Behavioral Health Story Archives - West Virginia Public Broadcasting

Conference Aims To Help Teachers Teach Troubled Students

School mental health professionals from across the state had the opportunity to learn how to address mental health challenges and more in their classrooms.

The state Department of Education hosted a conference in Charleston to raise awareness of trauma, opioid addiction, and mental health challenges in schools, and to provide teachers, school counselors and other professionals with tools and strategies to address these issues.

The Student Support Conference is being held Nov. 29 through Nov. 30 at the Charleston Coliseum and Convention Center.

David Lee is the director of student support and wellbeing for the West Virginia Department of Education. He said teachers, and especially new teachers, aren’t always equipped to handle what they see in a classroom.

“So how do I know what to look for, for the emotional problems of a child? How do I address those issues? How do I learn to de-escalate situations in my classroom?” Lee said.

The conference is a chance to support professionals who are working in schools by teaching them ways to identify and address mental health and trauma in their students to better help them succeed in school and life.

“We’re dealing with kids that are coming from very difficult situations at home, and they’re walking in school, and we’re expecting them to just be normal, and that’s not possible with some of the situations that they are facing,” Lee said. “So how do we address that? How do we work with the counselors? How do we work with communities and schools?”

According to Lee, student mental health issues continue to rise because of the ongoing opioid epidemic in the state and recovery from the global COVID-19 pandemic.

“We’ve got to start teaching behaviors because we got kids that come to school that have no clue about behaviors,” Lee said. “Did COVID have a lot to do with that? It did, yes. But we’ve had these problems before. They’ve been masking a lot of ways, but now they are really showing their true colors right now, because of the isolation that kids went through.”

Lee said he hopes this training makes teachers proactive in their classrooms and teaches them to act instead of react to potential behavioral issues that may arise from problems at home.

“You’re not gonna solve all the problems in high school right now, that’s not going to happen,” Lee said. “But you’ve got to start a building block and I really think in the K through three, teaching those behaviors, modeling those behaviors and what it should be like, is a good foundation.”

W.Va. Experiencing Mental Illness At Rates Higher Than The National Average

West Virginians are experiencing mental illness at rates higher than the national average, and it’s even worse in southern West Virginia.

According to multiple studies, Boone and Logan counties have the highest rates of depression in the nation.

Data from the Centers For Disease Control and Prevention show that in 2020 more than 18 percent of U.S. adults reported having ever been diagnosed with depression. In that same period, 27.5 percent of West Virginians reported being diagnosed with depression, the highest in the nation.

The CDC analyzed 2020 Behavioral Risk Factor Surveillance System data to estimate the national, state-level, and county-level prevalence of U.S. adults aged older than 18 years self-reporting a lifetime diagnosis of depression.

In the report, the CDC found that most of the states with the highest prevalence of depression were in the Appalachian and Mississippi Valley regions.

Jessica Bradley is a psychologist at Marshall Health. She said the rates of depression revealed in the June 2023 CDC report were concerning to her as a mental health provider and a citizen.

“The data showed that an estimated 32 percent of adults in Logan County have been diagnosed with depression, which is the highest in the nation,” Bradley said. “And that number for West Virginia was 27.5 percent. But that’s opposed to, I believe,18 percent of adults nationwide. So clearly, we are at a much higher rate. That’s concerning as a provider. It’s also concerning as a citizen because these are, these are our family members. These are my friends. These are people that I care about. And it’s not just numbers, these are humans with stories.”

While the CDC report revealed Logan County as the most depressed county in West Virginia, and the nation, Christina Mullins, commissioner for the West Virginia Department of Health and Human Resources’ Bureau for Behavioral Health, said the CDC’s data was compiled from 2014 to 2020 and cited the newly released West Virginia MATCH Survey as the research her department relies on.

“So what I think is happening, what I think has happened to some degree, is that we’ve all gotten a little worse through the pandemic and but I don’t know that Logan County has gotten as worse as some, as bad, you know, has worsened as much as other areas, because my data is right now is not supporting what’s shown in and that data is valid for the time period that it was collected,” Mullins said.

