CHARLESTON, W.Va. – A snapshot of West Virginia domestic violence services shows shelters straining under the pressure of budget cuts, and the need to lend life-or-death assistance to victims and survivors.

In a single day – September 10, 2014 – the state's domestic violence programs provided services in more than 300 instances.

But according to Tonia Thomas, team coordinator at the West Virginia Coalition Against Domestic Violence, their combined efforts still could not meet nine requests for help. She says state and federal budget cuts have put pressure on domestic violence programs.

"Emergency shelter, transitional housing, legal help. They had to eliminate staff so less services could be provided to victims and survivors," she says.

The snapshot results come from the ninth annual National Network to End Domestic Violence national one-day census. According to the West Virginia coalition, federal budget tightening and state cuts have left programs scrambling.

Despite the cuts and uncertainty, Thomas says they do their best to help and protect people who often are in dangerous and volatile family crisis situations.

"Try to seek other services in other areas, make referrals. They may be put on a waiting list," she says. "They do the best they can, but oftentimes it ends at maybe a referral."

According to Thomas, most domestic violence shelters "hate" turning people away. She says they know their services can be a matter of survival.

"The programs serve as the place for safety, as the place for people to figure out how to leave an abusive situation, or how to live safely in an abusive situation," she says. "They are often life-and-death services."

The national domestic violence hotline is 1-800-799-SAFE.


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Georgia is taking on its mental-health care challenges head-on through new legislation.

One bill is aimed at increasing the number of providers in the state. Senate Bill 480 offers loan repayment assistance to mental-health care professionals who choose to work in underserved areas.

Rep. Sharon Cooper, R-Marietta, highlighted the state's access landscape, noting that of its 18 public health districts, 12 are located in rural areas. She said the goal is to ensure equitable access to mental-health services for all.

"Georgia is terribly short of psychiatrists, psychologists, social workers, marriage and family providers, all levels of people that deal with various aspects of mental illness," said Cooper.

According to the Rural Information hub, most of Georgia struggles with having enough mental-health providers. The data shows out of 159 counties, only six have no shortage, and two only have shortages in parts of the county.

Cooper elaborated on the multifaceted challenges Georgia faces in mental-health care, citing historical underinvestment and rapid population growth as contributing factors to the current shortage. She described the evolution of mental-health care policy in Georgia, including previous legislative efforts to promote parity between mental and physical health care.

"We are trying to make up for mistakes of the past and trying to do what's right for mentally ill people and to put their illness on parity with anybody that would have a gallbladder or heart disease," Cooper added.

Cooper pointed out that in this past legislative session, 19 bills were signed to help increase the state's ability to care for mental- and behavioral-health needs. Other legislation includes SB 373, which helps provide expedited licenses to marriage and family therapists.


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New York's 2025 budget improves access to mental-health services.

Budget legislation stipulates commercial insurers have to pay rates similar to Medicaid for in- and-out-of-network behavioral health services.

While many New York adults can access care, younger people can't because of insurance coverage.

Matthew Shapiro - senior director of government affairs for the National Alliance on Mental Illness-New York State - said people are glad this broadens access to often limited mental health services.

"We hear from people all the time that they can't access care, they can't find a psychiatrist, they can't find a social worker, they can't find someone who'll prescribe medication," said Shapiro. "It can be very, very difficult, especially in parts of Upstate New York where these services just aren't readily available."

Some insurance companies pushed back, saying it would raise customers' rates. Shapiro noted that this will hopefully resolve long-standing issues in obtaining mental-health care.

A state Attorney General's office report finds 86% of the listed, in-network mental-health providers were either unreachable, not in-network, or not accepting new patients.

The budget allocates millions of dollars to other programs that establish new inpatient psychiatric beds statewide, and increase mental health support for first responders.

But, Shapiro noted that other insurance companies' barriers prevent New Yorkers from getting the best mental-health care they can.

"It's so important those people get the medications their doctor believes are best for them, and their individual set of symptoms as quickly as possible," said Shapiro. "So, eliminating things like fail-first procedures and what they call step-up procedures."

He added that these policies can significantly set back a person's recovery.

A 2024 survey finds 1 in 5 adults required to fail first had to visit the emergency room or be admitted to a hospital as a result of the policy.




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Studies show suicide is a serious public health problem, claiming more than 48,000 lives each year in the nation.

A new initiative from the Zero Suicide Institute aims to change it and demonstrate how a diverse group of hospitals in South Carolina and elsewhere can improve their suicide prevention practices.

Allyson Sipes, director of clinical initiatives at G. Werber Bryan Psychiatric Hospital in Columbia, said the Institute worked with her staff to develop best practices.

"The Zero Suicide Institute brought in a group of individuals that we could learn from," Sipes recounted. "Then having an expert faculty with a change package that we used to set our facility and what to look at and address."

Sipes explained the program was developed by the Pew Charitable Trusts to test evidence-informed methods to detect suicide risk and connect patients to treatment.

Nearly 27% of U.S. hospitals do not practice recommended suicide prevention practices, including safety planning, warm handoffs to outpatient care, patient follow-up and lethal-means counseling.

Laurin Jozlin, senior project associate for the institute, said studies show half the people who die by suicide saw a health care professional in the month before their death but were never referred to a mental health professional.

"We know that there's an opportunity in health and behavioral health care systems to intervene," Jozlin acknowledged. "They are being seen by health and behavioral health care professionals but they're often not identified as someone who is at risk of suicide."

Sara Voelker, improvement adviser for the Education Development Center, said they take ideas proven successful elsewhere and develop them into best practices.

"We put it together into a change package," Voelker noted. "Then teams pulled out ideas that had worked in other places and then, essentially, figured out a way of, 'How do I adapt this to make it work in my organization?'"

If you are struggling with mental health, help is available by calling or texting 988, the Suicide and Crisis Lifeline.

Support for this reporting was provided by The Pew Charitable Trusts.


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