A shortage of providers has prompted this region to be labeled a mental health care desert.
Emory & Henry is working to correct the situation.
One of the people who has given his full support to the effort is Smyth County Sheriff Chip Shuler. In a letter endorsing E&H’s plan to launch a new Master of Science in Clinical Mental Health Counseling Program, Shuler said, “I have witnessed our drug situation growing into an epidemic throughout Southwest Virginia. Some blame the poor economy…, but I believe our drug epidemic comes from the increasing need to self-medicate for mental health issues in our community. I know that we cannot arrest our way out of the drug problem; we must heal our community.”
Shuler went on to write, “Our current mental health system is overwhelmed.”
The 37-year law enforcement veteran ended his letter with a plea: “We cannot continue to build jails to house/hide our problem. Many of the inmates… are only addicts or low-scale distributors supporting their habit. Please help me help them with treatment by providing local education for more mental health professionals in the field.”
Statistics back the need for more health care providers.
In the 2018 State of Mental Health report, Virginia was ranked 36th regarding adult individuals with unmet needs for mental health treatment, with 22% reporting barriers to treatment. The Health Resources and Services Administration classifies this region that surrounds Emory & Henry College as a High Needs Mental Health Professional Shortage Area.
Approximately 1,137,259 to 1,497,870 adults in Virginia (age 18+) have a mental illness, according to the National Alliance on Mental Illness Virginia. Of those, 239,750 to 305,000 have a serious mental illness – one that causes “a substantial functional impairment.”
NAMI Virginia also notes that suicide ranks 11th as a cause of death in the commonwealth, but jumps to the third leading cause among 10- to 24-year-olds. Southwest Virginia has consistently recorded even higher rates of suicide.
The organization also notes that 1 in 4 of Virginia’s jail inmates live with a mental health disorder as do 15% to 20% of post-deployment veterans.
Experts agree that the real number of people struggling with a mental health illness is much higher because many haven’t been able to access services.
Even with the region’s private and public mental health services combined, the need for services far exceeds the number of providers.
Susan Hoagland, Smyth County school system’s nursing supervisor, recently said that students who need mental health intervention may get referrals to care but it can take months for appointments to be scheduled.
Dr. J.P. Barfield, associate dean of E&H’s School of Health Sciences in Marion, observed that a number of mental health service positions in the region regularly go unfilled.
As E&H was completing its application for accreditation of the program, Barfield said that both Mount Rogers Community Services Board and the Southwestern Virginia Mental Health Institute were advertising for multiple positions.
While the COVID-19 pandemic has also heightened demand for mental health care, Barfield expects the colder, more isolating winter months will be even harder.
He also noted the needs witnessed among school students.
“We need people who have the skill sets” to address these problems, Barfield said.
Meeting the Need
E&H plans to help, he said, adding that the program fits the college’s mission “to serve our region.”
Pending approval by Southern Association of Colleges and Schools Commission on Colleges, Barfield said the 60-credit, 24-month counseling program would launch in the fall of 2021.
For the first cohort, Barfield said, E&H expects to enroll 18 students, slowly bringing that number up to about 24.
A master’s degree in clinical mental health counseling is the minimum educational requirement for licensed professional counselors (LPCs). These counselors can treat a variety of mental and behavioral health conditions, including depression, grief, and trauma-related disorders, alcoholism, opioid addiction, and other substance misuse resulting from adverse childhood experiences, among others.
LPCs can help prevent emotional and mental health concerns, provide early intervention when problems are identified, and empower clients.
Graduates are expected to be prepared for a full range of career opportunities in a variety of settings, including community mental health agencies, substance abuse treatment programs, schools, colleges, universities, rehabilitation agencies, hospitals, residential treatment programs, employee assistance programs, and social service agencies.
As they learn, they’ll be gaining experience in area mental health care settings. Barfield said that numerous partners have already stepped forward to help and serve as teaching institutes, including the Mount Rogers and Highlands community services boards.
