Upriver community plans future of healthcare

Behavioral health for kids could turn into a medical revolution

The lack of medical or mental healthcare contributes to many of the problems the Upriver area has, including behavioral health issues, poverty, geographic isolation and a lack of preventative care. These issues were discussed at the Swisshome Church this week, as Mapleton School District Superintendent Jodi O’Mara held a town hall discussing the Western Lane Behavioral Health Network.

However, for every problem that was listed, a hopeful solution was offered.

The meeting’s purpose was to get feedback on the problems facing the community, via the lens of healthcare, in hopes to build a blueprint on how to improve the lives of Upriver residents.

The genesis for the network came from a Health Resources and Services Administration grant that PeaceHealth Peace Harbor was interested in, with the goal being how to improve access in Western Lane County. That process looked at a wide swath of issues that face the Upriver community and Florence, until it was decided that the mental health of children “womb to 18” would be the main focus.

Partners in the project include Oregon Family Support Network, Mapleton School District, Siuslaw School District, Trillium, Lane County Mental Health, the Child Center out of Eugene, Options Counseling and Peace Harbor.

The plan is to have behavior health counselors available to both Mapleton and Siuslaw school districts twice a week, with offices on school property.

For Mapleton, O’Mara is picturing turning the old Mapleton Middle School building into a small facility where a counselor could work with students in a more private setting.

But the grant only covers behavioral health to children two days a week, leaving the facility empty the other five days.

O’Mara and her partners envision a future where medical professionals of all disciplines could fill the space on those extra days, from general practitioners to dentists, eye doctors to pediatricians. And the services would be available for all Upriver residents.

This is why, for the past two weeks, O’Mara has been holding meetings in Swisshome, Mapleton and Deadwood to get feedback on what issues the community is facing regarding healthcare, and what services could be added to the facility to help.

The Swisshome meeting began with a question from O’Mara: “What’s going good with healthcare?”

“I don’t think there is (anything good),” Pastor Bryan Moore said.

Currently, the only medical help that is immediately available in the area is the Swisshome-Deadwood Rural Fire Protection District. Dave Green, who volunteers for the district, talked about some of its strengths and weaknesses at the meeting.

“What I’ve been seeing is, we get these call outs for general illness,” Green said. “They stay at home two or three days and then call the ambulance to come up there.”

The district’s responders, as well as medics from Florence, do treat the patients.

“Our people are there within 15 minutes,” he explained. “It takes 30 minutes for the ambulance to get there. By that time, our people have been there, they’ve got them all assessed. The medics arrive and treat them. If they need something, they’ll take care of it.”

The reasons why the community relies on emergency services for even the simplest medical care are varied.

“People can’t afford to drive to Florence,” Moore said.

A one-way drive to Florence from Upriver can take up to an hour. Because of time, difficulty and cost involved with the trip, some Upriver residents simply wait until the illness becomes too extreme, in which time they call emergency responders.

Costs of the actual medical care can also be a barrier. Getting insurance can be difficult for those without knowledge of the system, or even access to it. Internet access is sparse in the region in even the best of circumstances, with cell phone service spotty at best. Because of this, programs like the Affordable Healthcare Act are difficult to apply for.

If a person is able to get hold of information on these types of programs, the rules and regulations can be confusing.

“You sit down with the paperwork and say, ‘I have to understand this?’” O’Mara said. “If you’re getting that and you’re elderly, you may not understand.”

Even accessing insurance information can be difficult, with internet access in the region sparse.

Even if they could get health insurance, the deductibles are high for the community.

Mashell Moore, who drives the school bus up and down Highway 36, expanded the idea of cost to the entire medical system.

“I can spend $250 to step in the door and you tell me to take a pill, go home and let it work itself out,” she said. “I can’t afford that and most people up here can’t afford that stuff. People don’t want to pay $200 for them to take their blood pressure.”

The Swisshome audience asked for educational opportunities on insurance, where someone would be able to take a person through the process step by step, a solution that O’Mara thinks the proposed medical building could handle.

A mobile medical unit was also suggested by the Swisshome audience, or, at the very least, a transportation system that could bring residents down to Mapleton for medical care.

One of the largest discussions of night revolved around mental healthcare.

“We need addiction and mental health counseling in this area,” Pastor Moore said. “It’s a big problem in this area. Huge.”

“There’s a big lack of support for any mental health services,” O’Mara said. “And that runs the gamut from children who have behavioral problems all the way to addiction, to mental health crisis.”

