Gov. Evers is allocating $1 million in grants to reduce mental health disparities. Here's why.
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Workforce shortages, stigma and prejudice, cost, and transportation are some of the factors that complicate the mental health crisis in Wisconsin, and those problems are only magnified across the state's underserved populations.
From rural residents to people in the Hmong community, the need to increase support for a diverse set of lived experiences is part of a larger effort to close gaps in the state's mental health care system.
That's part of why Gov. Tony Evers and the Wisconsin Department of Health Services on Monday awarded 10 organizations a total of $1 million in grants to help enhance access to mental health and substance use care for these communities. Each of the following organizations will receive $100,000 to develop projects that support people with diverse values and beliefs.
Arbor Place in Menomonie
Autism Society of Greater Wisconsin in Menasha
Chrysalis in Madison
Community Advocates in Milwaukee
HIR Wellness Institute in Milwaukee
Hmong American Friendship Association in Milwaukee
Meta House in Milwaukee
SOAR Case Management Services in Madison
These 10 organizations are "doing the kind of work we must continue to invest in to ensure that all our Wisconsin communities have adequate access to mental and behavioral health services,” Evers said in a news release Monday. The grant comes a month after Evers declared 2023 "the year of mental health" in his State of the State address where he announced his 2023-25 executive budget would include $500 million to expand access to mental and behavioral health.
For Jason Cram, Children, Youth, and Families Section supervisor for Wisconsin Department of Health Services, the grant helps to identify cracks in the behavioral health care system, which can better inform the way future money is used to support mental health in the state.
"That's where (Evers') declaration should come in, to stand up and support these individuals who are falling through the cracks, to make it a true continuum of care that's a safety net for everyone," Cram said.
What do mental health disparities look like in Wisconsin?
It's not always clear who's underserved without going into the community, which is part of why, in early 2022, Cram and his colleagues went on a listening tour of all the county agencies and county human services directors. The goal was to learn where the greatest needs in the state were, identify those diverse populations and help promote funding efforts.
Cram heard loud and clear from agencies on the ground that people living in rural communities struggled with transportation, access to broadband and access to nearby services.
That's supported by a report from the University of Wisconsin Population Health Institute, which found that 55 of Wisconsin's 72 counties had "significant shortages" of psychiatrists, with 31 counties needing anywhere between two and 10 additional full-time psychiatrists to remove psychiatric shortages. All 31 counties are considered rural.
Jill Gamez, executive director of Arbor Place, one of the 10 grantees that specifically works with rural communities, said the amount of isolation and disconnectedness people in rural areas face has risen to the top of the organization's concerns for mental well-being. That's especially troubling for those rural-based people who have untreated mental health conditions and substance use disorders, Gamez said.
Cram consistently heard about struggles to connect the Hmong population to mental health services, and chief among those difficulties was accessing culturally relevant therapists. For the more than 58,000 Hmong people living in the state, Hmong American behavioral health providers are few and far between. Hmong American Friendship Association met the DHS rubric for its program design.
Additionally, Wisconsin became the new state home for many predominantly Muslim refugees following the U.S. withdrawal of troops from Afghanistan in the summer of 2021. Those individuals require trauma-informed support and a range of specialized needs that Milwaukee Muslim Woman's Coalition will provide over the course of a three-day mental health conference.
And while Cram said there weren't applications from tribal populations this round, he heard from counties and tribes across the state that mental health needs are underserved and widespread. Suicide looms large for Indigenous youths ages 15 to 24 in Wisconsin, where it's the top-leading cause of death, according to the Centers for Disease Control and Prevention.
Why do these mental health disparities exist?
Often, people from underserved populations have been historically excluded and systematically marginalized, putting them at a disadvantage as they attempt to navigate behavioral health care systems, said Nze Okoronta, peer services director at SOAR Case Management Services, another grantee this year.
Those systemic barriers, Okoronta said, prevent many populations from "accessing meaningful care" that responds to the whole person, everything from culturally responsive to linguistically appropriate services.
Cram echoed this, adding that transportation has been a huge issue he's heard across counties as a barrier to mental health care. It's part of why DHS issued grants to 27 behavioral health agencies to expand telehealth last year, but those grants are coming to an end in July.
Stigma continues to contribute to gaps in mental health care, said Gamez, of Arbor Place, especially when law enforcement perpetuates the message that people in crisis need to be arrested or transported to a hospital.
"Let's say you have an EMS person saying things like, 'Oh, we're responding to this person's house again, they just need to get a job, they need to quit drinking' — that's the voice of stigma. That's the voice of, 'They're not good enough,'" Gamez said. "When we can change that narrative to say recovery is possible for this person, that can reduce the stigma."
Sense of belonging is often missing from underserved communities. Kirsten Cooper, executive director of Autism Society of Greater Wisconsin, another grantee, said that is especially felt by people in the autism community, many of whom struggle to be understood by their often neurotypical therapists — that is, people who are considered part of the normal variation in the general population.
"Over the years, we've gotten so many questions about wanting to get connected to therapists that really understand autism and autistic neurology. And we just don't always have a whole lot of places to send families," Cooper said.
Unique needs require unique solutions, Cram said, whether that means free training courses for behavioral health therapists to better accommodate the needs of autistic clients or implementing peer-based support over traditional clinical frameworks.
"The purpose of this (grant) is to provide training and technical assistance to therapists, so that they can expand their knowledge base on how to provide culturally relevant services and culturally aware services to these diverse populations," Cram said.
Natalie Eilbert covers mental health issues for USA TODAY NETWORK-Wisconsin. She welcomes story tips and feedback. You can reach her at neilbert@gannett.com or view her Twitter profile at @natalie_eilbert. If you or someone you know is dealing with suicidal thoughts, call the National Suicide Prevention Lifeline at 988 or text "Hopeline" to the National Crisis Text Line at 741-741.
This article originally appeared on Green Bay Press-Gazette: Gov. Evers awards 10 organizations grants to close mental health gap
