Current Issues in Mental Health

Coping with Mental Illness in the Mid-Shore Region

In September 2005 focus group meetings sponsored by the Shore Health System and conducted by the Ashley Group, a professional research consulting firm, discussed the mental health and substance abuse services available in the five-county mid-shore region. Participants included professional clinicians and consumers alike.

The region served contains 1,797 square miles (larger than Rhode Island) and 165,000 people (91 people per square mile). Anne Arundel County, by way of contrast, contains 416 square miles and 507,000 people (588 per square mile). Thus the mid-shore region may be defined as a rural environment with widely dispersed centers of population.

Currently this area is served by twelve clinical centers accessible to the general public: four in Dorchester County, three in Talbot County, one in Caroline County, two in Queen Anne County, and two in Kent County. Typically, there is a six to ten week waiting period to see a psychologist or psychiatrist. This is because:

• The region lacks the population density to provide more appropriate services under
  the current “one formula fits all” distribution of state and federal funds.
  
  
• There are not enough mental health professionals to go around.

Urgently needed is a revised state reimbursement system that takes into consideration the added costs incurred by service providers in rural jurisdictions, notably supplemental transportation where there is no scheduled public transportation system, and extending patient care to outlying areas. At the same time there is a critical lack of psychiatrists and psychologists whose services are available to those not adequately covered by insurance and not capable of paying fees for service.

The mid-shore region is, accordingly, poorly served when it comes to the funding of mental health services, and it is seriously deficient when it comes to providing access to those services. Its current “system” is fragmented, redundant, and uncoordinated. Furthermore, as it has grown and changed demographically there has been little coordination among the five counties to improve access to care and parity of funding.

State funding formulas should take into consideration regional needs with respect to availability of services, housing, transportation, and financial assistance (especially Medicaid). The state should encourage greater regional planning and coordination in rural areas. The state should consider issues of mental illness at parity with other human illnesses.

Written by William E. Vincent, Chair person of Transformation Work Group

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