A matter of the mind

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KELLOGG — It is no secret that Shoshone County ranks poorly in overall health compared to the rest of Idaho. In fact, the county was rated 41 out of 42 participating counties in overall health earlier this year by countyhealthrankings.org.

These rankings considered a variety of health factors that contributed to their scoring. On top of the many poor ratings in physical health categories, pedestrian ratings in many mental health categories also did not go far to help the county’s results.

Statistics such as a higher than state average number of poor mental health days (4.1 to the state’s 3.7), a lower than state average ratio of mental health providers (780:1 to the state’s 520:1), and the highest reported suicide rate in the state (42.8 per 100,000 in the population) all paint Shoshone County as a place with a problem.

Hoping to attack this matter of the mind head-on is the ever-expanding mental health staff at Heritage Health in Kellogg. Located at 740 McKinley Ave., Heritage Health has been giving Silver Valley residents another option for health care since they set up shop in 2014.

Understanding the need for more than just physical care resources, Heritage has worked to grow a sizable mental health staff over the last few years. One of the counselors among this staff is Pinehurst native Karen Currie.

Currie, a Kellogg High School and Boise State Coeur d’Alene graduate, started working at Heritage in July 2015 with the idea of combating the community’s mental health issues while streamlining a process of working with other departments and programs.

“We care very much about having more options for care and being able to provide an integrated care type of model,” she said. “We built ground up from no program over here to — ‘OK lets figure out what we need to do to work with the doctors downstairs and push it out to the community so that they know that we were here.’”

This emphasis on linking-up the new mental health staff with Heritage’s other departments/providers was done to help solve a common problem that affects many locals who have specific medical needs — being forced to drive out-of-town.

“Between the therapy program, taking intakes for the medication management program, and coordinating everything was definitely a big effort and helping shift the perspective of the downstairs providers that they always have to refer out (a lot of times, over the hill),” Currie said.

As the therapy program continued to succeed, it was apparent that further resources were needed. In three years, the program’s staff has grown to two full-time councilors (Currie and Christopher Garrett), two part-time councilors, a mental health intern, and various special providers for programs such as Community Based Rehab Specialist (CBRS), peer support and substance abuse.

“We’ve really tried to expand to meet the needs,” Currie said. “It has just blown up so much since then and we are really excited about it.”

Growing up in the Silver Valley, Currie was familiar with many people’s situations even before she came on at Heritage. Because of this familiarity, she believes that she is in a better position to give help to those who are seeking it and understand the area’s health care limitations.

“It’s really hard growing up in the Valley and knowing that there was no real options. We were left with — ‘well, everything is over the hill.’”

Ensuring that confidentiality is strictly adhered to when working with patients (especially in a small community such as the Silver Valley), Currie explains that she and the rest of the mental health staff are equipped to handle a variety of different situations involving children to the elderly. Regardless of the situation though, they must first break through the ingrained skepticism concerning their specialty that is prevalent in the Silver Valley.

“Part of what we want to do here is break down the stigma of mental health,” Currie explained. “We live in a community that has a pretty strong attitude towards, ‘we are capable, pull up your boot straps, just keep on going, what happens in the home — stays in the home.’ It’s a part of the culture we are hoping to break down. When somebody comes in here, we want them to feel like its not because they are crazy or they have something so wrong with them. It’s about, ‘what are your goals and what do you want to achieve?’”

Once a patient is willing to seek help, then it comes down to tailoring a plan to fit their specific situation and will ensure engagement.

Currie said the big problems that they see patients suffering from are anxiety, PTSD, substance abuse, depression, suicidal thoughts and unhealthy relationships. The causes for these general mental maladies can be traced back to more specific issues depending on the patient’s circumstances.

For example, Currie explained that many of these illnesses are spurred by the homeless problem in the community.

“Even though we don’t have people sleeping on the street very often, there’s so many who are displaced or don’t have their own space or other basic needs,” she said.

This lack of basic needs can bring about depression, anxiety, substance abuse and even suicidal thoughts.

“We are treating a lot of suicidal thoughts and feelings,” Currie said. “We see the most of what we call ‘morbid thinking’ or that hopelessness — ‘I wish I could just go to bed and not wake up. I can’t do this anymore.’ That’s what we most frequently see, then the next set up is the actual suicidal thoughts.”

When morbid thinking or suicidal thoughts are suspected, the key for Heritage’s mental health team is to help the patient find purpose and show them that they have reasons to stay alive. This process sometimes includes creating safety plans.

Like the other major illnesses, drug abuse and the reason for it can be linked back to the presence of the others.

“The co-morbidity of that (drug abuse) is a big deal and a lot of the time, it’s like the chicken or egg. Have you been coping with drugs for so long because you have unresolved mental health issues? Or did your mental issues come from living a life in drug abuse? And most of the time it’s both,” Currie said.

To fight this, councilors work to figure out the key factors that caused the initial abuse. A lot of the time, Currie said, it can be traced back to depression caused by unhealthy relationships (in one way or another).

The most prevalent of these unhealthy relationships are domestic violence situations — whether they involve mental, verbal, physical or sexual abuse.

“We have so, so many domestic violence issues. A lot of people are isolated and not knowing how to reach out,” Currie said. “We do see a lot of that and sometimes it’s both people that are engaging in this behavior. There are definitely a lot of people where that is their ‘normal.’”

In most of these instances, the behavior is repeated over and over and leads to the abused remaining in the situation with a feeling of hopelessness.

“It’s hard to sit by and watch those who continue to choose to stay in their (abusive) relationship,” Currie explained. “A lot of times, they don’t feel like they have a choice, but there are some who say ‘Eh, it’s comfortable. Making a change would be hard.’ (We strive to) open those blinders of opportunity like, ‘you don’t have to live this way. You don’t have to accept someone belittling you every minute of everyday.’”

Anxiety can play a role in the prevalence of the these mental illnesses. Responsible for impulsive behavior and actions, many slip into substance abuse problems after seeking medication to alleviate their anxiety.

“The anxiety here is off the charts, Currie said. “Lots of panic attacks.”

With all of these issues, Currie cites a lack of resources in the community for the slow (or arguably stagnant) improvement of local mental health. Without proper shelters or support systems, victims of domestic violence, homelessness, or any other mental illness have very little options.

This is why she believes that the work that she, and the rest of the Heritage mental health team, is so important. Little by little, they hope to improve relationships one person at a time.

“We want to see healthy relationships, because if this Valley had more healthy relationships, it would be 100 percent different.”

Heritage Health CEO Mike Baker also stresses the need for healthy relationships with not just patients, but others in their field of work as well.

“Heritage Health prides itself with working closely with community partners, including the Shoshone Medical Center. We’re all one family, striving to help people.”

Heritage Health’s mental health team can be reached at 208-783-1454 and are available Monday through Thursday from 8 a.m. to 7 p.m., and Fridays from 8 a.m. to 5 p.m.

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