Mental health care slow in valley

Illness rate high, but few therapists

kalexander@fresnobee.comJuly 29, 2013 

— While much of California is expected to see a boost in mental health services under the Affordable Care Act, additional treatment is likely to come slowly to the valley.

New research released Wednesday confirms that the San Joaquin Valley has fewer psychiatrists, therapists and clinical social workers than anywhere in the state — too few to fuel the expansion of mental health treatment called for in federal health reform.

Making matters worse, the valley has the state's highest rates of mental illness, according to the research. More than 1 in 20 adults is seriously mentally ill and nearly 1 in 12 children suffers serious emotional disturbance.

"It's kind of a double-whammy," said Neal Adams, deputy director of the California Institute for Mental Health and a co-author of one of the reports released this week.

Adams said the valley has difficulty recruiting mental health professionals while it also deals with the state's biggest mental health problems.

The research released this week was issued by the nonprofit California HealthCare Foundation and provides a gauge of the state's mental health situation before the main provisions of the Affordable Care Act roll out next year.

The law is expected to improve access to mental health treatment. The expansion of Medi-Cal, the state's insurance for the poor and disabled, will make many uninsured newly eligible for services. Also, private plans, under the law, will be required to beef up mental health coverage.

Being eligible for treatment, however, and getting treatment are two different things, and if there are not enough people to provide the care, the policy fails.

"The number of psychiatrists is a big problem in Fresno County and the valley," acknowledged Donna Taylor, Fresno County's former behavioral health director and now a consultant for the county.

Urban areas to benefit

Psychiatrists and other mental health professionals tend to cluster in larger urban areas, experts say, where pay is greater and medical schools churn out a regular supply of trained providers.

These areas are likely to benefit most from the expansion of mental health services under the Affordable Care Act, the research suggests.

According to the research, about half of adults statewide and two-thirds of adolescents with mental health issues are currently not getting treatment.

Serious mental illness is most prevalent among adults in Madera and Kings counties, with 7 percent and 6.9 percent suffering respectively. In Fresno County, 5.1 percent are seriously mentally ill. The state average is 4.3 percent, according to the research.

Researchers are hesitant to say exactly why more valley residents suffer mental health issues than people in other parts of the state. But they correlate it to poverty, which runs high here.

When people are stressed about money, a job or a place to live, depression and other forms of mental illness are more likely to set in, experts say. At the same time, those who suffer mental health problems often seek out more affordable places to relocate to, such as the valley.

"If you're struggling in life," Adams said, "it's easier to live in a more rural place with less costly housing."

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