Collective mental health is such an important issue that an elected official put 24 and a half of his allotted 25 minutes to discuss it with a room full of Springfield business leaders.
Greene County Presiding Commissioner Bob Dixon devoted almost all of his 2023 “State of Greene County” address on Oct. 5 to the Springfield Area Chamber of Commerce to talk about one topic: mental health.
“I apologize for the heavy nature of the material, but we need to talk about this,” Dixon said. “Not addressing the mental health crisis is costing us not just millions of dollars in money spent cleaning up the misfortunes and unaddressed needs, but it is also costing us quality of life and actual lives.”
Dozens of chamber members attended Dixon’s speech as part of a “Good Morning, Springfield!” event at Hill City Church on East Trafficway Street. In October 2022, Dixon used the same address to highlight county government work in several areas, including economic development. The discussion of mental health as a social issue was a dramatic shift in gears.
“The more we talk about it, the more we can end the stigma,” Dixon said.
Untreated mental health issues, like addiction, are progressive. Left untreated, Dixon said, they don’t get better or go away on their own.
“We can and we must as a community go upstream,” Dixon said. “As a community, we cannot accept the abysmal mental health care anymore in this country. We begin here, and we take care of ourselves in this area.”
Dixon said Greene County has pieces of a good health care system, but when it comes to mental health treatment, there are “gaping holes and systematic problems.”
“The crisis is real, despite many outstanding local organizations providing services in a variety of areas,” Dixon said. “The unpleasant truth is that many of our services are hard to navigate at best, even by trained professionals and clinicians. It is just too hard to get the services that folks need.”
Greene County is home to two large hospital systems that serve much of southwest Missouri on a regional basis. It also has Burrell Behavioral Health, one of the largest networks of mental health clinics in the nation, plus a host of smaller health networks and clinics operating in Springfield.
“We are a health care hub, but we could be a Mecca,” Dixon said.
Stigma comes with speaking up
Many Springfieldians, Dixon said, are reluctant to talk about their own struggles or the mental health issues family members and other loved ones might experience.
“It is a subject that we usually just keep to ourselves. Perhaps we’ve been afraid to speak about it in public forums,” Dixon said.
In the Greene County Jail, in hospitals, in the Greene County Family Justice Center, in other government offices and on the streets, untreated persons with diagnosable issues are suffering.
“I am here to call for our community to face the exasperating local mental health challenges facing citizens, caregivers and all of those seeking to help others,” Dixon said. “Working together, though, we can bring ourselves to a place where we break down the stigmas that all too often prevent folks getting help with the needs that they have.”
Dixon called for Greene County’s mental health service programs to undergo thorough and vigorous examination. He followed the call by citing data on suicide he obtained from the Springfield-Greene County Health Department.
“Our suicide mortality rate is 60 percent higher than the national average,” Dixon said. “Locally, we have seen suicide deaths increase by 30 percent since 2015.”
In Greene County, men over the age of 45 are statistically at the greatest risk to die by suicide, and the problem is magnified further for military veterans and law enforcement agents.
Making the issue personal
Healthy Living Alliance of the Ozarks launched an awareness campaign that encourages men to check in on other men to ask about their wellbeing, something as simple as asking a buddy, “Hey, man, are you good?”
In 2020, Dixon said he personally experienced anxiety and depression. He attributed it to some of the work he was doing as an elected official at the height of the COVID-19 pandemic, when Greene County issued stay-at-home orders to go side-by-side with similar orders in Springfield, surrounding communities and the rest of Missouri at one point.
“Like some other elected officials, I was the target of some not-so-veiled death threats,” Dixon said. “It was a time of heightened anxiety for a lot of us. I’m sure I wasn’t the only one whose life changed in unpleasant ways.”
Dixon said he had a friend who asked if he was okay, and when Dixon responded that he wasn’t, his friend listened to Dixon and encouraged him to talk to a mental health professional about the anxiety and depression he was feeling.
“It was just what I needed to get through that very difficult time,” Dixon said. “It may be uncomfortable or awkward, but the importance of discussing mental health with the people that we care about cannot be overstated. It is a normal and healthy way to create mental wellbeing.”
