In Crisis: Idaho's fragmented mental health system in 5 charts

Oct. 31--The Idaho Statesman and Boise State Public Radio published and aired stories in the final week of October about Idaho's fragmented, underfunded and threadbare mental health care system.

--Idahoans with mental illness lack options. Idaho has a shortage of psychiatrists and few treatment centers. It doesn't have enough mental-health funding for the state's poorest residents. So, more people are accessing mental health care once they're in the midst of a crisis, putting the financial burden on local governments.

--Idaho's hospitals are trying new ways to manage the influx of mental health emergencies. Their ERs have become an expensive last resort for people in crisis, many of whom are discharged only to return later.

--The justice system has become a mental health provider. Many Idahoans get the right kind of help only after they've been arrested. That cycle, too, repeats.

--The state's action plan for a better system includes carving out part of Medicaid's mental-health coverage and paying a contractor -- Optum Idaho -- a flat, per-person, per-month rate to manage it. The result has been a controversial shift in services.

Here are five other ways to look at Idaho's mental health system.

1. The spending

Mental health expenditures make up a smaller share of the total Department of Health and Welfare budget.

2. The court orders

That spending decline coincides with a rising number of court-ordered involuntary commitments to the state psychiatric hospitals.

3. The emergency response

The number of people being put on a mental hold -- the first step in an involuntary commitment process -- also has increased. Mental holds are typically required when the person lacks a grasp on reality and refuses to seek help. Last fiscal year, 40 percent more Idahoans were placed on a mental hold than in 2008.

4. Those who can heal

Idaho's mental-health shortage isn't just money. It's people with the right training to prevent crises. Idaho is designated by the federal government as a chronic mental health provider shortage area.

5. The suicide rate

All of that undoubtedly contributes to the high rate of suicide in Idaho, which is continually one of the highest in the nation. Idaho's suicide rate averaged 48 percent above the U.S. rate over a 10 year period. But in rural parts of Idaho especially -- where providers and funds are scarce -- it is even higher.

"In Crisis" is a series produced in a collaboration between the Idaho Statesman and Boise State Public Radio.

KNOW THE SIGNS OF MENTAL ILLNESS

If someone you know is in emotional crisis, call the Idaho Suicide Prevention Hotline at 1-800-273-8255.

Watch for these warning signs:

--Talking about wanting to die.

--Looking for a way to kill oneself.

--Talking about feeling hopeless or having no reason to live.

--Talking about feeling trapped or in unbearable pain.

--Talking about being a burden to others.

--Increasing use of alcohol or drugs.

--Acting anxiously, agitatedly or recklessly.

--Sleeping too little or too much.

--Withdrawing or isolating oneself.

--Showing rage or talking about seeking revenge.

--Extreme mood swings.

Other things you can do to help:

--Do not leave the person alone.

--Be direct. Talk openly and matter-of-factly about suicide.

--Listen. Allow expressions of feelings. Accept the feelings.

--Be nonjudgmental. Don't debate. Don't lecture on the value of life.

--Don't act shocked. That will put distance between you.

--Don't be sworn to secrecy. Seek support.

--Offer hope that alternatives are available, but do not offer glib reassurance.

--Take action. Remove means, such as guns, sharp objects or stockpiled pills.

--Get help by calling the hotline or visiting SuicidePreventionLifeline.org.

--Take the person to an emergency room or seek help from a medical or mental health professional.

Source: National Suicide Prevention Lifeline, National Institute of Mental Health

Audrey Dutton: 377-6448, @IDS_Audrey

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(c)2014 The Idaho Statesman (Boise, Idaho)

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