{"id":471183,"date":"2017-11-28T08:59:29","date_gmt":"2017-11-28T15:59:29","guid":{"rendered":"http:\/\/nmpolitics.net\/index\/?p=471183"},"modified":"2017-11-30T14:48:41","modified_gmt":"2017-11-30T21:48:41","slug":"fragile-behavioral-health-system-doesnt-meet-regions-needs","status":"publish","type":"post","link":"https:\/\/nmpolitics.net\/index\/2017\/11\/fragile-behavioral-health-system-doesnt-meet-regions-needs\/","title":{"rendered":"Fragile behavioral health system doesn&#8217;t meet region&#8217;s needs"},"content":{"rendered":"<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/Zmp_4NCCeho\" width=\"771\" height=\"433\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n<p>LAS CRUCES &#8211; The digital painting by Las Cruces artist <a href=\"http:\/\/www.micahpearson.net\/\" target=\"_blank\" rel=\"noopener\">Micah Pearson<\/a> tells two stories \u2014 one that\u2019s fictional, one that\u2019s grounded in a painful reality.<\/p>\n<p>It\u2019s an image of a person kneeling, seemingly in anguish, with an array of color splattered against the background.<\/p>\n<p>The first story is an artistic creation, the final frame in Pearson\u2019s recent gallery show. It depicts an otherworldly being who struggles to create the matter of the universe.<\/p>\n<p>The second, more subtle story is that of Pearson\u2019s own battle with mental illness.<\/p>\n<p>The image depicts an episode of manic activity, one of the characteristics of Pearson\u2019s bipolar disorder. In such frenzied states, his mind goes into hyperdrive. He feels compelled to create. He&#8217;ll go days without much sleep.<\/p>\n<aside class=\"module align-left half type-aside\">\n<h3>About this article<\/h3>\n<p><em>This article is part of a multi-newsroom investigative series that examines southern New Mexico\u2019s struggling behavioral health system and explores solutions.\u00a0<a href=\"http:\/\/nmpolitics.net\/index\/series\/distressed\/\" target=\"_blank\" rel=\"noopener\">Click here to read more<\/a>.<\/em><\/p>\n<\/aside>\n<p>The heightened mental activity overwhelms Pearson physically \u2014 hence the anguish of the person in the image. He loses his appetite, has dizzy spells and sometimes gets dehydrated. When he does sleep, his dreams are anxiety-laden. He often doesn\u2019t awake rested.<\/p>\n<p>Pearson, in a blog post from 2016, recounted describing to his girlfriend what prompted the painting. He said he felt he could \u201csee worlds\u201d in his mind\u2019s eye.<\/p>\n<p>&#8220;I can see all of them,\u201d he wrote. \u201cAnd I can make them, too. But they&#8217;re so big, and I&#8217;m so tired. I just want to rest and sleep, but I can\u2019t. Because they&#8217;re all in here, and I need to get them out.\u201d<\/p>\n<p>On a night <a href=\"https:\/\/www.facebook.com\/events\/914796101951212\/\" target=\"_blank\" rel=\"noopener\">in October<\/a>, dozens of people streamed through a gallery on Lohman Avenue, scrutinizing that image and Pearson\u2019s other intricately detailed, fantastic images \u2014 some still, some animated. The digital art gives vibrant life to Pearson\u2019s self-published novella that\u2019s also part of the show.<\/p>\n<p>Pearson mingled with the attendees, explaining the two-year creative process leading up to the exhibit, his third so far in Las Cruces. He spoke quickly, with a contagious energy. That was partly due to the enthusiasm any artist feels on opening night of a show, but it also had a second source: Preparing for the show, with its myriad details and looming deadline, helped trigger and feed a manic phase.<\/p>\n<div id=\"attachment_468711\"  class=\"wp-caption module image alignnone\" style=\"max-width: 771px;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-468711\" src=\"http:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-3-771x350.jpg\" alt=\"Micah Pearson\" width=\"771\" height=\"350\" srcset=\"https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-3-771x350.jpg 771w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-3-336x153.jpg 336w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-3-768x349.jpg 768w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-3-1170x531.jpg 1170w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-3.jpg 1500w\" sizes=\"auto, (max-width: 771px) 100vw, 771px\" \/><p class=\"wp-media-credit\">Robin Zielinski \/ NMPolitics.net<\/p><p class=\"wp-caption-text\">Micah Pearson mingles with guests during the opening night of his gallery show, &#8220;The Voyage,&#8221; in October.<\/p><\/div>\n<p>The multimedia art project, <a href=\"https:\/\/www.youtube.com\/watch?v=8s6B2sixrVM\" target=\"_blank\" rel=\"noopener\">\u201cThe Voyage,\u201d<\/a> tells the story of time-and-space traveler Jamie Hendrickson, who visits one far-flung world after the next, documenting her adventures in the process.<\/p>\n<p>Interwoven throughout is the story of Pearson\u2019s own arduous path to recovery from mental illness. It\u2019s a journey that has included hospitalization, jail time and, more recently, a role <a href=\"http:\/\/www.nami-dac.org\/about-nami-dac\/board-of-directors\/micah-pearson\/\" target=\"_blank\" rel=\"noopener\">as one of the foremost advocates<\/a> seeking to improve a fragmented system of mental health care in Do\u00f1a Ana County. The fragile network has been rocked by <a href=\"http:\/\/nmpolitics.net\/index\/2016\/04\/disarray-continues-to-plague-nms-behavioral-health-system\/\" target=\"_blank\" rel=\"noopener\">one controversy after another<\/a> in recent years. While several proactive efforts toward improvement are underway, challenges remain.