MATCH is a biennial survey – meaning data is collected every two years. One out of 14 adult West Virginians are randomly chosen to participate using a large database of West Virginia residential addresses. The first survey period was August 2021 to February 2022.

“The data indicators are not exactly the same,” Mullins said. “But I had Logan County as 12th, actually in the state for depression, anxiety or PTSD, PTSD in the last 12 months, at 27 percent. And the state average being 24.3. So they weren’t, they weren’t the worst when I was really looking at the stats.”

According to the West Virginia Match Survey, 27.4 percent of Logan County residents said they had experienced depression, anxiety or post-traumatic stress disorder in the past 12 months.

The highest rate, according to the West Virginia MATCH Survey, was in Boone County, just over the county line, with 32 percent of residents reporting experiencing depression, anxiety, or post-traumatic stress disorder in the past 12 months.

Researchers for the CDC found that rates of depression in West Virginia might reflect the influence of social determinants of health or patterns of other chronic diseases.

“Social determinants are a really broad concept,” Bradley said. “And they start out as anything from food insecurity to parental involvement. Whenever you’re a kid, to job security, and family stressors. on a community level, it looks like the economy and what’s going on the world around you. And that can be extended to just nationwide. So, if you take all of that into consideration, everything is playing apart, and where you are, how you’re feeling about things.”

Boone and Logan counties were coal-producing powerhouses until the nation moved away from coal-powered electricity and the mines began to close.

“One of the symptoms of depression is hopelessness,” Bradley said. “And it’s so much easier to feel hopeless about things, whenever the voices that you hear are telling you that there’s no hope.”

In response to these challenges, Logan County residents are banding together for better health.

The Coalfield Health Center in Chapmanville is part of a group that hopes to address southern West Virginia’s health outcomes. Next to the clinic, Wild, Wonderful and Healthy Logan County (WWHLC) is developing a public greenspace for all Logan County residents.

“We have relationships across our state to try to meet the need in these rural populations because it’s so difficult for it’s so difficult for people to get access to quality services are really just to get access to services period, in the rural settings they have to travel or maybe they don’t have the finances to be able to travel to the big city,” Bradley said. “That’s one of the things that’s so difficult so telehealth has really helped improve that access. And then also people are just willing to do the work to get to these places. And I think that’s a really wonderful thing.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

**Editor’s Note: A previous version of this story incorrectly said Jessica Bradley is a physiatrist. She is a psychologist.

Child Behavioral Telehealth Services Coming To W.Va. Underserved Rural Areas

Already underway in the Summers County community of Hinton, a prototype program is offering mental health support for pediatric patients with diagnoses including depression, anxiety and ADHD disorder.

A prototype program is offering mental health support for pediatric patients in the Summers County community of Hinton. Diagnosis and treatments include depression, anxiety and ADHD disorder.

The new program is a collaboration between Appalachian Regional Healthcare and Marshall Health Network. On appointment days, patients visit a rural health clinic, and are connected virtually to a psychiatric mental health nurse practitioner (PMHNP). In addition to conducting initial psychiatric evaluations and follow-up appointments, the PMHNP also prescribes and evaluates psychopharmacologic treatments alongside a collaborating psychiatrist.

Dr. Susan Flesher is the Department of Pediatrics Chair at Marshall University’s Joan C. Edwards School of Medicine. She said psychiatric care is the perfect place for rural telehealth.

“It’s a little bit hard for us sometimes to think about a child coming in to look in an ear or listen to a heart,” Flesher said. “Those things take more technology on telehealth. With the care that we’re talking about, it’s a matter of talking with the child, the family, figuring out what the issues are, what the concerns are, doing some screening tests, providing therapy, medications, whatever the case may be. It’s perfectly suited to telehealth.”

Flesher said the program offers access to specific medical professionals that otherwise would not be readily available.

