Georgia on my mind

Taking a closer look at mental health in the Peach State

One of the best parts of my job is getting to speak to different audiences across the country, not only about how I see the mental health landscape in particular states and regions, but also about what can be done to better care for those struggling with mental health challenges. This morning I get to do that during the State of the Public’s Health Conference at the University of Georgia.

Like many states, Georgia faces no shortage of challenges related to mental health. Nearly one in every five adults in Georgia battles mental illness in any given year; 1.4 million Georgian adults have some form of mental illness, and roughly 500,000 people have had a major depressive episode. Nearly 2,000 Georgians died of drug overdose-related causes in 2020. And, as the CDC reports, the number of overdose deaths in Georgia rose at least 38% during the pandemic.

Now, it’s not all bad news. The state has recently enacted legislation requiring suicide prevention training for school employees. Former Governor Nathan Deal pushed the state to invest tens of millions of dollars into state accountability courts, which “help people with mental health and substance abuse problems.” (Gov. Brian Kemp, who is currently in office, has requested that state agencies make some measure of cuts to these programs.) And while the United States finds itself in the grip of an epidemic of deaths of despair, health outcomes related to drug and alcohol use in Georgia have been less severe than in the significant majority of other states.

In other words, mental health concerns are not being entirely ignored, and relatively speaking, Georgia is not in crisis—but specific populations face real challenges, and robust policy options remain available to state leaders that could likely bring significant aid to those struggling the most with mental illness in Georgia.

For example, under the Affordable Care Act (ACA), the option exists for states to expand Medicaid coverage in the state. As the Atlanta Journal-Constitution reports, Medicaid benefits “can mean that a patient sees a psychiatrist or counselor within 48 hours instead of waiting weeks or even months.” And according to a study by the American Mental Health Counselors Association, “roughly 233,000 Georgians with serious mental illness or substance abuse conditions would gain health insurance if the state expanded” Medicaid coverage. Political leadership in the state has opposed Medicaid expansion due to affordability concerns, but mental health advocates in the state say that regardless, it would dramatically improve mental health care access for those who need it in Georgia.

While not a specific policy, efforts to depoliticize mental health care in the state will also be essential for improving treatment and increasing access to care for the most marginalized. We are already seeing some efforts to tackle mental health issues in a bipartisan way on Capitol Hill, and approaches like this one are paving a needed path. Mental health challenges don’t discriminate based on political party or any other characteristic, and leaders need to keep this in mind. The responsibility of politicians is to advocate for the well-being of all people, and this includes the mental health of constituents. Whether it is reaching a solution to expand funding for mental health services in Georgia or working more closely with individual communities to generate local responses to these challenges, the state’s leadership has a critical role to play in standing up for those least able to stand up for themselves. This is especially true when it comes to mental health issues, which can more significantly harm already marginalized communities.

At the end of the day, those of us in the policy space need to be able to provide concrete solutions to leaders regarding how to tend to the needs of struggling populations, and that’s what I want to urge Georgia’s leaders—at the statewide and community levels—to look for. We need to be asking and answering the question, “What are we going to do to more effectively resource solutions to mental health challenges in the state?

I proposed three things, but perhaps you have more ideas.

1) Bring mental health care to where people are;

2) Redesign our health care workforce to be more focused on communities rather than just clinical settings; and

3) Develop a plan to organize a new constituency that can begin to demand for change.

These are challenges I put to Georgia’s public health leaders this week, but regardless of my take, we should should all be asking more of those who represent our communities to address mental health.