'We all need a better handbook': 5 takeaways from Delaware's first mental health summit

The coronavirus pandemic affected everyone.

Physically, the virus has touched hundreds of millions of lives − as of May 31, there were nearly a billion confirmed cases since the pandemic's start in 2019 and nearly 7 million COVID-related deaths, according to the World Health Organization.

Yet the pandemic has also taken a serious toll on people's mental health. While less obvious, experts say this is no less dangerous.

Recent data from the World Health Organization shows that in the year following the start of the pandemic, there was a 25% increase in the prevalence of anxiety and depression. This year, 1 in 5 children will experience a mental disorder, according to the U.S. Centers for Disease Control and Prevention.

Lt. Gov. Bethany Hall-Long speaks with former U.S. Rep. Patrick Kennedy, D-RI, at Delaware's inaugural mental and behavioral health summit on Monday. Hall-Long convened the summit.
Lt. Gov. Bethany Hall-Long speaks with former U.S. Rep. Patrick Kennedy, D-RI, at Delaware's inaugural mental and behavioral health summit on Monday. Hall-Long convened the summit.

While mental health is certainly not a new topic of discussion, it was under this context that Lt. Gov. Bethany Hall-Long convened Delaware's inaugural behavioral health summit Monday.

Here are five takeaways from the summit and where Delaware stands.

Delaware is in a much better place than it was eight years ago. But it has a ways to go.

Delaware has made enormous strides in addressing mental and behavioral health since 2015 when the Delaware General Assembly established a Behavioral and Mental Health Task Force. The task force, now known as the Delaware Behavioral Health Consortium, is run out of the lieutenant governor's office.

In the years since its establishment, the state has particularly focused on combatting Delaware's opioid epidemic, which inherently means addressing the mental health issues of those who struggle with addiction.

Yet while there are many more addiction treatment centers in the First State than there were even a decade ago − at one point, facilities such as MeadowWood Behavioral Health Hospital and the Rockford Center were the only locations drug users could go to get help − the continuum of care when it comes to mental health and substance abuse still isn't where it needs to be.

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Dr. Sandra Gibney, a local doctor who has made it her mission to tackle the state's opioid problem, said her hope is that health care providers begin treating mental health "the same way we would if someone was having a stroke or a diabetic emergency or heart attack."

Dr. Sandra Gibney treats a woman who has a xylazine wound at a wound care clinic at Brandywine Counseling & Community Services on Thursday, April 20, 2023. Xylazine, an animal tranquilizer, is being mixed with fentanyl. It causes horrific wounds on users' bodies.
Dr. Sandra Gibney treats a woman who has a xylazine wound at a wound care clinic at Brandywine Counseling & Community Services on Thursday, April 20, 2023. Xylazine, an animal tranquilizer, is being mixed with fentanyl. It causes horrific wounds on users' bodies.

"If you had a heart attack, I wouldn't give you aspirin and send you home from the ER," Gibney said.

While most emergency rooms doctors who see people experiencing a mental health crisis don't just hand them an antidepressant or antipsychotic and let them walk out the front door, establishing meaningful follow-up care for mental health issues is often more difficult than for a heart attack patient, for example.

In part, this is because of a shortage of mental health professionals and community-based programs − yet the shortage is a result of poor funding and lack of coordination and governance.

Veterans are often caught between a rock and a hard place

Though there has been much focus in recent years on addressing the mental health of veterans − who are more vulnerable to homelessness, suicide, physical and mental illness, and substance use disorder as a result of their service − their road to getting help is often trickier.

While the Department of Veterans Affairs does offer mental health and substance abuse treatment, a 2019 study found only 30% of veterans enrolled in VA health get their care from the department. And even those who do get care from the VA may have to jump through numerous hoops before getting the level of treatment they need.

Former U.S. Rep. Patrick Kennedy, D-R.I., said at Monday's event that many of those who served in Iraq and Afghanistan were from the National Guard Reserve. While members of the Reserve do typically qualify for some VA benefits, it's less wholesome than those who are enlisted full time.

Thus, Kennedy said, unless Reserve members had a major injury when serving, to be eligible to receive many mental health benefits, they had to "check a box when they left the military, saying, 'Did they suffer from TBI or post-traumatic stress?'"

The catch, the former representative said, was that if they checked yes, they had to stay for another month for an intake process.

