"Access should be affordable and not limited to health insurance participation or reimbursement, office hours, or transportation in rural areas. Investments should be made to expand chemical dependence treatment options within the county so that more residents may receive care close to home instead of having to travel elsewhere. Additionally, improving availability and access to existing chemical dependence treatment and services may encourage residents in need to seek treatment."
There are several reasons why mental health services are sparse in upstate New York. It can be difficult for mental health providers to work with a work poor uninsured in rural areas. The study of Otesego County said "understaffing remains a chronic problem due to high turnover and low recruitment rates." A possible solution is to train primary care providers to treat depression and anxiety.
Peter, This post reminds me a lot of my clinical experience in POM last year, when I traveled to Tully to shadow a family practice physician for a total of three days. On the last day of my shadowing, I saw a young female patient who was newly diagnosed with bi-polar disorder, but had no access to a fully trained psychiatrist to help her manage her medical condition. I remember being struck at how even though we were so close to Syracuse, a mere 15 minute drive down 81, this patient did not have the resources to travel to a psychiatrist. I was also impressed by the family practice doctor I was shadowing, who suggested that this patient, whom she had been seeing since she was a baby, simply come back to her office once every two weeks to help her manage until arrangements could be made. As this was the last day I shadowed, I don't know how this plan turned out, but I very much liked how this rural family physician refused to lose her patient to follow up.
ReplyDeleteMental health problems are problems that are often neglected, but impact an individuals daily lifestyle greatly. Thus, I'm glad Otsego County is making strides to improve their mental health services.
ReplyDeleteI also think it is important as PCPs to screen, treat, and educate patients on mental health problem such as depression or anxiety. At the pediatric office I work at, we just implemented a questionnaire screening our pre-teens and teens for depression. This has been a helpful tool for helping and counseling our patients. I think similar tools can be implemented in many offices to assist patients that don't have access to mental health programs.