As funding for mental health services in Wyoming is reduced, mental health providers say they need more
Discussions about mental health have become more commonplace over the past several years, and it has only gained more attention during the COVID-19 pandemic. A growing number of people nationwide have reported that they have experienced a decline in their mental health during this time.
Paul Demple, CEO of Northern Wyoming Mental Health Center in Sheridan, is concerned that Wyoming’s mental health system in its current state is not meeting demand and isn’t prepared for the future.
“Us in the system, that are in the trenches, that got into this because we like community mental health and serving those people who are absolutely most in need, where we’re standing up and saying, ‘We’ve got to look at this system and we’ve got to support it,’” he said. “The cuts have gone so far, the system’s in real danger.”
Demple said the issue is complex and multi-faceted.
“We need to commit to investing in this, and it’s not going to be one thing, it’s going to be multiple things,” he stated.
Budget cuts have impacted the kinds and quantity of services that can be offered, but Demple claims there is still support for community mental health centers, not only from local communities but from the state as well.
“I genuinely think the people in the [Wyoming] Department of Health, the people in the governor’s office, the legislature—people are supportive of this in Wyoming,” he said. “I don’t feel like we’re necessarily specifically targeted at all. The State of Wyoming’s financial circumstances [are in] such a critical state, everybody’s taking a haircut.”
Demple pointed to the Department of Health’s budget.
“One of the big single investments is the mental health substance abuse system,” he stated.
Much of the mental health funding in the state comes from the general fund, which Demple said is problematic when budgets are cut.
“If we’re choosing to fund our system primarily with general fund dollars, when those shrink, everything shrinks,” he said. “You can’t go back to funding levels [for] 2006 and before and say we’re going to get 2021 level services—it just doesn’t work.”
And even with funding levels at a more ideal level, mental health services haven’t, nor do they currently bring in anything significantly moneywise. That means sometimes it isn’t going to be enough to cover the cost of the office itself. Demple said his overhead costs range from $120 - $140 per hour and the software used in billing and patient records is also very expensive, but it’s a necessity.
Demple said insurance reimbursements only cover a small fraction of patient expenses, though care comes on a sliding scale. Staff in the office continually haggle with insurance companies to get the most from them that they can for patient care, but the average insurance payment is just $39.
“[The community mental health system has been set up] to have support from Medicaid, from the state general fund dollars, because there’s nobody that pays totally for everything—there’s no cash cow out there for community mental health,” he said.
Over the years, and as funding levels have varied, programs to address the different aspects of mental health and addiction, among others, have been implemented.
“We went from some mom-and-pop shops to these systems that are extremely complex and do a lot of things for the citizens of Wyoming,” he said. “We have things like residential treatment programs for substance abuse, we have residential programs for mental health, we have in-jail treatment with the Department of Corrections, we’re doing in-jail intensive outpatient treatment, which we think is really going to be effective in [keeping] the recidivism rate down so people don’t go back to prison just for substance use.”
Despite the downturn in state budgeting, the opportunities that digital technology offers may be a way for those who are seeking out mental health services to be able to access them in the future. While Demple recognizes there are issues with internet bandwidth and service availability in some areas, he thinks they will be able to overcome it eventually.
“Telehealth certainly is going to be something that has improved outreach and connecting with people,” Demple stated. “I really think moving into the future that’s going to be something for Wyoming citizens, especially in our more rural areas, that’s going to gain acceptance.”
But the budget is still an issue. One of the possible solutions moving forward includes finding other funding sources outside of the state’s general fund, though Demple said there can be downsides to that too.
“The building of this system was from the communities and the [state] support came later and now the question is how do we come together as communities and as a state to provide these services,” he said. “We just have no choice. People are suffering, people are committing suicide every day, people are struggling with severe depression and alcoholism, people have lost everything and have nowhere to turn—[we are] that safety net.”
Focus is on getting those who need help the treatment they require so that more drastic action doesn’t have to be taken. This can include invoking Title 25 which is a state statute that allows for someone to involuntarily committed due to threats against themselves or others.
“It’s not a very complicated story—few dollars, more need,” he stated. “Wyoming is always vying for number one on suicide rate [nationwide].”
In planning for the needs of today and tomorrow, Demple said there are basic questions to be raised.
“What kind of services do we want our citizens to have?” he asked. “At the end of the day, what kind of system do we want?”
If you or someone you know is having thoughts of suicide, call the National Suicide Prevention Hotline at 1-800-273-TALK (8255) or text “WYO” to 741-741 for the Crisis Text Line. If you or someone else is in immediate danger of harming themselves, call 911. The Wyoming Department of Health also offers resources and contact information for mental health resources in your community.