<\/p>\n<p>In addition to <a href=\"https:\/\/www.nami.org\/Learn-More\/Mental-Health-Conditions\/Bipolar-Disorder\" target=\"_blank\" rel=\"noopener\">bipolar disorder<\/a>, Pearson, 41, has two other diagnoses: <a href=\"https:\/\/www.nami.org\/Learn-More\/Mental-Health-Conditions\/ADHD\" target=\"_blank\" rel=\"noopener\">attention deficit hyperactivity<\/a> and <a href=\"https:\/\/www.nami.org\/Learn-More\/Mental-Health-Conditions\/Posttraumatic-Stress-Disorder\" target=\"_blank\" rel=\"noopener\">post-traumatic stress<\/a> disorders. He emphasizes that his illness doesn\u2019t define him. He\u2019s an artist and an advocate. He\u2019s a politics aficionado, deftly discussing the latest national news with sarcasm-infused insight. He\u2019s a board-game enthusiast and a sci-fi film buff.<\/p>\n<p>Pearson weaves all of these interests into often rapid-fire, humor-laced conversations. Even when he\u2019s depressed, a spirit of idealism bubbles to the surface.<\/p>\n<p>\u201cOn the mental health side, I want to make a better world for those of us with mental health conditions and our families,\u201d he said. \u201cOn the art side, I want to see my work in a museum because I did something that moved art forward.\u201d<\/p>\n<p>\u201cI want to make sure my time on this planet was time well spent,\u201d he said, \u201cthat I left my mark and that the world was a better place because I was here.\u201d<\/p>\n<p>Pearson\u2019s is both a hopeful story of overcoming challenges and a cautionary tale for a community whose system of care needs dramatic improvements. Without the change Pearson and others seek, Do\u00f1a Ana County isn\u2019t adequately equipped to help many people struggling with mental illness live healthy, productive lives.<\/p>\n<p>As NMPolitics.net, the Las Cruces Sun-News and KRWG News <a href=\"http:\/\/nmpolitics.net\/index\/2017\/11\/people-in-crisis-deadly-force-and-the-search-for-a-better-way\/\" target=\"_blank\" rel=\"noopener\">reported Monday<\/a>, that currently means law enforcement is increasingly forced to deal with people in crisis, and the results are often tragic. While equipping police to better deal with such moments is important, real solutions come in creating a stronger network of care to reduce the number of crises that end up in the hands of cops.<\/p>\n<h3>The state of care<\/h3>\n<p>Pearson\u2019s struggles began as a child growing up in Washington, D.C. in the 1980s. He recounts being obsessed with \u201cdeath and dying\u201d at a young age.<\/p>\n<p>\u201cMy parents tried to explain to my providers that I was exhibiting behaviors that were not normal for a 4-year-old,\u201d he said. \u201cThe doctors, of course, told my parents I was too young to have any sort of mood disorder.\u201d<\/p>\n<p>Pearson said his parents wouldn\u2019t find out he had bipolar disorder until he was 22. By then he already was taking medication for hyperactivity disorder that had been causing psychosis.<\/p>\n<p>But <a href=\"https:\/\/www.webmd.com\/schizophrenia\/guide\/what-is-psychosis#1\" target=\"_blank\" rel=\"noopener\">psychosis is a symptom<\/a> \u2014 not a mental illness itself. It describes when a person loses touch with reality, hearing or seeing things that aren\u2019t there. Pearson recalls believing at one point the family cat was calling his name. Another time he was convinced he was a \u201cprophet of the Lord.\u201d That was especially strange, he noted humorously at a conference earlier this year, because he\u2019s an atheist.<!--more--><\/p>\n<p>For four years, Pearson held a job as an IT manager for a division of The Washington Post. Even as he achieved professional success, Pearson struggled in his personal life. Routine responsibilities, like a budget and paying bills, often overwhelmed him.<\/p>\n<p>\u201cI was either in a manic phase and spent, spent, spent, spent, spent. Or I was depressed and scared of my own mail,\u201d he said.<\/p>\n<p>In 2011, Pearson hit rock bottom. After a failed marriage, an assault charge and the loss of his job, he moved cross-country to live with his parents in Las Cruces and began putting his life back together. He\u2019d soon be witness to a figurative earthquake that would upend New Mexico\u2019s behavioral health care system. He couldn\u2019t have predicted then how big a role he\u2019d come to play in advocating for better systems and care for patients.<\/p>\n<p>In mid-2013, Gov. Susana Martinez\u2019s administration <a href=\"http:\/\/nmindepth.com\/2016\/02\/08\/backgrounder-on-behavioral-health-crisis\/\" target=\"_blank\" rel=\"noopener\">abruptly froze Medicaid payments<\/a> to 15 community mental health and addiction care providers across New Mexico, including four that provided services in Do\u00f1a Ana County. The justification? Allegations of possible fraud.<\/p>\n<p>By 2016, the state attorney general had <a href=\"http:\/\/nmpolitics.net\/index\/2017\/07\/states-credible-allegations-of-fraud-charge-against-health-providers-falls-apart\/\" target=\"_blank\" rel=\"noopener\">cleared all 15 organizations<\/a> of any wrongdoing. In the meantime, chaos ensued for health workers and patients. When the state froze funding in 2013, it brought in replacement providers from Arizona without serious planning.<\/p>\n<p>And by early 2015, La Frontera, the Arizona company that had replaced a network of providers in southern New Mexico, left the state, sparking yet another transition for workers and patients. <a href=\"http:\/\/www.lcdfnm.org\/\" target=\"_blank\" rel=\"noopener\">La Clinica de Familia<\/a>, a safety-net primary care clinic network in Do\u00f1a Ana County, <a href=\"https:\/\/www.abqjournal.com\/622327\/takeover-of-dona-ana-mental-health-services.html\" target=\"_blank\" rel=\"noopener\">stepped in to fill the void<\/a> in Do\u00f1a Ana County, picking up behavioral health as a major division of its services. It was perhaps a courageous move, considering the organization hadn\u2019t previously planned to take on such a large division of operations.