Nursing homes, jails, streets and cemeteries
In the Greene County Jail, it’s estimated that about 70 percent of the inmates in custody awaiting trial or serving short sentences likely have a diagnosable mental health issue. Dixon said 55 of the approximately 980 inmates, or about 5.6 percent, are on a waiting list to be taken to the Missouri Department of Mental Health’s Fulton State Hospital. Jail inmates from across Missouri are ordered to the Fulton high-security hospital for evaluation and treatment, with the idea that some of them will gain enough competency to stand trial for crimes they are accused of committing.
“We are just one county in the state,” Dixon said. “The sheriff’s mental health unit at the jail is full.”
The Fulton hospital serves 21 southwest Missouri counties, and a total of 51 counties in southwest, central and northern Missouri. It serves approximately 430 patients on any given day.
The Greene County Public Administrator’s Office is tasked with being the legal guardian for about 1,000 wards of Greene County. Often, these are elderly people with no immediate families who lack the mental capacity to care for themselves.
“Many of our nursing homes simply cannot continue to take those that we have to find places for,” Dixon said. “We do not have adequate systems in place to address the extreme cases that arise.”
Dixon touched on the American opioid epidemic and its grip on people in Greene County. He discussed the progressive nature of addiction, and how it generally leads the addicted person to one of four places: a hospital or nursing home, jail, the open streets and/or an early death.
County commissioner quotes Dr. Drew
Dixon showed part of a speech Dr. Drew Pinsky delivered at a National Association of Counties conference, in which Pinsky addressed community-based mental health issues in the United States. Pinsky is a medical doctor made famous through radio and television appearances from 1984 to the present, most notably “Loveline” on MTV and six seasons of “Celebrity Rehab with Dr. Drew” on VH1.
Pinsky gave a concise overview of the history of mental health care in the United States to county commissioners and executives from across the country. He explained that the federal government has largely passed on mental health care programs to state governments, and that mental health governance has been largely handled by doctors who are unqualified or operating outside their expertise.
Pinsky explained the condition of anosognosia. According to the National Alliance on Mental Illness, anosognosia is the condition of not knowing of one’s own illness, and occurs when, “someone is unaware of their own mental health condition or that they can’t perceive their condition accurately.”
On a larger scale, Pinsky said, American society is way behind when it comes to identifying and treating mental wellness issues.
“It’s a lack of understanding of how the brain works, what psychiatry is, what doctors do to treat serious mental illness,” Pinsky said. “We need the resources, we need the beds, we need the psychiatrists.”
According to the National Association of Counties, about 75 percent of the 3,069 counties in the United States reported increased incidents of behavioral health issue reports, and 72 percent of counties reported a “serious shortage” of behavioral health care workers.
What’s being done?
When it comes to mental health in Greene County, several initiatives and resources have undergone major development in 2023.
- The Greene County Youth Medical and Mental Health Collaborative is comprised of mental health professionals in education, government and health care who seek to more effectively deliver their services to the youth in Greene County.
- Sept. 18, Burrell Behavioral Health broke ground on a new health center focused on mental health services for kids 13 to 17 years old. When finished, the Youth Resiliency Campus will offer an always-open crisis center for emergencies, outpatient programs, partial hospitalization and a long-term youth residential facility with 16 beds.
- Burrell Behavioral Health opened a walk-in crisis center in Springfield in 2020, in collaboration with the Greene County government.
- The Springfield Police Department and Burrell Behavioral Health launched the Mental Health Mobile Response Team, creating a new approach that partners police officers with mental health professionals to respond to people in mental health crises. In June 2023, Springfield Mayor Ken McClure put the spotlight on this collaboration in his “State of the City” speech to the Springfield Area Chamber of Commerce.
- Professionals offer solutions and changes that might lessen the frequency or severity of domestic violence in Springfield and Greene County, as part of the Springfield Daily Citizen’s four-part investigative series “Living in Fear.”
- Opened in 2018, the Greene County Family Justice Center has served tens of thousands of persons impacted by domestic violence in the last five years.
- Greene County’s efforts to reform juvenile justice and better track data associated with its juvenile justice system have become models for change for the rest of the United States.
