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Mental health support still needed across Yellowstone County, report finds

Billings Gazette - 1/5/2023

Jan. 4—Despite additional challenges presented to community members during the COVID-19 pandemic, Yellowstone County's top health priorities have seen little change in recent years, according to a new report released Wednesday.

In the most recent edition of the Yellowstone County Community Health Needs Assessment (CHNA), county residents reported that mental health support continues to be the primary challenge they're facing, along with substance misuse, access to health care services and nutrition, physical activity and weight.

During a presentation detailing the report's key findings at the Billings Public Library, Yellowstone County Health Officer John Felton acknowledged the similar issues highlighted in the previous report while adding that none of them have a quick fix.

"These have been our priorities for a while," Felton said. "We have moved the needle on these issues as a community, we've helped them get better, but we still have a ways to go."

Other speakers at the conference included Montana St. Vincent Healthcare President Jennifer Alderfer, Billings Clinic Interim CEO Clint Seger and Rehabilitation Hospital of Montana CEO Jennifer Graves.

Using data recorded through local, state and national surveys and input from community stakeholders, the CHNA is a collaborative study conducted every three years to plan, promote, and provide input on local community needs. New to this report were questions relating to the COVID-19 pandemic, an online survey option and health disparities now broken down by ethnicity along with income, gender and age.

With the pandemic being taken into account for the study, 23% of county residents were financially impacted by lost employment, wages, hours, or health insurance, while 15% avoided medical care at some point due to COVID-19 concerns.

Despite these new figures, results showed some improvements from three years ago. The survey found 75% of county residents surveyed saying their mental health status remained the same or improved since the pandemic and 79% saying their mental health is good, very good or excellent.

The report found 24% of community members have considered suicide at some point in their life and 26 deaths by suicide per 100,000 residents during 2018-2020, nearly doubling the national suicide rate of 13.9.

Alderfer said during a breakdown of the figures that it would take the entire community to properly address these mental health issues and that it can start with reducing the stigma in seeking treatment.

"When you have cancer issues, you talk about that and you see oncology specialists and you take care of it. If you have respiratory issues, you readily access specialists for that," Alderfer said. "We need to do the same for our neighbors, our friends, our loved ones who are experiencing mental health issues.

Other worsening trends include an increase in substance misuse negatively affecting community safety. The report found that 23% of county residents drink excessively versus the 20% reported in 2020. Increases in partner violence, access to unlocked firearms and deaths caused by unintentional injuries have all also increased over the past three years.

While some metrics have worsened, some have improved with some caveats. More residents now have health insurance than ever before with only 5% uninsured. But, 30% struggled to find appointments and providers. Adults reported an increase from 23.3% to 33% in meeting physical activity guidelines while children aged 2-17 dropped from 66.2% to 58% since 2020. Only 28% of adults reported to eat five daily servings of fruits and vegetables with 27% finding it difficult to buy affordable, fresh produce.

These new figures are broken down further by specific metrics that include residents' income, age, gender and race/ethnicity. When taken into account, specific health challenges are revealed to be more prominent in different socioeconomic groups. Examples included people of color and lower income residents reporting much higher rates of food insecurity and symptoms of chronic depression, and residents aged 18-39, white and/or earning a high-income all reporting higher rates of excessive drinking.

Felton said the greater detail in these groups will help in determining solutions going forward.

"These are the most vulnerable people in our communities," he said.

The information will be used to determine the health alliance's priorities to improve community health through the county's Community Health Improvement Plan which will be implemented by the summer.

All of the report's findings along with previous reports can be viewed at Healthy by Design's website.

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