HJBR Nov/Dec 2023

DIALOGUE 16 NOV / DEC 2023 I  HEALTHCARE JOURNAL OF BATON ROUGE Secretary Russo Thank you very much. That’s something that I surely hope the new administration carries forward because it has been very helpful. It lets the public knowwhat we’re focused on because a lot of times, it’s a very big agency, the public really doesn’t knowwhat we’re focusing on. It also gives us some accountability as to, “Okay, this is what you’re trying to do, show us that you can actually focus our taxpayer money and actually get things done that you’re trying to get done.” Editor I’m going to switch gears. Which would you like to address first — the opioid crisis or the mental health crisis first? Secretary Russo They’re kind of one and the same, to be honest with you. I mean, one leads to the other potentially, and so either one. Let’s start off really with just the overall priority around mental health. It has been a big focus for LDH, especially since the pandemic, as you can imagine. A lot of folks want to focus on the pandemic, marking when the behavioral health and mental health crisis really started. To me, it started well before that. Now, I think it was exacerbated by the COVID pandemic. Then I also think it was exacerbated by ice storms, then we get hurricanes. Nowwe’ve got wildfires. Nowwe’ve got saltwater intrusion. People have all these things going on in their lives. That’s where, if we don’t get a handle on it, give them access to high-quality mental health- care in their communities, this problem can get even more out of hand than it already is. I know we’re implementing a new state- wide crisis response system. I know we’re trying to increase access to Naloxone, and I knowwe’re trying to increase overall access to behavioral health providers — to every member of the family, from the parents all the way down to the children. I’m very excited we expanded 988. I think one of the big deals with 988 is that we have to get folks to recognize that you can call 988 for a variety of reasons: sub- stance abuse, depression, bullying at school, anxiety, anger, even if you’re just having a bad day. That will hopefully help eliminate the stigma surrounding mental health. That is the first step, for people to realize one of our taglines here, “It’s okay to not be okay,” and to maybe need some help every once in a while. That’s a stigma we would like to eliminate and to amplify the message that 988 is available 24 hours a day; there is no cost; it’s confidential. You can call, text, or online chat 988. That’s our big focus around mental health, and also just stepping up our crisis response. Editor Do you think there are enough in-patient mental health treatment slots for people to go? Secretary Russo Well, no, I don’t. The fed- eral government, and this is just one man’s view, is the problem. I guess this is prob- ably one of my benefits from being here so long. The federal government viewed men- tal health back in the early days as a state responsibility. I mean, that’s why you saw the IMD [Institution for Mental Disease] exclusion thrown out there and things like that, because the federal gov- ernment viewed mental health as something that the states needed to worry about. It really became, inmy opinion, hamstrung by the amount of state dollars a state wanted to put toward mental health. It all goes back to the stigma of mental health and folks not wanting to get treatment for mental health because of the stigma involved. I don’t think that, back in the day, there was much funding put forth for it. And then what funding was put forth for it was in these larger institutionalized settings. So, you weren’t really getting folks the level of mental health services that they needed, where they needed it, because most people don’t need an in-patient, large congregate setting. Most folks might be able to get by with some out-patient treatment. We’re starting to see and starting to focus more and more funding toward in-patient mental health. I really think you’re going to start to see a shift in funding priorities, more toward mental health going forward. One thing to point out too for the readers, is this mental health struggle is not only for Medicaid folks. There is a shortage of men- tal health providers for Medicaid, Medicare, commercial payers, even if you’re just a pri- vate payer willing to pay money out of your pocket. There is a shortage of providers out there, and a lack of access to providers for folks. Editor No, we certainly understand that. The Surgeon General said the other day