Think you know what mental illness looks like? Think again

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Billy Watkins/Mississippi Center for Investigative Reporting

Bobby Thomas talks with his mentor, Angela Ladner, executive director of the Mississippi Psychiatric Association.

Mental illness could look like the mother of three suffering from post-partum depression.

Or a single man with an engineering degree who can’t find a job because he has a history of paranoid schizophrenia.

Or the child with autism who reads voraciously but won’t talk to strangers — including a doctor — under any circumstances.

Mental illness manifests itself in signs and symptoms at times readily identified by a doctor, at times only known by the one who is affected. Don’t think it’s easy to look at someone and tell if they’re mentally ill. Mental health is nothing if not fragile. Even the most well-adjusted suffer periods of depression over a job situation or a poor marriage.

Where does one begin to seek help?

Family doctors often prescribe medication for mental health issues based on their own training or in conjunction with a therapist trained to treat mental disorders with therapy, said Angela Ladner, executive director of the Mississippi Psychiatric Association.

Other resources include education and advocacy groups such as the National Alliance for Mental Illness for adults or Families as Allies for children. NAMI has chapters throughout Mississippi to offer support and education on mental illness to families and individuals needing help, said Sitaniel Wimberly, program director in the state.

Another place to seek help for mental health issues could be ministries operated by faith communities. Valerie McClellan, program director for Solomon Counseling Center at Catholic Charities in Jackson, said the nonprofit’s outpatient mental health services served 181 families and individuals in its 2018 fiscal year.

The three counselors at the center offer a range of services, McClellan said, from children’s trauma services to premarital counseling to family conflict.

Jo Hebert, licensed professional counselor at St. Mark’s United Methodist in Flowood, said her eight-year-long ministry has seen many individuals with a variety of issues as well—grief counseling and issues stemming from divorce, depression and anxiety. “I meet with people right where they are and feel comfortable sharing their burdens and helping them find hope, then take steps to finding more hope,” Hebert said.

Not everyone with a mental health issue needs to see a psychiatrist, Ladner said. “Psychiatric providers are for the 20 percent of the population with a chronic mental health issue,” she said.

Counselors, however, are trained to know when a client’s need outstrips what they can offer, Hebert said. That’s where a psychiatrist can step in and offer more support.

Local mental health centers, located throughout the state, funded by county boards of supervisors and the state Department of Mental Health, see many of the individuals with more severe and chronic mental illness, said Adam Moore, communications director for the Department of Mental Health.

The centers must meet state guidelines to be certified mental health providers, Moore said, but are not directly operated by the department. They provide a wide array of services, including crisis management, medication management and outpatient counseling, he said.

The state is divided into 14 regions, each having a system of mental health satellite offices, Moore said. People seeking mental health treatment can locate the office nearest them using the provider locator on the department’s website.

Individuals in crisis can call a toll-free number for their region and reach a crisis intervention team, who can assess the individual’s needs for mental health treatment. Shareka Jefferson, county administrator for the Region 7 office in Choctaw County in north Mississippi, said staff there regularly get calls to the hotline for individuals needing assistance.

With no inpatient facilities available in the area, Region 7 can only offer services at the crisis center in Clay County, a 16-bed facility several miles away. The Choctaw County office also has one psychiatrist available three times a month and a psychiatric nurse practitioner twice a month for medication management, Jefferson said.

Such an arrangement is not unusual in Mississippi, Jefferson said.  “There’s a shortage of psychiatrists all over Mississippi,” she said.

Jo Ann Marsh, director at Region 12 Pine Belt Mental Health Center in south Mississippi, echoed that assessment. “We always need more of them so we can help more people,“ Marsh said. With 565 employees covering nine facilities, only two are psychiatrists with a number of nurse practitioners filling in the gaps for medication management, Marsh said.

Often a severe crisis, such as a suicide threat or attempt, leads to a need for inpatient services. The Department of Mental Health provides 401 adult psychiatric beds for intensive inpatient services, with 118 adult acute beds and 75 continued treatment service beds at Mississippi State Hospital at Whitfield, 50 adult acute psychiatric beds each at North Mississippi State Hospital in Tupelo and South Mississippi State Hospital in Purvis, and 108 adult acute psychiatric beds at East Mississippi State Hospital in Meridian, according to figures provided by Moore.