<\/p>\n<p>During La Frontera\u2019s tenure, hundreds of behavioral health patients countywide dropped out of care or lost access as programs were cut. La Clinica was tasked with picking up the pieces.<\/p>\n<p>\u201cThe Medicaid crisis hit and scarred our community, and that wound has not healed,\u201d said Suzan Martinez de Gonzales, former executive director of La Clinica, in an interview earlier this year.<\/p>\n<p>Pearson said he was among the affected patients.<\/p>\n<p>\u201cI didn&#8217;t have access to services for almost two years because of delays in scheduling and lack of availability,\u201d he said.<\/p>\n<p>When La Clinica took over Medicaid-funded behavioral health care in August 2015, it took on about 1,700 patients countywide. In the more than two years since, the number has climbed past 4,000, officials say, as the clinic has worked to re-establish ties with patients who left service during La Frontera\u2019s tenure.<\/p>\n<p>While the patient growth is positive, La Clinica officials said staffing levels haven\u2019t significantly changed. Therapists and other practitioners are strained and staff turnover is high. And adopting behavioral health care has taken a big financial toll on the organization.<\/p>\n<p>Also, patients, including people in crisis, have wait times for follow-up visits that span a few weeks, which is problematic for people actively struggling with their mental health. That points to another problem \u2014 a shortage of behavioral health professionals.<\/p>\n<p>\u201cIf the workforce was bigger, we would be able to see patients more often,\u201d said Rosario Olivera, behavioral health director for La Clinica.<\/p>\n<p>The shakeup caused by the Martinez administration freezing Medicaid funds was dramatic \u2014 and wasn\u2019t the only disruption in recent years:<\/p>\n<ul>\n<li>In 2014, Memorial Medical Center in Las Cruces <a href=\"https:\/\/www.abqjournal.com\/495622\/hospital-ceo-psych-ward-solution-expected-by-years-end.html\" target=\"_blank\" rel=\"noopener\">all but closed its 12-bed psychiatric unit<\/a>, sparking a wave of protests by local mental health advocates. The service was eventually restored.<\/li>\n<li>Earlier this year, a local private psychiatric services and addiction treatment provider, Epoch Integrated Health Services, <a href=\"http:\/\/www.lcsun-news.com\/story\/news\/local\/2017\/06\/03\/state-cuts-medicaid-payments-las-cruces-provider\/366774001\/\" target=\"_blank\" rel=\"noopener\">abruptly closed its doors<\/a> after the attorney general\u2019s office raided its facility, seizing documents. The practice closed. The investigation is pending.<\/li>\n<li>Counseling services for students at New Mexico State University underwent a consolidation with primary care at the Las Cruces campus\u2019 student health center. The move is in line with a national trend to integrate mental health care with primary care, but it also means fewer behavioral health professionals are available to see students.<\/li>\n<\/ul>\n<p>Meanwhile, more than 200,000 New Mexicans gained medical coverage because of Martinez\u2019s decision to expand Medicaid eligibility in January 2014 as part of the implementation of the federal Affordable Care Act.<\/p>\n<p>The sum of it all? More people have the ability to seek the treatment they need, but they place additional demand on a system that is still recovering from the turmoil of recent years and suffering from a limited workforce.<\/p>\n<h3>The high cost of NM\u2019s poverty<\/h3>\n<p>About one in five New Mexicans \u2014 more than 300,000 people \u2014 had a mild, moderate or serious mental illness in 2015, only slightly higher than the national rate, according to the organization <a href=\"http:\/\/www.mentalhealthamerica.net\/issues\/state-mental-health-america\" target=\"_blank\" rel=\"noopener\">Mental Health America\u2019s<\/a> most recent report card. About 9 percent of the state\u2019s population had an alcohol or drug addiction, again just higher than the nationwide rate.<\/p>\n<p>But in general, New Mexicans are less equipped because of the state\u2019s poverty to cope with mental illness and addiction than in more affluent states, experts said.<\/p>\n<p>The \u201csocial determinants\u201d of a person\u2019s mental health are hurdles to staying healthy for people who live in poverty, said <a href=\"https:\/\/psychiatry.unm.edu\/\" target=\"_blank\" rel=\"noopener\">Mauricio Tohen<\/a>, head of the department of psychiatry at the University of New Mexico. Can he or she afford the co-pays for treatment and medication? Does an individual have enough food to eat?<\/p>\n<p>In New Mexico, consistently one of the states with the worst poverty, the results are disastrous. The state logged the fourth-highest suicide rate in the nation in 2015, when nearly <a href=\"http:\/\/www.lcsun-news.com\/story\/news\/education\/nmsu\/2017\/09\/08\/aggies-hope-aims-prevent-campus-suicides\/646996001\/\" target=\"_blank\" rel=\"noopener\">500 residents took their own lives<\/a>. New Mexico\u2019s rate increased by 32 percent from 2005 to 2015, and spiked even more quickly from 2013, the year the Martinez administration froze Medicaid funding for behavioral health services, to 2015 \u2014 up by 17.5 percent in just two years.<\/p>\n<p>New Mexico is also among the worst states for <a href=\"http:\/\/www.lcsun-news.com\/story\/news\/local\/county\/2017\/07\/23\/opiate-reversal-drug-narcan-distributed-county\/414428001\/\" target=\"_blank\" rel=\"noopener\">fatal drug overdoses<\/a>, including from opioid addiction.<\/p>\n<h3>Struggles to build better systems<\/h3>\n<p>Even before the most-recent tumultuous events, the system of care in Do\u00f1a Ana County wasn\u2019t robust. In the absence of a stronger network, the resulting burden of dealing with residents in crisis has often fallen on law enforcement and other first responders. The cost can be heavy.