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Asheville’s unhoused population is accustomed to navigating complicated pathways to meet basic needs from city and county resources, nonprofits, and religious institutions. Now tens of thousands of other Western North Carolina residents are experiencing similar barriers on a temporary basis as the unhoused population grew overnight due to people who lost their homes in Hurricane Helene. The city has added four shelters for the general population, and the need continues to be high.

The number of unhoused people in Asheville was already a concern before Helene. Rental prices here are among the highest in the state, and as a heavily marketed popular tourism destination, a significant amount of housing stock is used for short-term rentals. The barriers to accessing treatment for mental health and substance abuse are also acute in a city that has become a hub for the rural region that surrounds it. Buncombe County’s January 2024 point-in-time count identified 739 people living in transitional housing, emergency housing, or living outside.

The bright green van that is Appalachian Mountain Health’s mobile medical unit usually visits the same location on a certain day of the week to provide primary and mental health care. Since Helene, however, the mobile team assesses daily what the needs are, and goes where they are greatest, said Summer Hettinger, a family nurse practitioner for Appalachian Mountain Health.

Caring for wounds that result from substance use has also been a necessity made more difficult with no running water in most of the city. In addition to giving out general hygiene kits from Direct Relief, the mobile team has handed out wound care kits for abscesses, such as xylazine wounds. Also known as “tranq,” the sedative xylazine can create open sores on the skin.

Prior to Helene, the mobile unit saw patients by appointment. Given the difficulties with cell phone and Internet service, it’s now “first come, first serve,” Hettinger said. (Locations for the mobile medical unit are shared on Instagram and Facebook.)

Anti-anxiety and antidepressant medications have been in demand post-Helene. Hettinger says the mobile medical unit is both refilling prescriptions and initiating new e-prescriptions at four pharmacies that have the capacity to do so.

Read more at TheAssemblyNYC.com.

Most are aware that homelessness and mental health are presenting as a two-fold crisis on the streets of Los Angeles County.

In short, it’s not enough just to find housing for the 75,312 homeless people in the county. That’s because surveys indicated at least 25% of the unhoused on the streets have a serious mental illness, such as psychotic disorders and schizophrenia. Thus, housing without behavioral treatment won’t be successful, experts say.

To help address both problems, Gov. Gavin Newsom on Sunday, Sept. 22, signed Senate Bill 1336, which frees up L.A. County to transform seven vacant buildings at the Metropolitan State Hospital campus in Norwalk into shelters for those removed from the streets, while also providing mental health treatment facilities.

“We are battling a mental health crisis, and we desperately need places where we can treat and house people who are struggling,” said Fourth District Supervisor Janice Hahn. “These buildings are doing no one any good sitting empty.”

A recent lawsuit brought by the Los Angeles Alliance for Human Rights against L.A. County and L.A. city and a resulting settlement required the county to create 3,000 new residential treatment beds and 450 new board and care service contracts to treat those with mental illness.

The facility is a state-run public hospital specializing in psychiatric care. The 826-bed hospital sits on 162 acres and is within a security perimeter, Hahn reported. It currently admits patients who are: incompetent to stand trial; have mental health disorders; been found not guilty by reason of insanity; or are under conservatorships, a legal means to provide care for mentally ill individuals.In those vacant buildings, the county wants to create 219 mental health beds where homeless individuals suffering acute episodes would get treatment, then after several months, move into housing, Hahn said. Two buildings would be used for permanent supportive housing. Some housing space would be reserved for foster kids transitioning out of the system, she added.

Read more at WhittierDailyNews.com.

Nearly one-quarter of American adults (22.8%), or almost 60 million, were living with mental illness during the past year. Recent survey data indicate that mental health conditions are even more common: One-half (51%) of Americans “have experienced depression, anxiety or some other mental or emotional condition in the past 12 months,” according to a 2024 West Health and Gallup survey.

Over the course of their lives, nearly one-half (46%) of Americans “will meet the criteria for a diagnosable mental health condition”; one-half of these cases start by 14 years of age and three-fourths by 24. In 2023, 18% of adolescents, or 4.5 million, had past-year major depressive episodes and 12.3%, or 3.2 million, had past-year serious thoughts of suicide. Among children and adolescents, 10%, or 6.5 million, have ADHD, and from 2016 to 2020, they had “significant increases” in anxiety (7% to 9%) and depression (3% to 4%).

nside Philanthropy has published columns and analyses revealing the relative lack of philanthropic funding for mental health in general and mental health research in particular. U.S. mental health research funding was only $2.6 billion in 2018 — a decrease from previous years — of which philanthropy accounted for just 1.3%, according to the latest available data from the International Alliance of Mental Health Research Funders. Moreover, half of Ph.D.s leave academic research within five years of graduation due to lack of funding, undercutting the potential for research breakthroughs.

