Idaho, another state of vast rural expanses, also has difficulty providing mental health services. In some cases, such as Grangeville, the nearest mental health provider is 71 miles away.
In rural areas, mental health patients simply cannot access services –community doctors do their best to patch up their physical problems and send them back home, knowing they’ll be back.
And even in Boise, a patient can’t get an outpatient follow-up visit with one of the 28 psychiatrists in town for two to three months after an emergency situation.
Throughout the state, police officers and sheriff’s deputies have become the gatekeepers for mental health services — and they aren´t trained to know what to do.
“We have to deal with the fact that by default our legal system has become our health system,” Saint Alphonsus Regional Medical Center ER director Dr. Mike Mercy said.
Too many mental health issues are first diagnosed in the emergency room, he said, and by the time patients get to the ER, they need extensive therapy, but they’re now in one of the most expensive places to get it.
Some tout the internet as a resource — online counseling. Unfortunately, online therapy services are not the answer. For one, financial obstacles prevent some people from affording a computer. Also, not all rural areas have reliable access to Internet connection. Most importantly, serious mental issues need to be handled in person; isolation is an exacerbating factor. The best answer is for the community to provide support via publicly funded government programs. Having worked at a for-profit mental health company, I have observed that the focus on profit often takes precedence over services. Mental health is best served by non-profit entities. At the moment, most services are provided thusly — except the government has decided mental health is expendable and has slashed funding for services.
It’s a quagmire.
From past personal experience, I’d say Idaho would be doing well to have a medical doctor of any stripe within 71 miles of somewhere.
I know this will pique your curiosity enough to ask, so I’ll just tell you ahead of time.
On Thanksgiving Day in 1992, I drove off a cliff in southeastern Idaho. It took four hours to get treatment, as the nearest doctor was in Logan, Utah. Well, not exactly true — there was a veterinarian in Preston, Idaho that I could have gone to. In spite of how much I respect the veterinary profession, I declined.
You drove off a cliff??!! They have cliffs in Idaho?
I’m glad you’re here to tell about it.
I just showed this post to someone, and he rather poignantly asked, “How do you know who’s crazy in Idaho?”
But back to the cliff. The Wasatch Range runs through Idaho, I believe. My particular cliff was about 70-100 feet high and was the bottom 70-100 feet of a decent-sized foothill. Somehow, for some reason, someone had erected a four-strand barbed wire cattle fence approximately ten to fifteen feet below the edge of the cliff. The fence ran perpendicular to the clifface and thus parallel to the ground. I blame aliens. So, when I inadvertantly drove the three-wheeler off of the road, I crashed through the tops of a couple of trees and landed in that fence. I had no idea that I was standing on a fence. When my friends helped me back up and I looked down, that was the first time I had any clue about just high off of the ground I had been. Coincidentally, that was when the first wave of pain hit.
I broke nothing, by the way. But I went through a lot of painful X-rays to prove it.