<\/p>\n<p>A single wooden cross memorializes Juan Gabriel Torres, a 36-year-old man fatally shot by police <a href=\"http:\/\/nmpolitics.net\/index\/2017\/11\/people-in-crisis-deadly-force-and-the-search-for-a-better-way\/\" target=\"_blank\" rel=\"noopener\">in August 2016<\/a>, next to the Lohman Avenue bridge that spans Interstate 25. After stealing a truck earlier in the day, Torres, a father of three, was armed with a 14-inch knife and lunged at officers. The district attorney cleared the two officers who fired on him of any wrongdoing.<\/p>\n<div id=\"attachment_468726\"  class=\"wp-caption module image alignnone\" style=\"max-width: 771px;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-468726\" src=\"http:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/JGTorres-11-771x514.jpg\" alt=\"Juan Gabriel Torres memorial\" width=\"771\" height=\"514\" srcset=\"https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/JGTorres-11-771x514.jpg 771w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/JGTorres-11-336x224.jpg 336w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/JGTorres-11-768x512.jpg 768w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/JGTorres-11-1170x780.jpg 1170w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/JGTorres-11.jpg 1500w\" sizes=\"auto, (max-width: 771px) 100vw, 771px\" \/><p class=\"wp-media-credit\">Robin Zielinski \/ NMPolitics.net<\/p><p class=\"wp-caption-text\">Juan Gabriel Torres&#8217; ex-girlfriend Maggie Calderon and their three children left balloons and a cupcake at a memorial for Torres near the spot where he died to commemorate his birthday in June.<\/p><\/div>\n<p>Torres, who attended high school in Carlsbad before moving to Las Cruces in the early 2000s, cycled in and out of incarceration for years. At one point, he told probation officials he was diagnosed with schizophrenia and anti-social disorder, court records state. In addition, Torres struggled with addiction and drug use, including of meth, opioids, spice and alcohol, according to court records.<\/p>\n<p>Maggie Calderon, Torres\u2019 ex-girlfriend and the mother of his children, said his death took a heavy toll. Her daughter and two sons were depressed and didn\u2019t want to attend school. She sought psychiatric help. The situation was worsened when strangers bullied them and carried out mean-spirited social media attacks after Torres\u2019 death.<\/p>\n<div id=\"attachment_468725\"  class=\"wp-caption module image alignleft\" style=\"max-width: 336px;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-468725\" src=\"http:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/JGTorres-10-336x343.jpg\" alt=\"Juan Gabriel Torres\" width=\"336\" height=\"343\" srcset=\"https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/JGTorres-10-336x343.jpg 336w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/JGTorres-10-60x60.jpg 60w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/JGTorres-10.jpg 447w\" sizes=\"auto, (max-width: 336px) 100vw, 336px\" \/><p class=\"wp-media-credit\">Courtesy photo<\/p><p class=\"wp-caption-text\">Juan Gabriel Torres<\/p><\/div>\n<p>\u201cI never thought this community or anybody would bash on kids \u2014 grown adults bashing on my kids and bashing on me,\u201d she said. \u201cI am just like: We didn&#8217;t do anything wrong.\u201d<\/p>\n<p>Calderon said she\u2019d always hoped Torres would remain in the kids\u2019 lives. It\u2019s difficult to accept that he\u2019s gone, she said during an interview on Torres\u2019 birthday in June. As for Torres\u2019 behavior the day he was shot, Calderon said it was a \u201ccry for help.\u201d Police should have tried to de-escalate the situation, she said.<\/p>\n<p>Calderon recalled her ex-boyfriend had once left prison with a mental health prescription, but, after he was kicked out \u201con the street\u201d by family, it was hard to get that filled.<\/p>\n<p>The county jail and local hospital emergency rooms have been the go-to places for authorities to take residents who are in behavioral health crisis.<\/p>\n<p>There are other ideas for building better systems of care, but local officials have struggled to implement some of them. Others are fledgling efforts that show promise but depend on grant funding that will expire in future years.<\/p>\n<p>The county has yet to open a crisis triage center that was built four years ago. Some say the state needs a second psychiatric hospital in Las Cruces to be closer to families in the southern half of the state and bolster the network of care in and around Do\u00f1a Ana County. How to fund it isn\u2019t clear.<\/p>\n<p>A grant-funded pilot project is underway that <a href=\"http:\/\/nmpolitics.net\/index\/2017\/11\/mental-health-court-could-lower-recidivism-cut-costs\/\" target=\"_blank\" rel=\"noopener\">could lead to a jail-diversion court<\/a> for people suffering from mental illness in Do\u00f1a Ana County, but how the court would be funded also isn\u2019t clear. The effort is boosting community services for people not in the program.<\/p>\n<p>Separately, some providers are trying to increase the number of <a href=\"https:\/\/www.samhsa.gov\/recovery\/peer-support-social-inclusion\" target=\"_blank\" rel=\"noopener\">peer support specialists<\/a> in the community \u2014 a support system considered a best practice by the federal Substance Abuse and Mental Health Services Administration. These are people who\u2019ve lived with addiction and mental illness and are tasked with helping others stay engaged in care or find community resources.