Benton County, Mental Health, Poverty, and Incarceration

As mental health is discussed more and more in an increasingly open culture, many people are thinking of counselling, therapy, and in some cases psychiatry as a means of getting help getting through life. And according to Dr. Ryan Howes, that’s the right line of thinking for essentially all people.  

In a Psychology Today article Dr. Howes argues that regardless of a person’s mental health, “everyone could benefit from the help of a trained, qualified, non-judgmental, objective, caring professional at some point in their life.” Howes adds that mental health is something all of us have, and taking care of it is a worthwhile endeavor that could benefit anyone in many aspects of life. 

However for many people, mental health care is difficult or even impossible to access. Sometimes this can be an inconvenience, and other times it can be a serious problem, as people with diagnosed mental illnesses may need counseling or medication which they can’t get without seeing a doctor. 

According to a 2017 study by the National Alliance on Mental Illness, some of the most common reported barriers to accessing mental health care included high co-pays and limited in-network providers on a patient’s insurance. 

Benton County Health Department Behavioral Health Director Dannielle Brown said some patients also have trouble accessing insurance at all — including Medicaid. She mentioned lack of transportation to clinics and an inability to afford prescribed medications as just a few other common barriers to access. Not to mention, many mental healthcare providers have long wait lists for treatment services as a result of under-funded programs.  

These core barriers mean that poor and working class people are hit hardest.  

The Role of Incarceration 

One example of the tangible impacts of mental healthcare inaccessibility is the number of incarcerated people with mental illnesses.  

According to a review by Mental Health America, rates of incarceration are correlated with access to care. “Often [people with mental illness’] involvement with the criminal justice system begins with low-level offenses like jaywalking, disorderly conduct, or trespassing,” the report reads. Through the practice of incarceration rather than care, people who need help are instead institutionalized.  

According to Brown, because of this trend, the Oregon Health Authority has been working with counties to engage with jails and law enforcement in order to divert individuals with behavioral health issues from jails.   

“The challenge,” she said, “is the lack of alternative resources to assist with diversion locally.”  

What makes the problem more insidious is that in many ways it is cyclical. Lack of financial means can lead to the inaccessibility of mental health care, which can lead to incarceration. Finally, it can be especially difficult for people to access jobs, education or housing after being released from jail.  

Benton County Responds  

Although mental health and poverty are unfortunately systemically challenging to balance in many cases, there is work being done to remedy some of these factors. According to Brown, BCHD accepts all types of insurance and offers fees on a sliding scale for uninsured patients.   

“Ability to pay,” she said, “is not a consideration when providing services to clients for behavioral health treatment.” 

She also said that BCHD has a jail and forensic team which engages with “individuals who are interacting with the law enforcement and judicial systems.” This is a very important niche to fill, but it has its limitations as well. Brown said the primary drawback to this program is the layout of punitive institutions themselves, which can make confidential treatment impossible. 

The systems currently in place are formidable drawbacks to many, but Benton County is working to remedy some of this issue through a new system involving the police and the health department 

By Ardea C. Eichner