"Adults living with serious mental illness die on average 25 years earlier than others."
That stunning statement comes from the Community Health Needs Assessment of Northeast Georgia, a study of the health needs of the communities served by different hospital facilities and the health department.
Among the findings: The area’s top three health needs in the service area — which includes ZIP codes in Gainesville, Clermont, Gillsville, Lula and Murrayville — were mental health, substance abuse and access to care.
Mental health also ranked first for multiple other health service areas across the region.
“Mental illnesses, such as depression, are the third most common cause of hospitalization in the U.S. for those aged 18-44 years,” according to the report.
With an increasing emphasis on treating the mind as well as the body, licensed clinical social workers are working alongside physicians throughout the Northeast Georgia Health System. By this summer, there will be 13 behavioral health locations across the Northeast Georgia Physicians Group.
“We wanted to bring a renewed or improved focus on asking not just about what’s the matter with them but how they feel, how are they coping with life,” said Katherine Rowland, director of population health.
Rowland said the program started three years ago with one position and has grown to 11, and Jennifer Little, Northeast Georgia Physicians’ Group administrative director, said two new psychiatrists were hired recently.
The program has also integrated into urgent care in some service areas, which allows for patients to come at times that would not conflict with work or school.
The graduate medical education program at NGHS will also in 2022 begin a psychiatry residency program, which could help churn out more mental health professionals into the field, which are sorely needed: The ratio of people to mental health providers in Hall County, according to the study, was 1,347 to 1. The statewide benchmark ratio is 829 to 1.
The goal is better overall health outcomes.
“It gives them an avenue to be able to talk to someone and deal with the issues at hand, then they are more apt to control their diabetes or take their blood pressures regularly because they have that willpower and renewed focus to do so,” Little said.
For example, if the physician and patient determine talk therapy could be beneficial, the patient can return to wherever they get their normal care and get connected to a behavioral health specialist.
In pre- and post-treatment scores looking at whether a patient is dealing with mild to severe symptoms of depression, Rowland said they have seen drops between 60% and 70% in an average of eight visits.
Sherry Franklin said she felt like she was in a maze, trying to find a way to help her loved ones who were showing signs of mental distress.
“I didn’t know how to communicate with my loved one on what was going on with them. You don’t want to have an adversarial relationship, so it’s learning what to say and how to say it,” Franklin said.
Now, she is the vice president for the Hall County chapter of the National Alliance on Mental Illness, a volunteer organization that strives for education, support and advocacy for those diagnosed and their support systems.
“That’s why I want to give back, because I was helped so tremendously. You can comfort someone when you’ve been comforted,” Franklin said.
Reasons people may not seek help for mental health include the stigma surrounding mental illness “as social exclusion or discrimination, or felt as a pervasive and underlying sense of being different from others,” according to the health needs report.
The counties of Barrow, Dawson, Franklin, Habersham, Hall, Hart, Jackson, Lumpkin, Stephens and Union had higher suicide death rates per 100,000 population than the statewide rate benchmark of 13.1 per 100,000 deaths.
Dawson County was more than double the statewide benchmark with 30.2 suicide deaths per 100,000 population.
“We’re trying to destigmatize mental illness and help people to get help, find hope. Recovery is possible. Treatment works, but often times people are afraid to get help. They don’t want to talk about it. It’s behind closed doors, and we’ll just deal with it ourselves,” Franklin said.
Another collective focusing on this issue has been the mental and behavioral health subcommittee of One Hall, which is sponsored by the United Way.
Dr. Monica Newton, who is an NGPG family medicine physician, co-chairs the behavioral health committee. The process began with a series of listening sessions with churches, schools, government and law enforcement.
The three common themes are: access, collaboration and education.
Newton said One Hall has been working on a “community-based platform” similar to a charity tracker that would help agencies connect patients to resources, which would include housing and food.
The platform would allow agencies to see “where people are getting services and make sure there’s not duplication,” Newton said.
“If our law enforcement were to come across somebody that was receiving mental health services, they could quickly know who their counselor was or what agencies to contact about getting them back in for services in lieu of incarceration,” she said.
They have also been pursuing the possibility of having social workers work with certain patrol officers that may lead to better outcomes than arrests.
Newton said this is especially important for those living in government housing, who can lose their space after an arrest.
“Your housing doesn’t just affect you. It affects the kids and everybody else that is there with you. You don’t even have to be convicted of a crime to lose your housing,” she said.
More beds on the horizon
The time it takes someone to get from the emergency department into a bed at a behavioral stabilization center has more than doubled in the last six months for those using the state system.
Adam Raulerson, business development manager at Laurelwood, said it used to be 11 hours, but it has recently increased to 24 hours. Laurelwood is an inpatient behavioral health facility with 54 beds in Gainesville.
“We’ve always been behind the curve when it comes to available beds in the state system. We’re fortunate that Avita has been granted funding for the behavioral health crisis center, because that’s going to increase our capacity right here in our community,” Raulerson said.
Avita Community Partners is a behavioral health provider primarily serving 13 counties in Northeast Georgia. Chief Executive Officer Cindy Levi said they hope to have the behavioral health crisis center opened by the end of the year, which will be on Old Cornelia Highway.
The number of beds will increase to 30 from 16 at Avita, which already runs a crisis stabilization unit.
There will also be 15 stations for 23-hour temporary observation.
“If it’s a situation where they have run out of medication or need an injection or something like that, then it should be able to be resolved, and then the person can leave,” Levi said.
If an uninsured patient lands in NGHS and needs inpatient behavioral health care, Raulerson said the staff work to connect them to a resource within the state.
However, if they are having a hard time connecting them, Laurelwood will go ahead and treat them.
The issue creates a balancing act, Raulerson said.
“If we admitted every patient that came to us that was uninsured every time without trying to connect them to a state resource, then everybody in the state would send all their patients to say, ‘Hey, that’s just the next state facility that provides free care,’” he said.
The patient is usually put on a state tracking board to see if there’s a bed available at a stabilization center. The problem: state behavioral crisis stabilization beds are almost always at capacity.
“The issue runs into when all of those beds are full and no beds available, then the patient waits and waits and waits for a bed to come open,” Raulerson said.
Service providers review the need of a person when a bed becomes available to see if they can be admitted to their facility. Some areas of Georgia do not have crisis stabilization units or behavioral crisis centers, and Avita is available to accept people from across North Georgia.
“We give a priority to those that are in our immediate area, but if we have a bed open and no one waiting that’s appropriate from our immediate area, then we can accept others that may be from Cobb County or over in northwestern Georgia or over toward the Athens area,” Levi said.