“There is a real shortage of psychiatrists and mental health nurse practitioners in rural areas,” Flesher said. “This is a service that they otherwise would not be receiving, or would have to travel a long distance to receive.”

Flesher said the Hinton program is a first step of an anticipated child mental telehealth network.

“We are in talks with some other places to expand this,” she said. “We don’t have signed contracts in place yet so I’m not necessarily free to speak, but we are definitely trying to provide this service where it is so very much needed, and there seems to be a lot of interest.”

The program is accepting new patients by referral. For more information, contact the Summers County ARH Rural Health Clinic at 304-466-2918.

W.Va.’s Health Care Future Laid Out For Legislators

The West Virginia-based experts said the future of healthcare in the state is focused on a culture of innovation that has gone beyond theory.

Legislators who gathered for interim meetings Monday attended a panel discussion of health care research leaders. The West Virginia-based experts said the future of healthcare in the state is focused on a culture of innovation that has gone beyond theory.

They explained and demonstrated, with examples of real-time advanced medicine, that the West Virginia focus on a culture of health care innovation has the state becoming a world leader. One example was a literal “eye opener.”

Dr. Ali Rezai, executive chair for the WVU Rockefeller Neuroscience Institute, explained a preventive innovation in combating Dementia and Alzheimer’s involves a simple eye test patients can do in their eye doctor’s office. Rezai said the test provides a risk profile based on the eye scan. He said that profile can tell patients – with AI published studies – if they have a higher risk for neurodegenerative conditions.

“Many times you have 20 years of progression of protein accumulation in your brain for Alzheimer’s and Parkinson’s and you’re not aware of it,” Rezai said. “After 20 years of degeneration, then you start having a little twitching your finger or forgetting your way around more than usual, and that’s the 20-year opportunity waiting to detect disease.”

Rezai said results from that eye test could lead to patients making life modifications like stress reduction, diet, exercise and better sleep hygiene. He said these are simple things can change one’s risk of getting Alzheimer’s.

The researchers demonstrated, with numerous health care innovations, that replacing diagnosis and treatment with preventive health methods using technology and artificial intelligence improves public health.

Marshall University Joan C. Edwards School of Medicine Dean Dr. David Gozal explained the future of health has become proactive, using genetic technology to assess internal body functions, looking at the environment, and preventing health problems before they ever start.

“Unique elements that are now becoming the next generation of technology,” Gozal said. “Sensors that today can measure a variety of things in real time and communicate these to computers in real time from the home of the patient to the physician and vice versa. All to assess risk, to identify unique interventions and to actually intervene in real time without necessarily coming to the office or going to the hospital.”

Rezai said new technologies, AI — and in this case a new use of ultrasound — are making great strides right now in combating substance use disorder.

“If you’re somebody with an addiction, you show somebody shooting heroin, your craving goes way up and you become very anxious,” Rezai said. “So by increasing the cravings, then we can deliver ultrasound to the craving centers of the brain and shut it down and essentially reboot the brain and reset the brain.”

Asock Aggarwal, chief strategy officer with Intermed Labs said his company is helping West Virginia move to a health care world that is preventive, starting with an expectation of predictability and preventative maintenance.

“That is what we’re all accustomed to here in West Virginia,” Aggarwal said. “We all do preventative maintenance on our cars, on our tractors, on our coal mines, on our power plants. We need to do more preventative maintenance on our human bodies. We have an ability to address a lot of issues related to obesity, rural health, eldercare, addiction and addiction sciences, and all the mental health issues that are related to that. In each of these areas, we have the ability to implement AI and preventative care, to try to address these issues before someone goes on to have a heart attack, before someone goes on to have a psychosis.”

Panelist Dr. Connie Bormans is chief scientific officer with RGEN, a company focused on molecular genetics and DNA analysis. Bormans is also working to replace diagnosis with prevention. Her focus is on Cystic Fibrosis and other inherited disorders.