<\/p>\n<h3>Success stories, and help<\/h3>\n<p>Chronic mental illness or addiction can be a major challenge for a person to overcome. But there are success stories \u2014 people who\u2019ve stopped bouncing from crisis to crisis and are living healthy, self-directed lives most of the time. Those are exactly the sort of people providers want to become peer support specialists \u2014 people like Pearson.<\/p>\n<p>His journey toward improved mental health began when he moved to Las Cruces. He took up art, a long-held interest he\u2019d let fall by the wayside. He painted 22 pieces in his first three months in Las Cruces. Within a year, he had a gallery show.<\/p>\n<p>Pearson had support and stability. His parents provided him a place to live and helped him get back on his feet. His mother, a retired federal employee, helped him apply for Social Security Disability. Because of her meticulous work, the application was approved on the first submission, he said. With that source of income, he was able to move into his own apartment.<\/p>\n<p>Hailing from an upper middle-class background, Pearson said he benefited from plenty of \u201cprivilege\u201d many others battling mental health conditions don\u2019t have.<\/p>\n<p>\u201cI had a wide system of resources available to me,\u201d he said.<\/p>\n<p>Perhaps that helped Pearson accept realities about his life.<\/p>\n<p>He said he first had to accept his diagnoses. Then he decided he shouldn\u2019t drink alcohol. He chose to have someone else manage his money \u2014 something he said has been \u201cthe most effective treatment I have ever had.\u201d That\u2019s because, with his conditions, impulse control is a weakness. Having a financial manager oversee his money means his bills get paid on time, he has enough for day-to-day expenses, and he has less anxiety.<\/p>\n<p>Also, Pearson said he\u2019s learned coping skills that help him counter his mental health conditions. For instance, he carries headphones \u2013 not necessarily to listen to music, but to block out background noise. Otherwise, ringing cell phones or conversations nearby distract him.<\/p>\n<p>Pearson said he pays attention to feedback from family and close friends. Sometimes they can tell he\u2019s headed toward an episode of depression. Crashes are impactful, but not outwardly flashy.<\/p>\n<p>\u201cWhen I\u2019m not functional I\u2019m at home, scared to leave my house,\u201d he said. \u201cI\u2019m worried that the people who say they care about me really don\u2019t. I\u2019m worried that I\u2019m going to have it all come crumbling down and not be able to do what I have dedicated my life to doing.\u201d<\/p>\n<p>Experts said a strong social network is key to someone seeking recovery from a\u00a0mental illness or an addiction.\u00a0Pearson further broadened his support network by joining the Unitarian Universalist Church and volunteering there. He became active in the local chapter of the National Alliance on Mental Illness, a major support and advocacy group he first discovered in 2004.<\/p>\n<p>He was certified by the state this year as one of about two dozen new peer support specialists in Do\u00f1a Ana County. A major goal now, Pearson says, is helping others who are on the same journey.<\/p>\n<p>As experts note, people living in behavioral health crisis often have strained or broken relationships with family. They might be kicked out of a family member\u2019s house, becoming homeless or near-homeless, which can worsen a mental health condition. From there, it becomes much more difficult to recover.<\/p>\n<p>In the absence of family support, social services play a bigger role.<\/p>\n<p>But resources aren\u2019t robust in Las Cruces. Sometimes they don\u2019t exist at all. That\u2019s according to James Sassak, a peer support worker for <a href=\"http:\/\/slhcclc.com\/\" target=\"_blank\" rel=\"noopener\">St. Luke\u2019s Health Care Clinic<\/a>, a medical and behavioral health clinic that serves homeless residents. He\u2019s tasked with helping those residents navigate systems to get housing and behavioral health care. He said people who\u2019ve had a recent crisis tend to be more willing to get help. But that window of opportunity is short-lived.<\/p>\n<p>Sometimes, because of a shortage of services, clients lose interest before they\u2019re able to plug into programs that could help them.<\/p>\n<p>UNM\u2019s Tohen said New Mexico\u2019s shortage of behavioral health providers is another consequence of its poor economy. Salaries tend to be lower than in wealthier places. About a quarter of Do\u00f1a Ana County\u2019s population lives in poverty, federal statistics state.<\/p>\n<p>\u201cThere are enough psychiatrists in Santa Fe or even Albuquerque, but there\u2019s definitely a need in the rest of the state,\u201d he said.<\/p>\n<p>Average pay for a psychiatrist in Denver is about $217,700 yearly, according to <a href=\"https:\/\/www.salary.com\/\" target=\"_blank\" rel=\"noopener\">Salary.com<\/a>. In Albuquerque it\u2019s about $201,000. In Las Cruces it\u2019s $182,600.<\/p>\n<p>New Mexico is faring better than most states in the overall number of behavioral health providers per capita, according to Mental Health America\u2019s report. But, according to federal assessments, gaps still exist across much of the state \u2014 including in Do\u00f1a Ana County.<\/p>\n<p>The federal Health Resources &amp; Services Administration considers Do\u00f1a Ana County a Health Professional Shortage Area in the category of behavioral health. A 0-to-25 scale takes into account several factors related to patients accessing care, including psychiatrist-to-resident ratios in an area. A rating of 25 is the worst. Do\u00f1a Ana County scored a 21.<\/p>\n<p>The workforce recruitment difficulties deepen for public and nonprofit providers, which most often are serving the lowest-income patients under more challenging conditions than providers working in private practice, experts said.