For-profit and nonprofit hospitals fill in the gaps for those in the state needing inpatient treatment.

Family members of children with mental illness can start looking for answers in their schools. “All 14 Community Mental Health Centers are required to offer their services to local school districts within their catchment area,” said Moore.

In fiscal year 2018, there were 22,074 children and youth served through School-Based Outpatient Therapy in 940 schools by 620 school-based therapists, Moore noted. Region 8 Mental Health in Brandon has counselors available at all 28 schools in the Rankin County School District under a pilot program that could be replicated across the state, according to Nina Williams, clinical director. “The goal is to catch children before they reach a crisis point,” Williams said.

Larrison Campbell, Mississippi Today

The G.V. (Sonny) Montgomery V.A. Medical Center in Jackson

Veterans can receive mental health care at the closest VA medical center to their home, said Susan Varcie, public affairs officer with the G.V .( Sonny) Montgomery Veterans Affairs Medical Center in Jackson. Over 9,500 veterans are enrolled in mental health programs at the Jackson VA, she said. Other Mississippi veterans are served by Biloxi and Memphis VA systems. Wait times range from no wait at Natchez’s outpatient clinic to 24 days at Greenville’s clinic, she noted.

Insurance is mandated to provide just as much benefit for mental illnesses as for physical illnesses, said state Insurance Commissioner Mike Chaney. The 2008 Mental Health Parity and Addiction Equality Act was the first law that required mental health care parity, and then under the Affordable Care Act in 2016, Mississippi chose mental health parity as an essential health benefit, Chaney noted.

The main difficulties are limitations to office visits and availability of coverage for prescribed medications, he said.

This story was produced by the Mississippi Center for Investigative Reporting, a nonprofit news organization that seeks to hold public officials accountable and empower citizens in their communities.

Where to seek help: 

National Suicide Prevention Helpline:  1-800-273-TALK

Crisis numbers for Regional Health Centers:

Region 1 – 888-404-8002 (Coahoma, Quitman, Tallahatchie, Tunica)

Region 2 – 866-837-7521 (Calhoun, Lafayette, Marshall, Panola, Tate, Yalobusha)

Region 3 – 866-255-9986 (Benton, Chickasaw, Itawamba, Lee, Monroe, Pontotoc, Union) Region 4 – 888-287-4443 (Alcorn, DeSoto, Prentiss, Tippah, Tishomingo)

Region 6 – 866-453-6216 (Attala, Bolivar, Carroll, Grenada, Holmes, Humphreys, Issaquena, Leflore, Montgomery, Sharkey, Sunflower, Washington)

Region 7 – 888-943-3022 (Choctaw, Clay, Lowndes, Noxubee, Oktibbeha, Webster, Winston)

Region 8 – 877-657-4098  (Copiah, Lincoln, Madison, Rankin, Simpson)

Region 9 – 601-955-6381 (Hinds)

Region 10 – 800-803-0245, after hours only (Clarke, Jasper, Kemper, Lauderdale, Leake, Neshoba, Newton, Scott, Smith)

Region 11 – 877-353-8689 (Adams, Amite, Claiborne, Franklin, Jefferson, Lawrence, Pike, Walthall, Wilkinson)

Region 12 – 888-330-7772 (Covington, Forrest, Greene, Jeff Davis, Jones, Lamar, Marion, Perry, Wayne)

Region 13 – 800-681-0798 (Hancock, Harrison, Pearl River, Stone)

Region 14 – 866-497-0690 (George, Jackson)

Region 15 – 601-638-0031, goes to message menu (Warren, Yazoo)

Department of Mental Health Crisis Line—1-877-210-8513

Veterans Crisis Line-1-800-273-8255, Press 1

NAMI Crisis Line: 1-800-750-6264 or test “NAMI” to 741-741

Social Security Administration—1-800-772-1213

Department of Rehabilitation Services—1-800-443-1000