Mental Healthcare Shortage in Rural Areas: CH-F's Efforts

Eighteen months ago, CH-F started on a journey to better understand the needs of our community. When we started the process of our Community Health Needs Assessment (CHNA), we knew that mental health would rise to the top as an unmet need in our community. For years, our physicians have told us that the need was great and the resources very limited. And time and time again, we have experienced it ourselves when a patient seeks the ER as a last resort.

What you might not realize about mental health in our community:
*14% of the U.S. population suffers from moderate to severe mental illness from short-term situational depression to long term chronic conditions such as bipolar disorder or schizophrenia.
*Suicide rates in rural areas are higher than urban areas.
*Rural areas have a higher proportion of people who are at risk for mental and behavioral health problems, especially older adults.
*Stress is associated with increased mental health disorders. Rural people experience stress with cyclical farm crisis, natural disasters and isolation.
*Rural populations have a greater portion of untreated mental illness than non-rural communities.
*33% of households responding to the CH-F CHNA survey reported depression as a minor or major problem in their household.

And here are a few facts about mental healthcare:
*Distance to mental health providers and transportation costs can be a barrier. There is no psychiatric care in Atchison or Holt Counties.
*Rural Americans are less likely to have health insurance that covers mental health.
*Atchison and Holt Counties are not alone. 104 of Missouri's 114 counties are designated by the federal government as mental health shortage areas.

*http://www.ahrq.gov/research/findings/nhqrdr/nhqr11/chap8.html

So what is CH-F doing?
We are so pleased to announce that Carl Greiner, M.D. will begin seeing patients in a psychiatry clinic in January. The clinic will be conducted using video conferencing where patients interact face to face with Dr. Greiner through the use of a screen.

With the shortage of psychiatric care, underserved communities all over the country are utilizing technology to increase access to mental health professionals. The CH-F Psychiatry Clinic is the first telemedicine clinic at CH-F.

Patients will be referred to the clinic by their primary care physician. Our staff will then schedule the patient for an appointment at the hospital. At the hospital, the patient will interact with Dr. Greiner face to face via a screen just like a traditional office appointment. After the appointment, Dr. Greiner and the patient's primary care physician will then collaborate on treatment recommendations.

Psychiatry has been a significant need in our community for many, many years. This clinic represents the first  step toward getting the patients the care they need close to home. We are honored to offer this service to our community.

Those interested in this clinic should contact their primary care physician.

Cindy Lewis Breathes Easy After a Visit to the CH-F Emergency Room

Being short of breath with a paling complexion were the first signs that something was not right for Cindy Lewis. When these symptoms turned into a struggle to breathe, it was time to seek help. She arrived at the Community Hospital-Fairfax (CH-F) Emergency Room that October afternoon struggling for every breath.

On duty that afternoon was Nurse Practitioner Melissa Masonbrink and registered nurse Bryan Krutz. The team quickly assessed Cindy's condition and began to examine what could be causing the dangerous symptoms. After giving Cindy blood and running a number of tests, it was determined that Cindy had bleeding ulcers and needed a procedure offered at The Nebraska Medical Center. Cindy was quickly transported north to receive the care she needed.

Not long after her recovery from the bleeding ulcers, Cindy found herself struggling to breathe once again. Without hesitation, she arrived at the CH-F Emergency Room where she was diagnosed with blood clots in her lungs within one hour of arrival. Soon, she was once again on her way to breathing easy.

Cindy Lewis is a believer in the CH-F Emergency Room, "I feel like they are going to figure out what is wrong with me very quickly. They are always friendly, attentive and efficient. When they order a test, it is done and the results are relayed to the patient quickly. When the diagnosis is made, they waste no time starting treatment or, if necessary, getting you to the right place to get the help you need."

Samantha Grist, RN, Med/Surg and ER Nurse Manager, is proud of the response time at the CH-F Emergency Room, "In many larger hospitals, patients wait hours to get help. In most cases, we are able to connect our patients with a provider very quickly. In a stressful situation, the last thing any patient wants is a wait."

Cindy wants to remind the community about the CH-F Emergency Room. She commented, "I lived in Kansas City for 28 years, so I know what it's like to wait for several hours in the E.R. when you're not feeling well.  The zero wait time here is a luxury that I very much appreciate."

The CH-F Emergency Room is staffed 24 hours a day with Family Nurse Practitioners or Physicians. Staffing the Emergency Room are specially trained individuals in emergency care. CH-F is also a stroke ready facility.

For more questions about the CH-F or the services offered, please call (660) 686-2211.