<\/p>\n<p>Those were the agencies hit hardest by Martinez\u2019s Medicaid freeze. Many behavioral health workers quit during that tumultuous transition.<\/p>\n<h3>Coping with a provider shortage<\/h3>\n<p>Two psychiatrists outlined what they see as an additional problem for New Mexicans: inaccurate diagnoses and treatment. At issue, they said, is that New Mexico is one of the few states to let health professionals who aren\u2019t doctors write prescriptions. It\u2019s an attempt to address a provider shortage that might have unintended negative consequences.<\/p>\n<p>Manuel Mota-Castillo, a Las Cruces-area psychiatrist at Memorial Medical Center and Burrell College of Osteopathic Medicine, said he\u2019s seen nurse practitioners prescribe the drug Adderall, for an incorrect diagnosis of ADHD, to people who are addicted to methamphetamine. Adderall contains a compound closely related to meth; prescribing it to meth addicts is an unsafe practice that should be investigated by licensing authorities, he said.<\/p>\n<p>New Mexico is one of 12 states in which nurse practitioners <a href=\"https:\/\/www.ama-assn.org\/sites\/default\/files\/media-browser\/specialty%20group\/arc\/ama-chart-np-prescriptive-authority.pdf\" target=\"_blank\" rel=\"noopener\">aren\u2019t required<\/a> to have physician oversight to prescribe medication, according to the American Medical Association. Other states require partial or full oversight. Five states, including New Mexico, grant prescriptive authority <a href=\"http:\/\/www.apa.org\/news\/press\/releases\/2017\/04\/idaho-psychologists-medications.aspx\" target=\"_blank\" rel=\"noopener\">to psychologists<\/a>.<\/p>\n<p>Recognizing the need for more psychiatrists, Mota-Castillo helped recruit one of his colleagues to Las Cruces in 2016. Psychiatrist Daniel Pistone spent less than a year practicing in the city before leaving for California, frustrated at the lack of medical oversight of psychiatric nurse practitioners at the organization where he worked. Some nurses were interested in learning and improving their practices, he said. Others weren\u2019t.<\/p>\n<p>Because of the problem, Pistone said, \u201cthe situation was so substandard it was more harmful than helpful.\u201d He said he tried unsuccessfully to push for change, and is speaking now in hopes that doing so might lead to improvements in care.<\/p>\n<p>Pistone said he was also frustrated by what he called the hindrance created by the education levels of patients. One patient lodged a complaint because he refused to prescribe an anti-depressant, which he said wasn\u2019t the correct treatment for her condition. The complaint was dismissed, he said.<\/p>\n<p>\u201cI made a commitment because I\u2019m Hispanic, I\u2019m Latino,\u201d he said of his decision to move to Las Cruces. \u201cI wanted to help that under-served population. But No. 1, I couldn\u2019t do what I wanted to do, and No. 2, the liability risk was very high.\u201d<\/p>\n<p>Given his experience in Do\u00f1a Ana County, Pistone agreed that salary levels should be raised to attract well-qualified psychiatrists to the state. Plus, he said prescribing psychologists and psychiatric nurse practitioners should report to psychiatrists so they can receive \u201cappropriate supervision.\u201d<\/p>\n<p>Other providers contend that psychiatric nurse practitioners, who have medical training but not on the same scale as a doctor, and prescribing psychologists, who train under psychiatrists initially, are needed to address provider shortages in New Mexico. Rural areas can\u2019t afford to pay psychiatrists, they said, and access to a nurse practitioner is better than no provider at all.<\/p>\n<p>Dario Silva, a Ph.D.-level counselor, currently heads NMSU\u2019s counseling services for students and employees. He said a psychiatric nurse practitioner is the main medication prescriber for patients at the clinic and described her as \u201cvery, very good at what she does.\u201d<\/p>\n<p>While psychiatrists have the most medical training and education, Silva said they cost double the salary of a nurse practitioner. NMSU has faced steep budget cuts in recent years.<\/p>\n<p>St. Luke\u2019s Health Care Clinic is seeking to hire a psychiatric nurse practitioner, said Pamela Angell, executive director of the nonprofit.<\/p>\n<p>\u201cThat\u2019s definitely a hole or a gap in our services,\u201d she said.<\/p>\n<p>Tohen said what\u2019s key for prescribing personnel who aren\u2019t doctors is knowing when to refer a patient to a higher-level expert. He said he\u2019s worked with some \u201coutstanding\u201d psychiatric nurse practitioners.<\/p>\n<p>\u201cWe need good nurse practitioners, but we also need good psychiatrists,\u201d he said.<\/p>\n<p>Mota-Castillo said he\u2019s comfortable sending his patients to three psychiatric nurse practitioners with whom he\u2019s worked, so he doesn\u2019t believe all of them require supervision by a psychiatrist. He can think of about five, however, who should be under supervision of a doctor.<\/p>\n<p>Requiring more supervision for psychiatric nurse practitioners or prescribing psychologists would require changes to a state law that\u2019s generally seen as helping to attract members of these professions to New Mexico.<\/p>\n<p>To address the shortage of psychiatrists, La Clinica de Familia, along with Do\u00f1a Ana County government, has plans to launch a physicians\u2019 residency program next year to train three new doctors to practice psychiatry. The new psychiatrists could go anywhere upon completing the residency, officials noted, but research has shown <a href=\"http:\/\/www.pewtrusts.org\/en\/research-and-analysis\/blogs\/stateline\/2015\/08\/11\/to-address-doctor-shortages-some-states-focus-on-residencies\" target=\"_blank\" rel=\"noopener\">that people who go to medical school<\/a> and do their residency in the same state tend to stay there.