Editor's note: This is the final installment in a four-part series on the Community Health Needs Assessment completed by SIH.

When Southern Illinois Healthcare released findings from its Community Health Needs Assessment in March, it chose three health priorities for the region: Cancer, cardiovascular disease (commonly called heart disease) and its risk factors of diabetes and obesity, and mental health.

To help define the mental health risks for Southern Illinois, SIH conducted a community survey in May 2015 and conducted interviews with healthcare providers in May and June of 2015. Here’s what those surveys and interviews found regarding mental health.

Nearly 42 percent of adults in Franklin, Jackson, Johnson, Perry, Union, Saline and Williamson counties reported that their mental health was not good at least one day in the month before the survey.

Our children aren’t doing any better. The assessment also looked at eighth graders, and 26 to 34 percent said they felt hopeless almost every day for two weeks or more in the past year — so hopeless they stopped participating in their usual activities.

It also looked at the increasing suicide rates in Southern Illinois. The age-adjusted rates for the state of Illinois is 9.05 suicides per 100,000 residents, one and a half percentage points under the Healthy People 2020 Goal of 10.5 per 100,000. (Healthy People 2020 is a government program designed to improve the health of Americans by providing science-based health goals.)

In our region, the suicide rates are much higher at 15.02 per 100,000.

To help reduce the rate of suicide, SIH will:

• Increase depression screening among adults and youth ages 12 and older;

• Increase the number of primary care facilities that provide mental health treatment onsite or by referral;

• And increase the number of children and adults with mental health problems or disorders who receive treatment.

According to the National Alliance on Mental Illness, depression is a serious mental illness. It is much more than just feeling sad. Symptoms can include not sleeping or sleeping too much, weight loss or gain, lack of concentration, loss of energy, low self-esteem, hopelessness, changes in movement, both agitation and exhaustion, and physical aches and pains.

We all have times when we cannot sleep or concentrate or feel agitated or exhausted. How do we know if it is a serious depression?

Christopher Rural Health Planning Corporation, an organization that also is required to perform community health needs assessments, has some answers.

The corporation’s most recent health needs assessment showed mental health was a priority, too. As a result, the organization hired additional staff specializing in mental health and trained existing staff to help identify patients who might be in need of additional assessment and treatment.

Samantha Pulley of CRHPC said the organization hired two psychiatrists to work one day in Albion and one day in Flora. One of the doctors also provides services via telemedicine one day a week.

They also hired a mid-level nurse practitioner trained in mental health to work four days per week in Christopher, as well as a licensed clinical professional counselor. A grant has provided support for the additional positions.

Along with the additional staff, all staff was trained to do basic depression screening. All patients age 13 and older are screened for depression at least once a year.

April Kiefer of CRHPC explained the process. That initial screening is simply asking two questions:

• Do you have little interest or pleasure in doing things?

• Are you feeling, down, depressed or hopeless?

“If the answer to either question is yes, we use 10 questions to get a score for depression,” Kiefer said.

Based on the depression score, patients are then referred to a mental health provider for further screening and to develop a treatment plan.

“I think having electronic health records where we can all share what is going on with a patient as a whole is beneficial to us,” Kiefer said.

Those electronic health records are used to track patients and make sure they access treatment as planned.

“We are definitely seeing an increase in patients who are in need of services,” Kiefer said.

Those patients are keeping the new staff members busy, too.

“Our new staff is booked a month or two in advance for new patients,” Pulley said.

Mental health affects the whole patient, and depression goes along with chronic diseases like diabetes, high blood pressure and heart disease. Pulley added that one of the goals of Federal Qualified Health Centers is to make mental health a talking point to help break down barriers to accessing care.

SIH and its partners will implement many strategies to help change the statistics.

One is increasing education among community members and partners regarding mental and behavioral health resources, targeting school staff, churches, faith community nurses, spiritual homebound visitors and Healthy Community Coalitions. They also will educate students in healthcare fields, including nursing and medical students, regarding resources available.

Another strategy is developing and implementing a standard screening tool for depression to be used by primary care providers. Along with this, they will develop a referral system between emergency departments or primary care providers and mental health providers for treating people with mental health issues in a timely manner.

They will advocate for appropriate mental health services and sustained funding to support it. John Markley, CEO of Centerstone, addressed this issue when he spoke to The Southern in July.

“In this industry, we have a very difficult time keeping people as funding is inadequate and the long term viability of these programs is in danger from lack of legislative and financial support,” Markley said.

Markley added that it just does not make any sense because when you look at the outcomes of these treatments, they save money in other systems. For example, people who can no longer go to the Crisis Center in Carterville will end up in hospital emergency rooms.

Perhaps the first step to improving the mental health of Southern Illinoisans is to talk about it.

For more information about the SIH community health needs assessment, contact the community benefits department at 618-457-5200.

If you are depressed, hopeless or just need to talk, call the Suicide Prevention Lifeline at 1-800-273-8255.

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Marilyn Halstead is a reporter covering Williamson County.

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