'Not a casserole condition': Leaders gather to raise awareness, reduce stigma around mental health

BOISE — Behavioral health has come a long way in Idaho since Rick Huber experienced his first mental health crisis in the early 1980s.

Huber said he was home for the summer while studying engineering at the University of Idaho when he started seeing things that weren’t there.

“It’s like one minute, you’re OK, and then it’s like somebody takes a spoon and turned your world up, and everything doesn’t make sense,” Huber said.

His parents were unsure how to get him the help he needed, so they took him to an alcohol addiction treatment facility. There, he only grew more paranoid and scared, and he ran away. He was found by police officers, who put him on the ground and placed him in handcuffs. They were going to arrest him, take him to jail to go to court for commitment when someone at the alcohol treatment facility flagged them down and notified the officers that Huber had health insurance.

“It’s like you flipped a switch on those officers and they’re like, ‘oh we’re sorry for basically beating you up’,” Huber, who now serves on the Idaho Behavioral Health Planning Council, said. “So that was my first experience with the disparities with mental health. Once they found out I had the insurance, it was like I was a total different person in their eyes.”

On Friday, Huber joined leaders from other government and nonprofit behavioral health organizations at the Capitol for a Mental Health Month event, which included a proclamation by the governor and discussion of the available resources and challenges of administering them.

“We celebrate today not in exaltation but with determination,” said Dustin Lapray, public involvement officer for the Division of Behavioral Health.

Gov. Brad Little said the state has made progress in the area of mental health and substance use treatment, but acknowledged that there’s more to be done.

“It seems like the problem almost grows at a faster rate than what we’re doing,” Little said.

He highlighted the progress made by the Behavioral Health Council, which brings together the legislative, judicial and executive branches of government to create recommendations and a plan to improve care for Idahoans in this area. The council was formed in 2020 and Little re-established the group this year in January through an executive order.

Nearly all the recommendations from the council’s first strategic plan have been implemented or are in the process of being implemented, including establishing the statewide 988 suicide hotline, adding resources to expand the number and training for credentialed behavioral health workers, funding four youth crisis centers and providing funding for new psychiatric residential treatment facilities, which were the first in the state and helped bring home children who were being treated out of state. The first treatment facility opened in 2023, with the Idaho Youth Ranch Residential Center for Healing & Resilience in Caldwell.

Little also highlighted that this year the Legislature approved $25 million for a secure mental health facility, which will be a 26-bed facility for those determined to be dangerously mentally ill by the courts and for inmates in need of acute behavioral interventions.

Division of Behavioral Health Administrator Ross Edmunds said that he used to see the state’s behavioral health system as “completely fractured” between his division, Medicaid, law enforcement and politically among the executive and legislative branches.

“Over the last several years, what we’ve really been able to do is help repair so much of that fracture,” Edmunds said.

The council was a step in repairing that, and another step was implementing the Idaho Behavioral Health Plan, which manages all mental health and substance use disorders under one managed care organization, regardless of whether the patients are in Medicaid.

David Welsh, executive director of Magellan of Idaho, which is the organization tasked with administering the plan, said the group is looking at managing this type of care more “holistically” and getting people connected to resources in their community.

Under the new plan, the managed care organization will oversee delivery of inpatient services, residential treatment for substance use disorder, psychiatric services and others throughout the state for those with Medicaid, private insurance and uninsured.

Groups that offer support and access to resources also spoke about their work as well as the need to continue discussing mental illness and substance use disorder, and how to reduce stigma about seeking help.

National Alliance on Mental Illness (NAMI) Idaho Executive Director Beth Markley said that while there’s been some reductions in the stigma around mental health, it hasn’t yet disappeared.

“I will be clear, stigma is a very, very real thing,” Markley said. “... If you don’t deal with mental illness firsthand ... you might be tempted to think mental illness is somebody else’s problem. Statistics tell us that mental illness is probably closer to each us than we we want to realize.”

She said one in five people will deal with some form of mental illness this year, much of it in the form of anxiety and depression. One in 20 people will deal with serious disorders like schizophrenia, bipolar disorder, and borderline personality disorder.

She also talked about how mental health in the workplace is often not discussed, and people who might be struggling with it are reluctant to tell their colleagues or supervisors. She compared it to how coworkers might pass around a card or give flowers to someone who had an injury; mental health crises aren’t treated the same way.

“Mental illness is not a casserole condition,” she said. “What we mean by that, is there are so rarely meal trains for mental health crises and that’s what stigma is about.”

She said the important thing is for people to listen and create a culture where it’s safe to bring forward struggles in this area.

Organizations that provide resources include Families and Youth of Idaho (FYIdaho), NAMI Idaho, Empower Idaho, and the Division of Behavioral Health.