<\/p>\n<p>\u201cIf they stay in the region, it\u2019s a win,\u201d Martinez de Gonzales said. \u201cIf they stay in the community, it\u2019s a win-win.\u201d<\/p>\n<p>La Clinica is also working with NMSU to support a faculty position to <a href=\"https:\/\/newscenter.nmsu.edu\/articles\/view\/12124\/nmsu-school-of-social-work-partners-with-la-clinica-de-familia-to-help-community\" target=\"_blank\" rel=\"noopener\">boost the number of social workers<\/a> being trained. While this program has increased training capacity for certain mental health professionals, another program at NMSU, an accredited internship for students pursuing a doctorate in psychology, has been cut back.<\/p>\n<p>New Mexico\u2019s poor <a href=\"https:\/\/bhw.hrsa.gov\/shortage-designation\/hpsas\" target=\"_blank\" rel=\"noopener\">Health Professional Shortage Area<\/a> ranking does mean some educational advantages for medical school students and graduates, as well as some other types of mental health professionals. They can apply for <a href=\"https:\/\/www.ruralhealthinfo.org\/topics\/scholarships-loans-loan-repayment\" target=\"_blank\" rel=\"noopener\">scholarships or loan repayment<\/a> if they commit to serving a set amount of time with a qualifying provider in a shortage area, state and federal officials said.<\/p>\n<div id=\"attachment_468713\"  class=\"wp-caption module image alignnone\" style=\"max-width: 771px;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-468713\" src=\"http:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-5-771x613.jpg\" alt=\"Micah Pearson\" width=\"771\" height=\"613\" srcset=\"https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-5-771x613.jpg 771w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-5-336x267.jpg 336w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-5-768x610.jpg 768w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-5-1170x930.jpg 1170w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-5.jpg 1500w\" sizes=\"auto, (max-width: 771px) 100vw, 771px\" \/><p class=\"wp-media-credit\">Robin Zielinski \/ NMPolitics.net<\/p><p class=\"wp-caption-text\">Micah Pearson is one of five people across the U.S. who were elected in June to the National Alliance on Mental Illness&#8217; national board. He works locally as a peer support specialist.<\/p><\/div>\n<h3>Good things happening<\/h3>\n<p>Though the provider shortage and many other problems don\u2019t have easy solutions, there are some good things happening in Do\u00f1a Ana County when it comes to behavioral health.<\/p>\n<p>Pearson is one of five people across the U.S. who were elected in June to the NAMI national board. Along with that role, he\u2019s vice president of the local NAMI chapter and was certified by the state as a peer support specialist.<\/p>\n<p>For the first time in about 15 years, the state hosted a training session for peer specialists in Las Cruces, garnering about two dozen participants. La Clinica officials said that was a success, but a continuing challenge is that a follow-up testing and certification process is held only in Albuquerque, requiring out-of-pocket travel costs for participants.<\/p>\n<p>Experts say peer support specialists are a critical link in care. Their experience living with mental illness or addiction can give them credibility with people in crisis, which can help them connect people in need to community resources.<\/p>\n<p>Pearson is working as a peer support specialist through a $2.8 million federal grant Do\u00f1a Ana County was awarded in 2017 to launch what&#8217;s known as assisted outpatient treatment, a jail and hospital diversion pilot project.<\/p>\n<p>The grant, which goes hand-in-hand with <a href=\"http:\/\/www.santafenewmexican.com\/news\/local_news\/new-law-allows-court-ordered-treatment-for-mentally-ill\/article_57129d4b-ad22-5c41-8243-665fc6a03102.html\" target=\"_blank\" rel=\"noopener\">a statute dubbed Kendra&#8217;s Law<\/a>, pays for intensive treatment for people who, up until now, have been stuck in a cycle of hospitalization and detention because of mental illness, addiction or both.<\/p>\n<p>Before the law and the money that was awarded to enact it, a person in need of intensive treatment for a crisis had only the option of being involuntarily hospitalized, and only with a judge\u2019s approval. The new program gives the judge another option: ordering a person participate in an intensive outpatient care program, which includes peer support from someone like Pearson, to avoid hospitalization.<\/p>\n<p>While the grant pays for more staff at La Clinica de Familia to serve clients, there are certain costs it doesn&#8217;t cover, including housing, food, transportation, clothing and cell phones, said state District Judge Mary Rosner. She&#8217;s pushing for staff to find access to these resources elsewhere. Already, the county has assigned a housing coordinator to work with the outpatient clients. An estimated 30 people with mental illness and addiction will be served in the current calendar year.<\/p>\n<p>Rosner said she&#8217;s already seen positive results in clients&#8217; lives. But she notes the grant is set to expire after four years. By then, she&#8217;s hoping public support will have grown to establish a mental health court. The pilot outpatient program is setting up the structure for such a court, but it will need to be funded \u2013 which she said will be a state responsibility.