Building Effective Programs to Improve Mental Health

By John Gregory | 8/25/18 8:30 AM

Some 40 million Americans have a mental health condition.

But more than half of them won’t receive treatment because they lack access to care.

The national nonprofit Mental Health America is trying to change that statistic by working to get people who need help to receive the care they need before they reach a crisis point in their lives. Marcie Timmerman is the executive director of the Kentucky chapter of the organization. She appeared on KET’s Connections to discuss mental health issues. The program also featured Kelley Kitley, a licensed clinical therapist in Chicago, who has written a memoir about her own struggles with abuse, addiction, and anxiety.


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Normalizing Mental Health Care
By the time a person with a mental health problem reaches the critical stage, they are likely to either be in a hospital or a jail, according to Marcie Timmerman. If they can be reached sooner, Timmerman says they can likely be treated with a simple intervention by a mental health professional or with medications.

So, why don’t more people get help? Timmerman says access is a major issue, especially in smaller communities across the commonwealth.

“We have major problems with getting our rural folks into the system at all because there’s simply not someone who lives and works there… to lean on,” Timmerman says.

Other factors that inhibit care include a lack of transportation, the ability to take time off from work to see a counselor, insurance that doesn’t include mental health coverage, and the social stigma that’s still associated with therapy.

“It’s not different than going to the regular doctor for a heart attack, or cancer, or diabetes,” says Timmerman. “Not everyone who sees a therapist is really crazy, they don’t always have an illness, they may just need some tools that maybe they didn’t grow up with.”

Mental Health America outlines four stages of mental health conditions. Stage one is a sense that something is not right, such as feeling blue for a couple of days. In stage two, those feelings deepen and last for a longer period of time. They may also affect a person’s performance at work or school, or impact their family and social life.

Stage three involves recurring episodes of severe symptoms and a serious disruption of daily activities. By stage four, the physiological symptoms are often paired with physical health conditions, and have the potential to lead to homelessness, hospitalization, incarceration, or even death.

The organization offers free screening tools on its website to test for a variety of mental health concerns. Timmerman says the online tools also provide guidance on whether the individual may need to seek help from a professional. At the earliest stages of a potential problem, she says people often simply need to learn some general coping skills such as how to regulate their emotions, or how to set proper boundaries with a family member or coworker.

From Victim to Survivor
Kelley Kitley knows what it’s like to reach a mental health crisis point. It started when she was sexually abused when she was only 10 years old.

“There was a piece of me taken that I’ll never get back,” she says, “and so many women and men can relate to that experience.”

When she summoned the courage to tell her parents about the abuse, Kitley says they simply encouraged her to put the incident behind her and not to talk about it. That led to Kitley developing an eating disorder. When that threatened her physical health, Kitley finally got the treatment she needed to recover from both the original abuse and eating problem.

Later, as an adult, Kitley suffered new rounds of trauma when she was assaulted on the streets of Chicago, and when she suffered postpartum anxiety after the births of her four children. Today, she is a successful counselor, mother, and author of the memoir, “MY self: An Autobiography of Survival.”

“I so want to break the silence and stigma of addiction and mental health,” she says. “It actually bothers me when people think that my life is perfect just by what it looks like, because it has been so far from that.”

Kitley uses cognitive behavioral therapy to help people overcome trauma. She says her own experiences taught her how thoughts like self-blame can lead to an eating disorder or other self-destructive behaviors.

“There was a lot of ‘It’s my fault’ and ‘If I only would have done this differently,’” Kitley says. “When we play that negative mental tape, we just stay stuck and more depressed and more anxious.”

But when life circumstances are viewed through a different, more positive perspective, Kitley says the person can evoke more functional feelings and behaviors. They go from being a victim to being a survivor, she says.

Connecting with Others
Trauma-informed practices are becoming more common among primary care providers and in schools and workplaces. Timmerman says Kentucky schools are training teachers and other personnel to help them recognize mental health concerns among students and be sensitive to the factors at home that may contribute to misbehavior at school.

“Often a kid who hasn’t eaten last night, who didn’t have a home to sleep in, who’s been couch-surfing between friends, that teenager is going to have more problems than the average teenager,” Timmerman says. “So let’s start addressing those core problems.”

Timmerman says it’s also important for young people to have a trusted adult that they feel comfortable talking to, whether that’s a teacher, an administrator, or a janitor or lunchroom worker. When encountering a traumatized person, she recommends avoiding phrases that imply blame.

“They’re learning is to ask, ‘What happened to you?’ not, ‘What did you do?’” Timmerman says. “When you change that conversation, that completely changes the way a kid relates to you.”

Many Kentucky communities do have mental health centers, but Timmerman says the state could use more of them, especially in rural areas. The commonwealth also suffers from a shortage of child psychiatrists, she says. That’s why she encourages people young and old to look out for one another and be open to the personal connections that can benefit us all.

“It’s easy to get very isolated… and forget to reach out to others and check in on those folks,” Timmerman says. “We say check in on everyone, not just the ones you’re worried about.

“We all have our black moments, and our bad days, and our rough times, and we all build from them,” she adds. “It’s what makes us stronger and it’s what makes us better people.”