When Raychelle Black moved to Atlantic City in October 2013, she was at a low point – both of her parents had died in the previous year, and she had lost her family home in New York City.
Then Sandy struck, and she lost nearly all of her remaining possessions when her new home was flooded. But it wasn’t until several months later, through a visit to her primary-care provider – a Southern Jersey Family Medical Centers’ clinic – that she learned she had depression.
“Until that moment, I hadn’t even realized that I really wasn’t dealing very well,” Black said. But a center worker trained in screening her for behavioral health problems helped her realize that she needed to seek help for depression.
Black’s experience was made possible through a federally funded grant that the center received through the state Department of Health, one of $4.3 million in grants given to community health centers and hospitals to identify those in need of behavioral healthcare.
While these screenings reached 50,000 residents, they also had another long-lasting effect. They have helped forge stronger bonds between primary-care providers and behavioral health providers, a link that is increasingly important as research has shown the interconnections between physical and behavioral health.
While the funding for the screening is nearing its end on Sandy’s third anniversary, the storm has increased recognition that many people are in need of mental healthcare, according to providers involved in treating patients throughout the Sandy recovery process.
For example, local municipal officials have grown comfortable referring residents to local behavioral health providers for help. (Behavioral health is a term that covers both mental health and addiction).
State Acting Health Commissioner Cathleen Bennett said the discomfort that many people have in talking about mental-health issues made the screening effort particularly important.
She noted that it wasn’t unusual for people to show up at doctor’s offices due to physical ailments when their suffering was actually tied to depression or anxiety caused by the storm.
“They thought they had physical health issues – like, they had a cold that wouldn’t go away, the flu, and it’s because they actually couldn’t even self-identify,” Bennett said. “The screening – particularly when you do it as a piece of primary care – actually was able to get to the right result.”
Bennett said the screening experience will leave primary care offices better able to identify similar patients in the future. She linked this to a broader trend, which includes the state’s federally qualified health centers (FQHCs) that serve low-income communities, toward strengthening the links between primary care and behavioral healthcare.
She noted that the state Department of Health recently issued a waiver from some regulations that will allow FQHCs to locate behavioral and clinical health practices under the same roof.
“We don’t want to be a barrier or a wall to their getting to the right result, and we’re trying to expedite it, because we do see this growing need, and we do see that, you know, primary care is poised and desiring to provide that type of service,” Bennett said.
Carol Mallette, who directed the Sandy behavioral-health grant program at Southern Jersey Family Medical Centers, said the relationships forged over the past three years will outlast the grant money.
“It has allowed us to improve our relationships with behavioral-health organizations,” she said. “It’s forced us to sit and talk with them, to share information about our programs with them, and then how we could work together to improve conditions for residents within our community.”
She said her organization’s efforts to help people with mental-health issues extended beyond those directly funded by the grant.
For example, when the local behavioral health agencies that her organization has partnerships with couldn’t schedule patients for appointments – a situation that isn’t infrequent due to a shortage of providers – she was able to turn to the Mental Health Association in Atlantic County for help.
This association connects people with mental health problems and their families with available resources. Working with Southern Jersey Family Medical Centers, it found private mental-health providers to treat patients who couldn’t wait for appointments.
Vicki Phillips, executive director for the Mental Health Association in Atlantic County, said the Shore communities had an “enlightenment” regarding behavioral-health services after Sandy.
“Before Sandy hit our shores, it was almost taboo to pick up a phone and call a mental-health provider,” Phillips said, adding that she’s now “practically on speed dial” with municipal officials in Ventnor and Brigantine.
“I think that it has opened the conversation with many more people that, yes, we are all vulnerable, we are all susceptible to mental-health challenges,” Phillips said. “It’s been so wonderful to see the community embrace the fact that we are all human.”Phillips said that previously, those who came into contact with people suffering from behavioral health problems might not have thought it was their role to help. But this perception has changed – Phillips cited the example of a veterinarian who referred a person for behavioral healthcare when the vet could recognize that the grief over the loss of a pet had uncovered a serious issue.
“That to me is a real change in the way that the community at large is viewing the people they come in contact, with their customers,” she said.
Raychelle Black has been doing much better since receiving behavioral-health treatment following up on her screening. Not only did her clinic connect her with a treatment provider, it also helped her cover basic financial needs and address issues with utility bills that directly resulted from the storm.
Black said she never would have sought behavioral healthcare if it weren’t for the screening. She noted that she was focused on caring for her 8-month-old son Gabriel when the storm hit, and had ignored her own feelings.
“There’s a stigma in dealing with people with mental issues, you feel weak because you can’t deal with everyday life, you can’t cope with loss, so you feel ashamed,” she said. “You hide it and pretend like you’re OK. And in truth, pretending you’re OK makes it harder to deal with the fact that you’re not OK.”
“So, somebody, just walked in and said, ‘Hey, you’re not OK, and it’s OK that you’re not OK,’ and it made me feel a lot better. I didn’t feel so alone, or so weak-minded.”