"If you've been away from your family for nearly a year, how many of our returning soldiers want to spend another month at Fort Dix or somewhere else?" Kennedy said.

Lt. Gov. Bethany Hall-Long speaks with former U.S. Rep. Patrick Kennedy, D-RI, at Delaware's inaugural mental and behavioral health summit on Monday. Hall-Long convened the summit.
Lt. Gov. Bethany Hall-Long speaks with former U.S. Rep. Patrick Kennedy, D-RI, at Delaware's inaugural mental and behavioral health summit on Monday. Hall-Long convened the summit.

As a result, many went back to their civilian jobs − which also typically don't offer great mental health insurance coverage − and suffered silently.

"We (need to) fight to make sure parity is enforced so that every one of those Guards and Reservists and their families have the protection for their 'invisible wounds of war,'" Kennedy said.

Mental health treatment still isn’t funded the way other ailments are

In Delaware, like most other states, mental health services are not adequately funded, nor is treatment viewed the same way as it would be for a disease like cancer.

Largely, this has to do with the stigma surrounding mental health, much like how the HIV/AIDS epidemic was viewed in the 1980s and 1990s, Gibney said.

When that disease first emerged in the U.S., Gibney said there were "very few providers" who were willing to treat patients because they "thought that if they touched them they might get it," or that "there was something wrong with them that they got HIV in the first place."

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Yet over the decades, as scientists conducted more research into the disease and better treatments became available for not just treating HIV but preventing it, the stigma "melted away," Gibney said.

She said the medical community needs to treat mental health illnesses just as they would physical ailments, and devote more time and money to research.

"My wish would be that we would (treat) mental health issues and behavioral health issues ... with the same vigor that we we do diabetes or HIV or cancer," Gibney said.

Schools must be part of the equation

Mental and behavioral health care must extend to the educational system and everyone who comes in contact with students, panelists who spoke at Monday's summit agreed.

Kennedy said teachers are perfectly poised to play a key role in helping determine children's mental health outcomes, given "they're on the frontlines with this children's mental health crisis."

Yet in some places, educators don't even have the proper tools to offer kids a full education. Without funds and training to help with students' mental health, kids will continue to suffer, Kennedy said.

Typically, he added, schools treat "problem" kids through disciplinary action, when what they really need is proper treatment for traumas they experience at home or in their communities. This can include anything from food insecurity or homelessness to gun violence or addiction.

Instead of handling school disruption issues with discipline, Kennedy and others said, more resources must be poured into schools to train teachers and add counselors.

A leaflet at Delaware's inaugural mental and behavioral health summit on Monday. Lt. Gov. Bethany Hall-Long convened the summit.
A leaflet at Delaware's inaugural mental and behavioral health summit on Monday. Lt. Gov. Bethany Hall-Long convened the summit.

He added that reaching kids at a young age with proper services will ideally make for better mental health outcomes as adults.

"We all need a better handbook," he said.

Even bus drivers can play an important role, panelists said. Yet it all comes back to funding, and recognizing that mental health is a health problem just as a physical ailment is.

Delaware is uniquely situated given its size − and that's a good thing

Though Delaware is small, in the context of collaboration between state agencies and community partners, the state's size is a good thing, panelists said.

While smaller states typically bring in less money than other states with larger revenue streams, the state's tiny square footage − and the fact that everyone knows each other − makes it so that those in the mental and behavioral health fields are uniquely positioned to work together.

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Physically, people in these fields can get from one end of Delaware to the other in a little over two hours (traffic-dependent, of course). This is important because studies have shown that in-person collaboration allows people to better communicate and develop new solutions.

Delaware's size also means that there are fewer groups doing the work. While this can be a detriment, it can also be beneficial in making tangible progress toward getting things done, as well as trying out various models − such as New Castle County's Hope Center − to see what works.

How to get help

To get help in Delaware, contact 211, a state telephone and text message line available in multiple languages that connect users with resources on a variety of issues, including mental health and substance use. The 988 Suicide and Crisis lifeline is also available 24/7.

Got a tip? Send to Isabel Hughes at ihughes@delawareonline.com or 302-324-2785. For all things breaking news, follow her on Twitter at @izzihughes_.

This article originally appeared on Delaware News Journal: Delaware mental health summit tackles veteran care, treatment funding