervention and prevention; engaging with local juvenile authorities to increase referrals for youth substance-use services; promoting services with school personnel; and prompt services with substance-use residential providers.

Youth suicide prevention

The needs assessment data did not show an elevated rate of suicides in the area compared to statewide numbers, but education professionals throughout the region expressed that more youth are reaching out for help than ever before, said Kyle Schott, administrative projects specialist at CCC who compiled most of the information in the report. Isolation during COVID-19 remains problematic for children and teens, he said, even four years after the worst of the pandemic, as children struggle with social connections beyond their phones. That combined with depression and bullying associated with social media has made mental health a challenge for youth today.

A 2024 report from the Centers of Disease Control and Prevention said more teens are experiencing bullying and violence than they did two years prior. The number of students who felt persistently sad or hopeless was 40% nationally. Those numbers were higher for girls and Hispanic students. Sixty-five percent of LGBTQ+ students said they experienced persistent sadness or hopelessness; 53% reported “poor mental health” in the last 40 days; and 41% said they had seriously considered suicide.

Some of those trends are expressed differently in local data cited in the assessment. For example, schools in Cape Girardeau County reported 111 suspensions because of drug use and 74 because of violence or weapons. Those numbers were higher than the state average.

Schott said CCC want to bring a “Hope Squad” peer program into schools. The program would train students to recognize signs of mental distress of other students, who can help lead their friends and colleagues to help. CCC hopes to develop a Hope Squad program in each school in the service area by 2027.

Schott said peers are uniquely situated to help friends and acquaintences who are struggling, but don’t feel comfortable getting adults involved. Schott said Cape Girardeau Public Schools has already received a grant to start up a program.

The students on the Hope Squad “promote positivity, and positive messages, and each month is a theme. But then other kids can go talk to this kid because they're on the Hope Squad, and if somebody says, you know, I've been having these suicidal thoughts, let's go talk to our adviser about what we need to do next. It is the only evidence-based peer suicide reduction for youth program that's out there.”

Medical, mental health care integrations

One of the other major problems identified in the report is how much and how often mentally ill people depend on the medical system. Data showed that Cape Girardeau’s emergency rooms are seeing and discharging patients at a rate higher than what is seen elsewhere in Missouri.

Ideally, patients could receive behavioral and mental health care before they reach emergency status.

Some of that is because of access issues for regular mental health care, and some is related to a lack of integration between medical and mental health care. That issue is an area identified by the Missouri Department of Mental Health as needing improvement. Sometimes patient privacy laws can prevent communications about patients’ mental and medical care, the assessment stated.

Plans include efforts with the Missouri Department of Mental Health to develop models to bridge care and communication gaps between doctors and counselors, as well as integrate services between federally qualified and rural health clinics. CCC also wants to develop and hire a liaison position to work with primary care providers to assist with continuity of care.

Educating those who want to help

The final top priority expressed in the assessment is community education. This involves engaging community leaders in different sectors of the community, including education or churches.

“One of the things we've noticed, especially in this post-COVID era, is there's so many people that are in need, and there's so much more of an openness for mental health,” Schott said. “And there's lots of people that want to help, but they're not educated to do so. So we developed a community education program. We have a lot of expertise here. So let's get out to the community. Let's talk to the churches. Let's talk to the schools. Let's talk to the businesses. Let's talk to the other nonprofits. Give them a little bit of some tools, a little better understanding, work at breaking down that stigma more, and then they feel more confident.”

By the numbers

Cape Girardeau data showed that Cape Girardeau County was higher than the state average in the following categories:

• Alcohol involved fatal crashes
• Substance-use involved fatal crashes
• Substance-use ER visit (secondary)
• Mental health ER visit (secondary)
• Hospital admission for mental health (primary)
• Child neglect
• Juvenile violent offenses
• Juvenile self-injurious behaviors
• Juvenile substance-use school suspensions
• Juvenile violence/weapon school suspensions
• Juvenile alcohol use (self report)
• Juvenile OTC drug misuse (self report)
• Substance-use admission alcohol
• Substance-use admission methamphetamine
• Substance-use admission heroin
• Substance-use admission fentanyl
• Substance-use admission cocaine
• Life expectancy
• Poor or fair health (self report)
• Poor or fair mental health (self report)