“We deal with the kids all the time about this,” Mashell said. “Just go online and look at their Facebooks. You’ll see what’s going on. If we don’t get to them in time, we’re going to have more Brandon’s. And then we’ll have the fallouts.”

In December 2016, Mapleton High School freshman and football player Brandon Kimble took his own life.

“We don’t want that,” Mashell continued. “We want to have healthy, happy kids that grow up to be healthy, happy adults. And that’s not going to happen if we don’t do anything about it.”

And it isn’t just children that are having issues.

“I’m talking about adults,” Pastor Moore said. “There are people in this area who don’t have the mental ability to even help themselves. I mean, we’ve got some people in Mapleton that walk the streets, and they’re not mentally stable.”

Getting behavioral healthcare in the area can be impossible, even in times of immediate crisis.

“There’s plenty of services out there you can call,” O’Mara said. “The problem is getting them to respond to such a rural community. It has to be an extremely dire need. And even at a school district, when I call a crisis line to say ‘This kid’s in crisis and I need the crisis response team,’ they won’t come. And it’s not my first rodeo, it’s not my first crisis. But even as an educational professional, I can’t get the crisis response teams.”

The situation can be worse for those without the crisis training O’Mara has, particularly in an isolated location.

“I can be driving a bus up the creek and some crazy dude comes out of the woods,” Mashell said. “I need to be equipped to know how to help this person. I need to know to distinguish what’s wrong, and who I call to get somebody some help. We need to know those things because we are out in the middle of nowhere.”

But even if someone could identify a problem and attempt to help, getting regular mental health checkups can be daunting.

“I called a place that said, ‘Leave your name and number and I’ll get back to you within two days.’ It’s been nine months. And she never called me back. And I had to go a different direction,” Mapleton High School Principal Brenda Moyer said.

“Every case worker is too busy,” Green said. “And then you have people who aren’t in the system who need to be.”

And for a tiny minority of those who don’t get help, tragedy can strike.

Pastor Moore brought up the recent shooting in the area. In a carjacking spree that spanned a large swath of the Upriver community, Mapleton resident Cameron Ollman, who himself suffered from behavioral health issues, ended up in a shootout with Florence city police, along with county and state officials.

One of the major hurdles regarding mental health is the negative stereotype that can surround it.

“People feel like that’s a stigma,” Mashell said. “So, they don’t want to admit that they need help. And then if they do get to the point of desperation where they need help, they’re afraid that they can’t afford it and that no one will help them. They slip through the cracks. Even if they get to step one, then they’re shoved off to nowhere land.”

That stigma is something O’Mara wants to alleviate by calling the program Western Lane Behavioral Health Network.

“A lot of people don’t understand what ‘behavioral health’ is,” she said. “But when you say, ‘mental health,’ there’s a stigma. And we’re trying really hard to reduce that stigma.”

While behavioral support for adults is still a vision, counseling for children and young adults would be taken care of by the grant.

O’Mara went over different forms of therapy that could be offered.

Play therapy would have children and counselors building a trusting rapport that could help coax out issues. Another therapy would be teaching a parent how to interact with their child in a one-on-one parenting class.

“We need to teach parents it’s okay to say, ‘I don’t know how to handle my child,’” O’Mara said. “That doesn’t reflect negatively on the parent, it just means you need help and support. We need to remove the stigma.”

O’Mara hopes the decision on the grant will come down in March. When that occurs, progress on the project will be rapid. 

“We’re already in the planning process,” she said. “So, when we get the grant, we’ll just hit the floor running. We can say OK. This is our site, we’ve already had an architect come look at the site and talk about the cost to update and renovate it. So it’s ready for healthcare support.”

To make that project successful, with a path to greater medical help in the area, O’Mara said the community needs to be a part of the conversation.

“We need to keep that conversation going and getting ideas and thoughts,” she said. “And once we get the grant, we’ll come out and say, ‘We have a grant, here’s the plan.’”

The turnout at that night’s meeting in Swisshome was low — only five participants showed up. There had been other meetings in the past couple of weeks at Mapleton and Deadwood, and they were equally anemic, according to O’Mara.

“It’s OK,” O’Mara said. “We will have other meetings.”

O’Mara is confident that the community will continue the conversation, with new ideas and support coming in. She’s also confident that the grant will go through.

“If for some reason the grant is not awarded, we won’t give up and we won’t stop. This is important,” she said.

For more information on the network, contact O’Mara by phone at 541-268-4312 or email at [email protected]

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