Shaking the stigma: A look at mental healthcare access in eastern Kentucky

Experts are concerned about a growing Mental health crisis nationally. In part one of our series on rural health, we take a look at the struggles faced by those dealing with mental health access in eastern Kentucky.

“We're Appalachian people, so we're seen as being strong, and that's how we want to portray ourselves, and if you have any kind of mental illness it is seen as a weakness.”

Kasey Wright is the System Director of Behavioral Health, Education, and Psychological Support for Appalachian Regional Healthcare. She said this is a stigma surrounding mental health that many people in eastern Kentucky face. Wright and her colleagues try to convince their patients this is not the case.

“We try to tell our patients, like I've said before, if you have diabetes, you have to treat that, its a medical condition, its the same if you have depression, you have to treat that, it's a medical condition.”

For some, it takes a major incident for them to make the decision to seek help.

“I had a suicide attempt when I was 21.”

That's Valeri Jones of Morehead, Kentucky. She reached her tipping point almost twenty years ago. She said dealing with substance abuse and anxiety was getting to be too much for her to handle.

”I just couldn't live like that. I couldn't live feeling depressed and I couldn't function, I couldn't work, I lost my job, I just couldn't function. So, that is when I was like “it's time to do something, it's a true, real chemical imbalance.”

But it hasn't been an easy road. Once she started getting help, it was hard to find consistency with her treatment.

“My appointments would get canceled, they would get rescheduled, and every third or fourth appointment that I would finally make it in for, now, some of that was my fault, I would have work or scheduling conflicts or whatever, when I would make it in, I was constantly with a new therapist.”

And she said, seeing a new therapist every other visit was a struggle in and of itself.

Jones said it is frustrating because she is constantly told she needs to pair her medications with therapy.

“I'm prescribed all these medications that I'm told by my doctors that “you need to pursue counseling, you need to be in therapy while taking these medications because this is the most effective way to deal with your issues.” But then I'm trying to keep up my end of the bargain, but then I keep getting canceled and told “basically, it doesn't really matter.”

She said sometimes it makes her lose heart.

“And it makes me not want to go, and I'm limited with what providers I have access to.”

Jones works in the mental health field herself. She knows it isn't easy for those trying to help.

“So I get it, the pay is not great, the work is demanding, it's mentally exhausting, but as someone on the other end of that, who is trying to get those services for myself, and someone with anxiety, it's hard to, it's hard to just go in and talk to someone period.”

This isn't the only hurdle people face. Kasey Wright, with ARH said, in southeast Kentucky, sometimes, even just getting to the appointment is difficult.

“We don't have Uber, we don't have taxis here, we don't have things like that. Most of our people live in hollers and things like that, that aren't close to town, so it's really hard for our people to get a ride to any of their appointments.”

Paulina Jones is the Director of Counseling and Psychological Services at ARH. She said public transportation isn't much of an option either.

“Our public transportation, when you have to make an appointment for them to come and get you, you have to do it three days in advance. So, some of our patients don't even have telephones, and even for WiFi, there isn't good WiFi service either.”

Paulina Jones said another stumbling block for those seeking help is finances. Many of the people who get help from ARH are on Medicaid, but for others, it can be much more difficult to pay for treatment.

“But if you have Medicare, only certain providers can get paid for that, and if you have private or insurance, you're only allotted so many days of like, outpatient therapy, so you may be only getting like 10 days to clear up whatever the issue is, and if you have trauma and something like PTSD you're probably not going to get that healed up in 10 sessions.”

Both Paulina Jones and Kasey Wright say they are seeing more funding being directed toward mental healthcare, but they would like to see officials do more. Jones said while they have several inpatient facilities for those dealing with substance use disorder, there needs to be something set up for long term mental healthcare.

“We have patients here, they get stuck here for quite a while and they need a lower level of care and there is just not placement. There is no personal care homes, there's no nice facilities for our chronically mentally ill to go and live and live the rest of their lives and not have that high recidivism, keep coming into the hospital because of the living conditions or not having a safe place to go.”

Along with funding, other efforts are underway. Earlier this year, Governor Andy Beshear signed into law House Bill 385, known as Seth’s Law. Officials say the law will result in fewer citizens needing to be placed under state guardianship to access health care.

The bill honors the memory of Seth Stevens, who was an advocate for mental health reform, who died by suicide in 2023.

Anyone who may be experiencing suicidal thoughts or any kind of mental health crisis can call or text 9-8-8 twenty four hours a day, seven days a week to speak to someone qualified to help.

More information on the 9-8-8 suicide and crisis lifeline can be found here.

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