AUGUSTA, Maine -- With about three weeks left in the legislative session, mental-health advocates want lawmakers to increase the funding for essential MaineCare services in order to attract more badly needed staff.

Experts contended long waiting lists often mean families can't get counseling and end up in crisis.

Amy Cohan, vice president of outpatient and community services for Spurwink Services and a licensed clinical social worker, said at times there have been as many as 500 families waiting for in-home counseling, especially people who live away from the I-95 corridor.

"Insufficient rates make it really impossible for providers to travel to families' homes, particularly in rural parts of the state, in a financially sustainable way," Cohan explained.

Cohan noted during the pandemic, calls to hotlines, rates of anxiety and depression, suicidal thinking and suicides all rose sharply. In addition, opioid overdoses increased to record levels, reversing progress made in recent years.

Multiple bills, including Legislative Document 432 and Legislative Document 1173, which are intended to address the situation, are waiting to get a vote. Lawmakers need to finalize the budget before the session ends on June 16.

Opponents objected to the cost of raising providers' pay, but supporters countered it's crucial in order to attract more people to the social-services profession.

Rep. Colleen Madigan, D-Waterville, co-sponsored several bills to help alleviate some pressure.

"There needs to be more money put into put state now so that kids can stay at home," Madigan asserted. "They can be treated in their communities, and they can get the behavioral health care they need before they wind up in an emergency room or needing inpatient hospitalization or residential care."

Madigan pointed out many programs have been forced to cut services for lack of staff, leaving families no option but to send their children out of state to find a residential placement.

David McCluskey, executive director of Community Care, a nonprofit that treats people with mental illness, said the staff shortages translate into a broken system that causes real suffering for families.

"So there's people who are waiting to leave psychiatric hospitals because there's no place for them to step down to," McCluskey stressed. "And then there's also people waiting to get into hospitals. And so the system is sort of frozen."

Many parents in Oregon and around the country will soon be bidding their children farewell as they head off to college for the first time, and a growing question on some parents' minds is about the mental health supports schools provide.

According to a recent survey, three of five college students have been diagnosed with a mental health condition. Schools like the University of Oregon have beefed up their services in recent years to meet the growing demand.

Mariko Lin, assistant director of counseling services at the university, said when they first come to college, students can be scared about making appointments with health services.

"But I want to make sure that parents and family members know that we really want to help their students," Lin stressed. "And are looking forward to them reaching out to us to make those appointments and to get the care that we want to give them."

Lin pointed out the University of Oregon is contracting with an outside company this year to meet any overflow in demand. Along with individual therapy, Lin noted her school also provides group therapies related to specific topics such as sexual assault survivors, as well as for marginalized community members.

Nance Roy, chief clinical officer of the Jed Foundation, which aims to prevent suicide among young people, encouraged parents to ask schools about their mental health supports when their children are deciding on a school, such as on college tours. Roy also urged parents to explore what the university is like beyond the walls of its counseling department.

"It's helpful to ask some questions about what is the culture like on their campus?" Roy emphasized. "Is it a campus where there's no wrong door for a student to walk through for support? Is everyone open and accepting, offering a warm hand? Are faculty and staff engaged in student well-being?"

Roy advised parents who know their children already have therapy needs may want to find local options off campus as well. And while stigmas around mental health are slowly coming down, she added it is important for parents to talk about this issue. For prospective students, Roy acknowledged going away to college can be scary, and it is OK to reach out to someone if they need help.

"Talk to a friend, talk to us," Roy recommended. "Don't feel like you're alone in that because it's very normal during periods of transition to feel a little bit of anxiety, and that's all right."

Support for this reporting was provided by Lumina Foundation.

Losing a loved one can be traumatic, but when it happens to children, it can leave them at risk of anxiety, depression and even post-traumatic stress that can derail their educational progress. Experts in grief say it's always a good measure to seek help.

New Hope for Kids in Maitland runs a program designed to bring hope and healing to children and families suffering from grief, for as long as they need.

"Kids are with us typically, very seldom are they here less than a year's period of time," said David Joswick, executive director of the volunteer-based organization that provides group grief support, free of charge. "More typical is two to three years."

The American Psychiatric Association recently added Prolonged Grief Disorder to its list of mental disorders, describing it as intense emotional pain that persists more than a year after a loss. Those at particular risk include people who lose loved ones to violence, parents who lose children and anyone without a support system to help them cope.

Joswick said the cost to run New Hope for Kids is about $600,000 a year, all through charitable donations. He said the program serves, on average, 400 to 425 children and more than 350 adults. As kids work in groups to overcome their grief, he said, the adults meet concurrently, so they can cope as a family.

"They've seen changes in the demeanor of kids in the family," he said, "and it's created questions on their behalf of, 'How do I interact with the kids during this period of time?' And so, we provide guidance to the adults in the family."

Prolonged grief disorder, also known as complicated grief, has sparked debate in the medical community. But clinicians now can bill insurance companies for treating anyone with the condition. Some say the APA designation also opens the door for more research and awareness. Joswick said his group made a decision years ago to stay non-clinical, avoiding insurance reimbursement forms.

Mental-health advocates say the new 988 Suicide and Crisis Lifeline could save the lives of many Utahns and others facing mental-health crises.

The new three-digit number is a "shorthand" version of the previous 10-digit National Suicide Prevention Lifeline that has been in use since 2005. The new number links callers to a local mental-health help center based on their area code.

Rachel Lucynski, director of community crisis intervention at the University of Utah's Huntsman Mental Health Institute, said saving the time it takes to look up an unfamiliar number could make the difference for someone in a crisis.

"We're confident that if folks can remember '911,' that they can definitely remember '988' in an easier way," she said, "and that remembering that, accessing the service, could be the difference in keeping someone alive in a suicidal crisis."

The 988 system was first proposed in 2014 by a Utah legislator who had experienced a suicide in his family. Subsequent efforts to pass the measure failed, but Congress finally approved the plan in 2020.

Lucynski said the Utah crisis team currently handles an average of 8,600 calls a month. While most of them are people looking for information, she said, a significant number are individuals dealing with a personal crisis.

"We know that the Utah crisis line really is effective for folks in accessing 24/7 life-saving services," she said, "being connected immediately to a crisis worker who can help de-escalate a situation and help keep folks safe during emotional and potentially suicidal crises."

The state Department of Health reported that from 2018 to 2020, Utah had the sixth-highest age-adjusted suicide rate in the United States, with an average of 657 incidences per year.

If someone you know is facing a crisis, Lucynski said, you can call 988 to get them help.

"It doesn't have to be just you that you're calling in for," she said. "If you're worried about a friend or family member or coworker, someone who is acting differently or maybe expressing thoughts of suicide, you can call 988 and ask those questions."