<\/p>\n<p>At St. Luke\u2019s Health Care Clinic, a nearly $1.3 million federal grant called Hurry Home aims to help house chronically homeless people who also have a mental illness or addiction. The savings to the community come in the form of the clients not winding up in jail or hospitalized, clinic officials say. Sassak, the peer support worker for the clinic, who has battled addiction and homelessness, said he believes his experience gives him credibility with potential clients, many of whom don\u2019t trust people in authority.<\/p>\n<p>\u201cThey think most people are against them,\u201d he said.<\/p>\n<p>The grant is in the second year and has one year remaining. Angell, the clinic\u2019s executive director, said of the nearly 70 people who\u2019ve applied so far, about 50 have remained housed within six months of beginning the program.<\/p>\n<p>Though the program shows positive results, Sassak notes that success still hinges on a person\u2019s willingness to participate. He\u2019s noticed younger people aren\u2019t as interested in getting help as people who\u2019ve been homeless for decades.<\/p>\n<p>St. Luke\u2019s will have to find new funding to continue the project once the grant runs out.<\/p>\n<h3>\u2018Recovery is a journey\u2019<\/h3>\n<p>Because of his interest in improving the behavioral health system for patients locally, Pearson is an active advocate on many fronts. He keeps a busy schedule. But he admits there are times he must retreat from the public eye because of his illness \u2014 a recognized limitation of peer support specialists.<\/p>\n<p>\u201cI fully expect that I\u2019m probably going to collapse tomorrow,\u201d Pearson told two women who attended his art exhibit in October.<\/p>\n<div id=\"attachment_468714\"  class=\"wp-caption module image alignnone\" style=\"max-width: 771px;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-468714\" src=\"http:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-6-771x422.jpg\" alt=\"Micah Pearson\" width=\"771\" height=\"422\" srcset=\"https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-6-771x422.jpg 771w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-6-336x184.jpg 336w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-6-768x421.jpg 768w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-6-1170x641.jpg 1170w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2017\/11\/MicahPearson-6.jpg 1754w\" sizes=\"auto, (max-width: 771px) 100vw, 771px\" \/><p class=\"wp-media-credit\">Robin Zielinski \/ NMPolitics.net<\/p><p class=\"wp-caption-text\">Micah Pearson speaks with guests during the opening night of his gallery show, &#8220;The Voyage,&#8221; in October.<\/p><\/div>\n<p>Creating \u201cThe Voyage\u201d did take a toll on Pearson. In the weeks since opening night, he admitted he\u2019s been struggling with a major depressive episode. Even for someone in recovery from mental illness, <a href=\"http:\/\/www.mentalhealthamerica.net\/recovery-journey\" target=\"_blank\" rel=\"noopener\">relapses are expected<\/a> from time to time, he noted. Perhaps the biggest differences between his life now and his life before moving to Las Cruces are that he\u2019s aware of his limitations and knows when and where to seek help.<\/p>\n<p>\u201cRecovery is a journey, one that is never over once you\u2019ve started it,\u201d he said.<\/p>\n<p>Even if he was offered a miracle cure for his mental health disorders, Pearson doesn\u2019t think he would take it. His conditions, he said, have helped shape him into the person he\u2019s become. And his mission \u2014 to improve the lives of people with mental illness \u2014 keeps him motivated.<\/p>\n<p>Some of the changes taking place in Do\u00f1a Ana County, like the outpatient treatment program that employs Pearson, have never been tried here before, and are encouraging, he said. The program has allowed the local chapter of the National Alliance on Mental Illness to increase the number of support classes offered to both patients and their families. And for the first time this year, the local chapter of the organization hosted classes in Spanish in a county with a high percentage of Spanish speakers.<\/p>\n<p>Though ups and downs will come in Pearson\u2019s life, his commitment appears to be for the long-haul.<\/p>\n<p>\u201cI want to change things and make the system better,\u201d he said. \u201cThat is my hope.\u201d<\/p>\n<p><em>Diana Alba Soular may be reached at 575-541-5443,\u00a0<\/em><a href=\"mailto:dalba@lcsun-news.com\"><em>dalba@lcsun-news.com<\/em><\/a><em>\u00a0or\u00a0<\/em><a href=\"http:\/\/twitter.com\/albasoular\" target=\"_blank\" rel=\"noopener\"><em>@AlbaSoular<\/em><\/a><em>\u00a0on Twitter. Las Cruces Sun-News photographer Robin Zielinski and Sun-News reporter Carlos Andres L\u00f3pez contributed to this report.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>But health care officials and advocates such as Micah Pearson are working to change that.<\/p>\n","protected":false},"author":1,"featured_media":468709,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[142,115,117,145,203,3281,107],"class_list":["post-471183","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news-and-analysis","tag-crime","tag-dona-ana-county","tag-health-care","tag-las-cruces","tag-law-enforcement","tag-medicaid-freeze","tag-roundhouse","series-distressed"],"_links":{"self":[{"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/posts\/471183","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/comments?post=471183"}],"version-history":[{"count":0,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/posts\/471183\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/media\/468709"}],"wp:attachment":[{"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/media?parent=471183"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/categories?post=471183"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/tags?post=471183"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}