The Scaffolding of Society: Celebrating Rhode Island’s mental health services

Rhode Island’s mental health organizations are among the state’s most under-recognized heroes, yet when events such as those that unfolded in Westerly on December 19 reawaken discussions on psychological wellbeing, it sharply puts into focus not only why Rhode Island needs mental health organizations, but also that their work is not defined by any single demographic or lone issue.

And that is because Rhode Island is a perfect microcosm of the theoretical American melting pot. It is a diverse, multicultural state, and with that variety comes its own sets of idiosyncrasies. Ana Bess Moyer Bell is founder of C.O.A.A.S.T. (Creating Outreach About Addiction Support Together), and explains why being aware of cultural difference is critical for the state’s mental health organizations: “Depending on a person’s background, they will experience different kinds of trauma, which often leads to distress and mental illness. Depending on the community, mental illness and addiction are addressed as diversely as its residents. The way communities react to mental health issues can do as much to help its residents find recovery as it can further isolate them.”

Like C.O.A.A.S.T, the state’s various mental health organizations (of which there are dozens), are integral parts of our community and each work diligently to understand — and appreciate — our diversity. Community mental health centers (to use one example), exist in Scituate, Burrillville, Warwick and Hopkinton … and Foster, Glocester and Barrington too, plus 30 other locations across the state. And long may they remain. The most recent SAMHSA Behavioral Health Barometer for Rhode Island (2017) found the prevalence of serious mental illness for adults 18 and older at 4.8% at a time when the national average was 4.2%. However, the same study also revealed Rhode Islanders are far more likely -– a whole 10% more likely, compared to the national average -– to take strides to support and empower themselves if they have the resources to do so. And that speaks volumes; when provided with a solid platform of mental health organizations, Rhode Islanders will go. 

But this is all relatively new. Five years ago, Rhode Island presented a dramatically different mental health landscape, with above average ‘high-risk’ factors (including single-parent households, higher rates of substance use disorder and higher unemployment) indicating a critical need for increased support for mental health services across the state. Real momentum began to occur in the past 12 to 18 months, and with the launch of BH Link in November 2018, the state’s only 24/7 triage center and hotline for Rhode Islanders 18 and over experiencing mental health and substance use crises, the gauntlet has been more than laid down. But it’s not all smooth sailing just yet.

Jim Ryczek, CEO of Horizon Healthcare Partners (HHP); a coalition of several of the state’s community mental health centers that oversees BH Link, comments that while “the introduction of BH Link is a great positive, and has already identified blocks in the system and areas where we need to close the gap, it’s difficult to facilitate without proper understanding, and that creates a logjam.” 

“Increased timelines of getting patients to higher levels of care results in them leaving the system early,” he continues, “or never managing to reach them at all.”

Ryczek isn’t alone is his sentiments. “Rhode Island has made significant inroads in service access over the past year with the initiation of BH Link,” explains Randal Edgar, public information officer of the State of Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals. “And it is fortunate to be home to many excellent providers who offer critical services and supports to residents. That being said, we still have work to do to ensure that every single Rhode Islander is connected to the services and care they need.”

And the disparities between initiatives and patients identified by Edgar and Ryczek are echoed across the state. At C.O.A.S.S.T, Moyer Bell explains that Rhode Island “faces fatalities resulting from mental illness and addiction at greater rates per capita than other states.” She continues, “Rhode Island sits in the top 10 list for states with the most drug overdose deaths and we are one of the 25 states in the nation that has seen suicide rates increase by 30% in the last two decades.”

Despite these challenges, the pendulum is swinging in favor of Rhode Island’s mental health organizations. In September, the US Department of Health and Human Services provided $9 million to be invested in mental and behavioral health services for students, while in April last year, the Senate Fiscal Office Report on the governor’s 2019 – 2020 budget detailed an increase of $10.5 million in federal funds within the Division of Behavioral Healthcare Services. In addition, the State Opioid Response Grant provided $12.6 million to be used in addressing the current epidemic, with $590,000 earmarked to fund mental health and behavior health training within the school systems. 

And that’s just the tip of the budget’s mental health iceberg; this is a State House on a mission, and Rhode Island’s mental health organizations are responding with thoughtful solutions for investing the funds.

“We talk about focusing upstream and increasing access to preventative services as well as early screening and intervention,” explains Edgar. “With prevention, universal screening and early intervention services we can have long-lasting impacts on the emotional wellness of our state and reduce the burden of mental illness and substance use disorders for individuals and their families.”

However, money does not always equate to results; at least not immediately. “We need more funding,” comments Ryczek, “because it’s competitive, and the state funds the program or entity that makes most sense. We all compete for money, but also coordinate with competitors, and I’m not sure how well that is understood and communicated at the state level.”

However, this is Rhode Island, and community spirit runs deep. “If you value a particular health organization,” urges Ryczek, “tell a decision maker. Write to your local state representative. When politicians hear you care, they care, and then it is easier for them to address the needs of the community from a place of understanding.” 

So, all things considered, where does this journey end, and where will it take mental health organizations in 2020? Edgar reports some encouraging data: “According to Mental Health America’s (MHA) 2020 ranking of states, Rhode Island is at number 4, which, according to MHA, indicates a lower prevalence of mental illness and higher rates of access to care. Pennsylvania, New York and Vermont are the only states with higher rankings.”

After all, as Gina Raimundo commented in December 2019, “I’m proud to be governor of a state where people come together to combat stigma and help our neighbors who may be struggling.”

Hyperbole it is not: Rhode Island’s mental health organizations are integral to our daily lives; psychological steel girders that buttress, support and encourage our residents. Let’s never take them for granted.