CONCORD, N.H. — The New Hampshire state Senate is expected to pass a bill on Thursday to implement an ambitious, 10-year mental-health plan.

Among other things, Senate Bill 292 recommends increasing jobs in the mental-health sector. Lynn Stanley, executive director of the New Hampshire chapter of the National Association of Social Workers, said NASW supports this bill and the plan. She said she appreciates that the plan includes loan assistance for mental-health workers.

"One of the ways to encourage people to enter the field is to look at loan-repayment programs, loan forgiveness, scholarships,” Stanley said, “because students are coming out of graduate programs with a tremendous amount of debt."

The bill, mostly sponsored by Democrats, asks the state to implement the plan within two years of its passing and finalization. If it becomes law, the expected cost will be more than $12 million dollars in 2020.

Another New Hampshire bill aims to ease licensing requirements for mental-health and drug-abuse professionals to encourage more people to enter these fields. Republican state Rep. Jack Flanagan of Hillsborough is the primary sponsor of House Bill 239. Flanagan got the idea for the bill after talking to people who found it hard to complete their supervision hours for licensure.

"They had a master's in social work, they worked in the local school district, and they were complaining how difficult it was to get the hours and a supervisor willing to work hours,” Flanagan said. “The other fact was that we're dealing with this opioid situation in the state of New Hampshire."

The bill recently was amended to not include a significant reduction in supervision hours, as was first proposed. Now, it just makes the location for supervision meetings more convenient.

Stanley said she’s glad the reduction in supervision hours no longer is part of HB 239.

"Licensure for mental-health professionals, including social workers, is to protect clients,” she said. “It's not about what's easier for social workers and other clinicians. It's about protecting clients."

She thinks the licensing requirements are necessary to ensure mental-health and drug-abuse professionals treat their patients responsibly. A vote on HB 239 has not yet been scheduled.


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Legislation signed into law this month by Gov. Charlie Baker is expected to bring updates long overdue to mental-health services in Massachusetts.

The Mental Health Addressing Barriers to Care or ABC Act mandates insurance coverage for an annual mental-wellness exam and enforcing mental-health parity laws. It comes at a time when the need for mental-health services has been heightened by the pandemic.

The law also creates an online portal for Emergency Department visits or ED Boarding. Dr. Grace Chang, president of the Massachusetts Psychiatric Society, explained how this can be beneficial for acute mental-health needs.

"ED Boarding occurs when people present for acute care. They're assessed to require it, but then when there is a bed search made for the patient, there's no bed available," she said. "One of the important things is that we need real-time data, and maybe this real-time data can be used to inform admissions."

Chang said she thinks the provisions in the new law can't come soon enough. According to a recent Blue Cross/Blue Shield Foundation study, 35% of adults in the state reported needing behavioral-health care, but 57% said they either had difficulty getting appointments or did not get the care they needed because of other issues.

While Chang said she sees the bill as a step in the right direction, she cited more work to be done. Although this bill removes plenty of barriers to accessing behavioral-health services, she said she feels a different problem must be addressed - a shortage of professionals to provide those services.

"We've got to have more people who can work at all levels in the mental-health care treatment system. So, that's a major factor," she said. "I think that a number of proposals and initiatives are being discussed, and will be offered and implemented, such as loan forgiveness programs for training."

One reason for the shortage is what Chang described as a "pipeline issue" - training to become a mental-health professional takes almost a decade. However, she remains hopeful that the potential incentives will attract more people to the field.

Your first heartbreak, accident, loss of a loved-one or being chased by a dog - these and so many other incidents can be lasting traumatic experiences, and mental-health practitioners are working to shift the way traumas of the past are being addressed today.

Trauma-informed care is growing effort around the country to shift the mindset and understanding that humans are deeply affected by their past. Studies show more people are dealing with something traumatic without society acknowledging it.

Yuki Reese knows this all too well, as the director of school-based services for ViewPoint Health - a public mental-health organization serving several Georgia counties. Reese said they've adjusted the way they speak to clients or families to avoid exacerbating the problem.

"So, you might be saying, 'What's wrong with you?'" said Reese, "when what you really want to say to the person is, 'What happened to you? What did you experience that might be causing you to react in this way?'"

Reese said it's important to uncover the causes of traumatic situations that may be contributing to anxiety or depressive disorders, addictions or abuse. It's only then you can more accurately treat the source of the problem.

There are currently two bills in Congress that would make these types of practices a requirement. However, some critics worry about the impact of labeling young people by their trauma, and that the practice should be more culturally responsive.

It's estimated that one in four children experiences child abuse or neglect in their lifetime, according to a study in the National Library of Medicine.

Reese said their approach is to find out what's going on in a person's life with more carefully crafted questions.

"All kind of things could happen many, many years ago and the person might be just fine for these years," said Reese, "but then something happens recently or you might be responding to the trauma that you experienced years ago without really knowing. "

In order for it to work, however, it depends on the person to be transparent with their past. The Campaign for Trauma-Informed Policy and Practices is a national movement to help communities adapt and shift to trauma-informed care.

As college students head to campus in the coming weeks, mental-health experts are urging both students and parents to familiarize themselves with the school's on-site mental-health resources.

Three in five college students nationwide reported being diagnosed with anxiety, depression or another mental-health condition by a professional, according to a Harris Poll released this year.

Virginia Rodilla, manager of the helpline and on-campus support for the National Alliance on Mental Illness-North Carolina, said especially for incoming college freshmen, the coronavirus has disrupted preparing for a new chapter.

"A lot of young people were stuck at home," Rodilla pointed out. "They were relying on social media and screen time, less social interaction, and a lot of uncertainty around the pandemic and societal issues."

She added while colleges generally are not staffed to handle severe psychiatric disorders, counselors located in health and wellness centers are a first stop for students living on campus. If you or someone you know may be considering suicide, contact the Suicide and Crisis Lifeline at 988.

Rodilla pointed out younger students may be used to a parent handling health care needs or making appointments, and might be in the dark about the details of their health insurance plan and what it covers, if they are insured.

She noted there also are places to turn for students who are far from home. The Alliance runs a helpline in North Carolina, at 1-800-451-9682, available Monday through Friday, 9 a.m. to 5 p.m. She added experts are on call to help connect students to the right resources.

"After those hours, a student can text the word NAMI to 741-741," Rodilla urged. "That's 24 hours a day, never closes, and a helping professional would be able to direct that person to services and help."

She emphasized NAMI is working with campuses across the state.

"If anybody is ever interested in bringing awareness to mental health on their campus, forming some student support groups, having some awareness and health events, healthy events," Rodilla outlined. "They can work on forming a NAMI On Campus club at their school."

Nationwide, people are becoming more informed on mental health. In a 2019 poll by the American Psychological Association, nearly 90% of adults agreed having a mental-health condition is nothing to be ashamed of, and 86% said they believe people with mental-health disorders can get better.

Support for this reporting was provided by Lumina Foundation.