“We’re going to couples who want to have children,” Bormans said. “In an attempt to identify couples who are at risk of having children with these diseases and preventing it. By shifting to prevention, there’s a huge cost savings. As a private lab, one of our goals is to make genetic testing affordable for everyone, regardless of their insurance rate, regardless of if they have health insurance that will cover it. We want to drive down the costs. So anyone that wants to have a test can have a test. And by doing that, we’re going to prevent or remove a lot of these cases, a lot of these conditions from the population.”

All the panelists agreed the future of educating physicians must focus on working as medical teams, working in public-private collaborations and embracing a culture of innovation.

“We are not individual physicians anymore,” Gozal said. “We are a team of professionals that work together. This is the way that medicine will be practiced in the next several years, as we advance the technology, as we advance the ability to introduce these elements into the practice. I believe that West Virginia, by virtue of the panel that has been assembled here, and all of you, by your interest, will see that by the next generation of physicians that we will train at Marshall University, at West Virginia University and many other medical schools around the nation.”

DHHR To Distribute Federal Funding For Mental Health And Substance Use Services

In a release, the DHHR outlined seven grant programs that will support various health initiatives across the state.

More than $33 million in federal funding was awarded to the Bureau for Behavioral Health (BBH) to enhance mental health and substance use prevention services for West Virginians.

Federal funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) will support prevention, early intervention, treatment and recovery services across the state.

“BBH and its partners are seizing every opportunity to meet our state’s behavioral health needs,” said Dawn Cottingham-Frohna, commissioner for the West Virginia Department of Health and Human Resources’ (DHHR) Bureau for Behavioral Health. “With this funding, we are not only addressing the immediate needs of our communities but also investing in the long-term well-being of West Virginians.”

In a release, the DHHR outlined seven grant programs that will support various initiatives:

The Screening and Treatment for Maternal Mental Health and Substance Use Disorders program will provide $750,000 annually for five years from the Health Resources and Services Administration to expand health care provider’s capacity to screen, assess, treat and refer pregnant and postpartum women for maternal mental health and Substance Use Disorder (SUD). BBH is partnering with the West Virginia Perinatal Partnership’s Drug Free Moms and Babies Project to implement the program.
The Children’s Mental Health Initiative will provide $3,000,000 annually for four years to provide resources to improve the mental health outcomes for children and youth up to age 21, who are at risk for, or have serious emotional disturbance or serious mental illness and their families with connection to mobile crisis response and stabilization teams and other community-based behavioral health services through the 24/7 Children’s Crisis and Referral Line (844-HELP4WV).
The First Responders – Comprehensive Addiction and Recovery Act Grant will provide $800,000 annually for four years to build upon the Police and Peers program implemented by DHHR’s Office of Drug Control Policy. The activities will be administered by the Bluefield Police Department, Fayetteville Police Department, and the Logan County Sheriff’s Office in collaboration with Southern Highlands Community Mental Health Center, Fayette County Health Department and Logan County Health Department.
The Projects for Assistance in Transition from Homelessness grant will distribute $300,000 annually for two years to support the system of care for adults in West Virginia and promote access to permanent housing and referral to mental health, substance abuse treatment and health care services. Grantees are located in areas of the state with the most need, based on the population of individuals experiencing homelessness, including the Greater Wheeling Coalition for the Homeless, Prestera Center, Raleigh County Community Action, the West Virginia Coalition to End Homelessness and Westbrook Health Services.
The Promoting the Integration of Primary and Behavioral Health Care grant will provide $1,678,044 annually over five years to serve adults with serious mental illness who have co-occurring physical health conditions or chronic diseases and adults with SUD. Three provider partner agencies have been identified to work on this project including Seneca Health Services Inc., Southern Highlands Community Behavioral Health Center and United Summit Center, covering 16 counties in the state.
The Cooperative Agreements for States and Territories to Improve Local 988 Capacity will provide $1,251,440 annually for three years to enhance the capacity of West Virginia’s single 988 Suicide & Crisis Lifeline center, which is funded by BBH and operated by First Choice Services, to answer calls, chats and texts initiated in the state. In addition to this award, First Choice Services received $500,000 from Cooperative Agreements for 988 Suicide and Crisis Lifeline Crisis Center Follow-Up Programs and a National Chat and Text Backup Center award from Vibrant Emotional Health to help answer overflow chats and texts from more than 200 local 988 centers nationwide.
The Behavioral Health Partnership for Early Diversion of Adults and Youth will provide $330,000 annually for five years to establish or expand programs that divert youth and young adults up to age 25 with mental illness or a co-occurring disorder from the criminal or juvenile justice system to community-based mental health and SUD services.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