To serve as the founding department chair and program director, E&H has hired Dr. Stephanie Hall, who comes to Southwest Virginia from New Jersey, where she chaired a counselor education department with a large graduate program.
Having grown up in Kentucky, Hall knew the area’s beauty and she found the prospect of helping start a new program appealing. However, it was the region’s people who convinced Hall this was the place she wanted to serve.
Despite the pandemic, Hall said she was able to meet a number of area residents, who are “really passionate and love their community.”
A greater opportunity to help that community also excited Hall. Within two years, she said, E&H plans to launch a mental health free clinic.
“The opportunity to do that felt like something very meaningful,” Hall said.
Hall also brings experience with accrediting agencies. She worked as a site visitor for the Council of Accreditation for Counseling and Related Educational Programs for 12 years.
Hall is already meeting with prospective students via Zoom.
To help train those students, E&H has developed a counselor education training lab, which features six individual counseling rooms and two group counseling rooms. Those rooms are equipped with the technology that will allow instructors to observe the students.
Hall is excited that the students will train alongside students in the physician’s assistant, physical therapy, occupational therapy and nursing programs. She believes such a holistic approach is “the future of health care” and will help providers be better able to serve people.
In their last several semesters, Hall said the students will gain clinic experiences in a variety of settings, including community services, hospitals, correctional facilities, and even non-profits. So, she said, the impact of E&H’s program will benefit the community before students even graduate.
Students will also be able to take elective courses to explore their individual interests. For instance, Hall’s specialization is in grief and trauma counseling. The loss of her mother when she was young influenced Hall as did the recognition that “I knew I wanted to help people.”
She expects a significant number of students may want to help those battling substance misuse. It will be important for them to learn, Hall said, that “underneath addiction is trauma.”
The vital importance of mental health care to the region was demonstrated in financial support granted the program. In May, the Virginia Tobacco Region Revitalization Commission OK’d funding for it. Of this program and others supported, a commission press release said, “These projects … will create opportunities for thousands of individuals across Southern and Southwest Virginia in the years to come and illustrate the key role the tobacco commission plays in the long term advancement of our rural economies.”
In an Oct. 29 report on the economic impact of the School of Health Sciences, Ken Heath, Marion’s director of economic and community development, wrote, “Marion has seen a precipitous rise in the number of new and repurposed apartments. Downtown, Marion's historic district now has over 120 apartments, up from 40 or so, and they are primarily filled by E&H students. Long-vacant buildings… found new life in apartments, returning long-vacant buildings into purposeful structures, adding additional population, night life, and tax revenues for the town, county and commonwealth.”
“Likewise,” the report continued, “the additional student and faculty population, along with visiting family and friends, provides a much-needed boost for Marion businesses.”
It went on to acknowledge other developments near the Marion campus, including the transformation of a vacant area “into a ‘live-work-play’ lifestyle development.”
Beyond tax revenues, new housing and business development, the report concluded, “As Emory & Henry grows, we not only see economic impact in holding steady with meals tax revenues, in keeping businesses afloat through the pandemic, in increased housing stock and development, but in the future of our community. Rural health care will continue to be a crisis, and with our region far removed from traditional models, having the collaborative efforts of E&H and their partner schools to train new practitioners in not only care, but in rural lifestyle, will be perhaps the absolute biggest benefit for rural America.”
An important component of the program will be helping students learn about that rural lifestyle and serving rural communities. It’s essential, Hall said, that students understand the area’s culture, the role of religion and similar factors in life. “They need to understand before they can help,” she said.
Both Hall and Barfield hope the counseling program will also help destigmatize seeking mental health care.
Within Appalachia, Barfield said, there’s an idea that people should be able “to tough it out.” That trait has been passed down through the generations, he said, and it’s “very disrespectful to go against tradition.”
However, Barfield said, “We deal with just as much grief, uncertainty and other problems” as other areas and can benefit just as much from mental health care.
Anyone who’d like more information about this program should visit https://www.ehc.edu/academics/clinical-mental-health-counseling/