As Inside Philanthropy has noted: “The lack of funding for research on mental health is a perennial issue. While more philanthropic support is going to research, these resources pale in comparison to amounts going for cancer, heart disease and other conditions that affect similar numbers of people.” These gaps have prompted some foundations and nonprofit organizations to step up. By expanding the scale and scope of investment in research, foundations can reduce the burden of mental health conditions for millions of Americans, as well as globally.

While the mental health research community has made significant progress, additional funding is needed for prevention, diagnosis and treatment advancements to improve outcomes. The tens of millions of Americans, and countless people globally, managing mental health conditions require it.

Read more at InsidePhilantrophy.com.

When Janice Probst read a report released in March by the federal Department of Agriculture’s Economic Research Service confirming that the health disparities gap between rural and urban Americans is widening, substantially, she was dismayed but not surprised.

According to the report, between 1999 and 2019 the gap in rural/urban natural-cause deaths for those aged 25–54 surged from 6 percent to 43 percent. Researchers also found that the more rural the region, the greater the increase. Recently retired as a professor of health services policy and management and as director of the University of South Carolina’s Rural & Minority Health Research Center, Probst has long decried the neglect of rural health in particular and rural communities in general.

The folks at the University of Wisconsin Population Health Institute’s County Health Rankings & Roadmaps have been thinking a lot about civic infrastructure and civic participation. By civic infrastructure, said Michael Stevenson, the programs co-director, they’re referring to the places “where people connect, where they gather, where they share information, and how that fuels civic participation.” This infrastructure includes many things: parks; schools; libraries; access to the information, resources, and services that support good health.

Regions with relatively under-resourced civic infrastructure, the institute’s researchers wrote, include the Black Belt region in the southeast, Appalachia, counties along the U.S.-Mexico border, and American Indian and Alaska Native tribal areas — regions that “bear a legacy burden of various forms of disinvestment and structural racism.”

Read more at NorthCarolinaHealthNews.com.

COVID killed more than 3,600 U.S. health care workers in the first year of the pandemic. It left many more with physical and mental illnesses — and a gutting sense of abandonment.

What workers experienced has been detailed in state investigations, surveys of nurses, and published studies. These found that many health care workers weren’t given masks in 2020. Many got COVID and worked while sick. More than a dozen lawsuits filed on behalf of residents or workers at nursing facilities detail such experiences. And others allege that accommodations weren’t made for workers facing depression and PTSD triggered by their pandemic duties. Some of the lawsuits have been dismissed, and others are pending.

Health care workers and unions reported risky conditions to state and federal agencies. But the federal Occupational Safety and Health Administration had fewer inspectors in 2020 to investigate complaints than at any point in a half-century. It investigated only about 1 in 5 COVID-related complaints that were filed officially, and just 4% of more than 16,000 informal reports made by phone or email.

Nursing assistants, health aides, and other lower-wage health care workers were particularly vulnerable during outbreaks, and many remain burdened now. About 80% of lower-wage workers who provide long-term care are women, and these workers are more likely to be immigrants, to be people of color, and to live in poverty than doctors or nurses.

The plight of health care workers is a problem for the United States as the population ages and the threat of future pandemics looms. Surgeon General Vivek Murthy called their burnout “an urgent public health issue” leading to diminished care for patients. That’s on top of a predicted shortage of more than 3.2 million lower-wage health care workers by 2026, according to the Mercer consulting firm.

A third of health care workers reported symptoms of PTSD related to the pandemic, according to surveys between January 2020 and May 2022 covering 24,000 workers worldwide. The disorder predisposes people to dementia and Alzheimer’s. It can lead to substance use and self-harm.

Read more at NPR.org.

Research shows that when people fleeing violence and persecution resettle in a new country as refugees, the toll of the trauma they’ve been through can haunt them for a long time. Children are especially vulnerable. The toxic mix of past traumas and the stresses of resettlement puts such kids at a significantly higher risk of long term mental health challenges, researchers say.

“We know from years of research that children exposed to violence, separation and loss due to armed conflict and forced migration have elevated risks for problems with depression, anxiety, traumatic stress reactions,” says Theresa Betancourt, director of the research program on children and adversity at Boston College.

Studies have shown that rates of depression among refugee and asylum-seeking children range from 10% to 33%. and post-traumatic stress disorder (PTSD) rates range from 19% to 53%. Anxiety disorders are also prevalent with rates ranging from 9% to 32%.

Parents or primary caregivers can buffer against these long-term mental health consequences, but refugee parents are often struggling with their own mental health and hesitant to seek care, says Betancourt.

That’s why Betancourt and her colleagues launched an effort to support refugee parents and children in the United States, as a way to prevent long term mental health and behavioral problems. It’s an effort run jointly by Boston College and the local non-profit Maine Immigrant and Refugee Services in the Lewiston-Auburn area.

Read more at NPR.org.