Lawmakers Hear Updates On DHHR Reorganization

The three appointed secretaries of the new bureaus of the DHHR provided lawmakers with updates on restructuring within the department. Legislation passed in 2023 required the department to be reorganized and split into three agencies after concerns of inefficiencies in the system.

Members of the Legislative Oversight Commission on Health and Human Resources Accountability voiced concerns about the restructuring of the Department of Health and Human Resources on Tuesday.

The three appointed secretaries of the new bureaus of the DHHR provided lawmakers with updates on restructuring the department. Legislation passed in 2023 required the department to be split and reorganized after concerns of inefficiencies in the massive agency.

The new secretaries are Dr. Sherri Young, incoming secretary of the Department of Health, Dr. Cynthia Persily, incoming secretary of the Department of Human Services and Michael Caruso, incoming secretary of the Department of Health Facilities.

Young said and her fellow secretaries are identifying critical vacancies in their departments and consolidating some empty positions.

“We have met with our respective new departments, within our bureaus and offices so that we can better understand what needs they have as far as critical vacancies and what positions need to be filled, and how we could be more administratively responsible with the positions that haven’t been filled for quite some time,” she said.

Young also reported a decrease in vacancies in the Bureau for Social Services, the Bureau for Child Support Enforcement, the Bureau for Medical Services and the Bureau for Behavioral Health.

However, the Department of Health Facilities, the Bureau for Public Health and the Bureau for Family Assistance increased in vacancies.

Caruso explained the problem in his presentation.

“Basically, we don’t pay our people enough on an hourly rate,” Caruso said. “All right, and neither does the rest of the systems. The fact is that most of our employees have just jumped to the contracted services.”

Caruso also reported that he brought in Baker Tilly US, LLP, an advisory, tax and assurance firm, to do a benchmark study on all facilities and perform a complete financial review.

“Those studies were completed last week, those studies will be integrated, and we will educate our leadership team as well as our CEOs over the next week and a half,” Caruso said.

Health Management Information Systems, or HMIS, are software used to manage and analyze healthcare data. Caruso said he is looking to improve the Department of Health Facilities’ HMIS.

“We are looking internally to improve that process and improve that program, as well as potentially looking at other outside vendors to cover our emergency or electronic medical records,” Caruso told lawmakers.

Persily reported a reduced vacancy rate in the Department of Human Services and accredited that to pay raises and access to behavioral health services for Child Protective Services workers.

“So the work that you did in the last session, to increase salaries, to provide regional salary differentials, it’s worked. We have reduced significantly the vacancies in that particular job classification,” Persily said. “I believe that in January last year, when you heard about this, the rate was about 30 percent. And our rate at the end of July was 17 percent.”

Lawmakers questioned the secretaries on their proposed structuring of the departments, voicing concerns about the level of bureaucracy operating in the agency.

Del. Amy Summers, R-Taylor, asked the secretaries to be proactive instead of reactive in their planning.

“My only concern is I don’t want to duplicate what we’ve been doing when we have this great opportunity to create something new,” Summers said.

Persily said she and the other secretaries will have a model in place by January 1, 2024, the deadline for the department to split, but advocated for flexibility.

“We are not going to be wedded to a model if it doesn’t work, and we will constantly be improving that model as we move along. And so any changes would be for efficiency, and for functionality,” Persily said. “But what I will say is that you will, you will see some consistencies across the three departments, you will see that we there are some things that each department needs.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.