Most South Dakotans live in federally designated mental-health professional shortage areas, and a new report recommended steps Congress and other decision-makers can take to help states close gaps within the behavioral health workforce, amid a growing demand for mental-health services and a shortage of licensed providers.

Kendall Strong, senior policy analyst for the health project at the Bipartisan Policy Center, said one solution is to enhance the role of those with mental-health training who do not have the full credentials. She argued behavioral-health support specialists are certainly up to the task.

"These people are underutilized," Strong contended. "They have a lot to offer because part of the folks that we're talking about are folks like peer-support specialists, who have lived experiences and can really connect with folks who are struggling."

Others in the group are community health workers and paraprofessionals. The report recommends reducing barriers for them to take on bigger roles in behavioral health, including adopting a certification framework to promote flexibility but still protect patients.

Strong acknowledged a divided Congress might provide obstacles but added there is optimism with both parties recognizing the provider shortage.

The report advised pulling in more help can free up licensed providers who are dealing with patient backlogs. Strong added behavioral health support specialists are embedded in the community and can meet in a nonclinical setting. She suggested it can be especially helpful in rural areas where mental-health stigma still might exist.

"In areas where there is just less infrastructure visibility as compared to urban areas, it's really clear if you're going into a health care facility," Strong noted.

The report also called on federal officials to explore expanding Medicaid and Medicare coverage of services provided by behavioral-health support specialists.

The Kaiser Family Foundation said South Dakota has nearly 60 areas with provider shortage designations, which affects nearly 800,000 residents.

A new blood test developed at the Indiana University School of Medicine
may shake up how doctors treat patients who suffer from anxiety disorders.

It took two decades to crack the code, but it now appears researchers can objectively diagnose anxiety through a simple blood test. The discovery offers peace of mind to some and takes away guesswork in treating more than 40 million Americans who struggle with the mental health disorder.

Dr. Alexander Niculescu, professor of psychiatry at Indiana University, said the new approach also helps match patients with existing medications.

"The big breakthrough here is not just developing the test, but in some way demystifying these stigmatizing mental health challenges; mild biological abnormalities or not so mild," Niculescu explained. "They are correctable, this can be in a primary care setting as part of your annual exam."

Niculescu added the test is available today with an order from a doctor, and results are usually returned after about three weeks.

Right now patients are responsible for the cost of the anxiety blood test, according to Niculescu, but there is a strong effort underway for Medicare and insurance companies to cover costs within the next year or two.

"Anxiety is usually viewed sort of not on par with other major severe mental health illnesses," Niculescu pointed out. "But if you ask patients who suffer from anxiety disorders it's as impairing. It curtails their lives; they're limited in terms of what they can do, and we want to do something to help them."

The I-U School of Medicine researchers who developed the test have spun it off with an Indianapolis-based tech startup, MindX Sciences.


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A host of barriers that make it harder for people suffering from poor mental health to access preventive care has led to an increase in care delivered through emergency departments, according to a new report.

Rick Doucet is the CEO of Community Reach Center, which provides mental-health care in Adams County. He said lack of adequate insurance coverage can cause people to put off getting help, which can lead to deteriorating conditions.

"It's hard for people that don't have insurance or Medicaid to make that decision to be seen," said Doucet. "That's why a lot of people end up in the ERs, or they end up being picked up by law enforcement."

Numerous efforts are underway in Colorado to improve diagnosis and treatment of mental-health conditions, reduce stigma, and expand coverage and access to services.

But according to new analysis by the Center for Improving Value in Health Care, the number of patients seen by Emergency Departments across Colorado continues to rise.

Emergency rooms have become the most accessible option for many suffering from potentially preventable mental-health crises.

From 2016 to 2021, the number of children seeking mental-health or potential self-harm care at emergency departments increased by 158%. In 2021, youths accounted for one in five of these visits.

Doucet noted that emergency rooms are not set up to provide mental-health services, and the services they can provide come at significantly higher costs.

"I mean, you walk into the ER, the dollars start adding up," said Doucet. "So it is going to increase the costs to the community, to the insurance companies, to the individual if they don't have insurance."

Anxiety, panic and major depressive disorders account for 44% of all mental health-related diagnoses in Colorado.

Doucet said the state is currently looking at the possibility of funding community mental-health centers at a higher rate to help cover the potentially crippling costs of uncompensated care.

"Because if you don't cover the costs for people that don't have insurance," said Doucet, "or their insurance companies don't pay enough for the services, you can't keep your doors open, you can't serve them."




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An estimated 291,000 Iowans suffer from eating disorders, which range from mild to lethal.

Experts are spreading knowledge and information during National Eating Disorders Awareness Week, and calling for additional education, funding and research to combat the problem.

Researchers have not been able to pin down exactly what causes eating disorders, which can range from an unhealthy relationship with food to a lethal obsession with overeating, under-eating, or both; often at the same time.

Lauren Smolar, vice president of mission and education for the National Eating Disorders Association, said the illnesses can show up in a variety of ways, including someone abruptly eating drastically greater or lesser amounts of food than they typically do.

"It could also mean that they are not interested in eating meals with other people anymore," Smolar pointed out. "Drastic changes in shape or weight can be a warning sign of an eating disorder. But even cause for concern can be just changes in mood and shifts in attitudes; the way that they're talking about foods."

One thing researchers agree on is eating disorders are a mental illness, not a choice, and while people often assume young, white females are most frequently afflicted, anorexia and bulimia nervosa, along with a host of other eating disorders, do not discriminate and are common in both genders of varying ages and ethnic groups.

Smolar noted the pandemic heightened awareness of eating disorders and other mental health issues, but added, despite some progress, there is still precious little research, funding and social acceptance of eating disorders as lethal mental illnesses the way, for example, cancer is accepted as a deadly disease.

"But you can see cancer on a physical screening, whereas it's a little harder to show that an eating disorder is there, in essence," Smolar observed. "There is still a lot to be learned about brain chemistry and rewiring of brains and how mental health works, and it's much more normalized to talk about it, but there's just a lot more education that needs to be done."

Smolar said because health care workers are not required to learn about eating disorders as part of their training, early detection is also lacking. The American Society for Nutrition reports more than 10,000 people die each year from eating disorders, the second most lethal mental illness, behind only opioid addiction.