Keep Trying: Rural Access to Mental Health

By HEATHER SEGGEL

Mendocino County has a lot of things going for it; the rural Northern California region passed a countywide GMO ban, ensuring ready access to fresh organic food, and it’s the largest growing region for organic wines worldwide. It’s also known for another popular crop; part of the “Emerald Triangle” of marijuana cultivators, Mendo attracts waves of short-term laborers, or “trimmigrants,” who sometimes find the living sufficiently easy here that they choose to stay when the harvest season is over. There’s wholesome fun to be had here as well, but the region’s own tourism outreach is targeted to children of the ’60’s, with a heavy emphasis on the grooviness, man.

Pick up a copy of the local newspaper, though, and you’ll find one issue that has people deeply concerned. The lack of access to mental health services has created a cycle of handoffs, from law enforcement to the hospital’s emergency room, that overtax workers unqualified to treat the offenders and don’t solve anything. There’s a complex homeless issue as well; some of those seasonal workers live on the streets by choice, shaking down pedestrians for handouts, while many are mentally ill, drug addicted or simply, as I once was, just up against it with nowhere to go. Shelters open and close seemingly at whim, and it can be hard to keep track of where one might find a sandwich or cup of coffee on a cold day, to say nothing of a bed or shower.

On Nov. 8 the county may have approved a measure that would add a half cent to our sales tax, with the money slated to build a mental health service center. It passed 65% to 35%, but it remains unclear if it received the two-thirds necessary to increase the tax, and even if it is approved, the project is something that exists some distance in the future. People seeking services now are struggling, and connecting with services can be harder when you’re queer, or otherwise part of a minority group.

Tara McRae Lorenz, LCSW, is a Primary Care Counselor at Hillside Health Center in Ukiah, and sees this play out in real time. The clinic tries to refer patients within the system so they get consistent care in one place and they work to see people quickly, but wait times can stretch as long as a month. Having worked previously in L.A., Denver, and Chico, Lorenz notes the shortage of bilingual counselors in rural Mendocino County as one obstacle to care for Latino clients, but there’s a cultural hurdle as well. “There’s been resistance to opening up to strangers about personal issues, especially seeing a white female. I often get a surprised look from new clients when I come around the corner and invite them into my office in Spanish,” she says. And small towns are, well, small. “It’s a tight knit community. Clients (might) have relatives or friends working at the clinic, or they’re afraid of running into family, friends, or neighbors in the lobby.”

A casual internet search turns up similar stories in locations countrywide. NPR recently ran a story about the merry-go-round cycle of mentally ill patients being sent to ERs where they are discharged without receiving needed care. And Governing magazine described a rural South Dakota town’s overcrowded jails as an indicator that law enforcement had become the de facto answer to treating the severely mentally ill, while more “high functioning” people may choose to simply gut it out rather than have their vehicle seen in a clinic’s parking lot. If you feel like an outsider to begin with, it can be especially challenging to cross the threshold and admit to a need for help.

Asking about local LGBTQ mental health resources netted very little response, in part because I wasn’t sure who to ask. The hosts of Pride Radio Mendocino, a local biweekly public radio show, mentioned a nonprofit that serves people living with AIDS and viral hepatitis, some drop-in programs for youth, and a local PFLAG chapter. All good to know about, but niche-y, too, and only available at highly specific times; if you work or otherwise can’t attend, too bad for you.

Some good news is coming on this front, though. The county has sponsored Community Resiliency Training for workers in multiple fields. The training, developed by the Trauma Resource Institute, can prevent post-traumatic stress disorder if people have received it before going into crisis situations. Locally, organizations working in tribal health, family support, youth outreach, and related fields are attending, with the long-term goal of each trainee being able to train others in turn. The bad news for anyone wanting to attend is potentially great news for the region: Demand was so high that the event was fully booked, but there are plans for a second session in the works already. Until we constitute a net strong enough to catch our neighbors most in need of help, though, the onus is on those least prepared to advocate for themselves to do just that. Here’s hoping they don’t give up.

Heather Seggel is a freelance writer based in Mendocino County. Email heatherlseggel@gmail.com.

From The Progressive Populist, December 1, 2016

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