Presentation of Idaho reports on Idaho Public Television is made possible through the generous support of the Laura Moore Cunningham Foundation, committed to fulfilling the Moore and Bettis family legacy of building the Great State of Idaho by the Friends of Idaho Public Television and by the Corporation for Public Broadcasting.

Accessing mental health care in Idaho can be challenging under the best of circumstances, and even more so when you add barriers like a lack of providers in rural parts of the state.

We take a look at some of those challenges and what's being done to address them.

I'm Melissa Devlin.

The 50th season of Idaho reports starts now.

Hello and welcome to Idaho reports this week producer Ruth Brown explores a shortage of mental health care for juveniles in rural north central Idaho.

Then Dr. Chris Yates of Idaho State University's Department of Counseling discusses what the university is doing to address those shortages and what the state can do to help.

Finally, Kevin Richart of Idaho Education News joins us to discuss vaccine mandates and the potential impact of next week's school district elections.

But first, it's the start of our 50th season.

Idaho reports started as a live program called State House Report that was broadcast directly from the Capitol in Boise.

Over the coming months, we'll be taking a look back at some of the highlights from the last five decades while bringing you the latest Idaho political news on taxes, health care policy, education and more.

And we're also embracing the future.

This year, we started a weekly podcast that comes out every Wednesday, as well as a newsletter with a round up of our reporting delivered to your inbox every Friday morning.

You can find the links to subscribe to all of those at IdahoPTV.org/Idahoreports.

Earlier this week, House Speaker Scott Bedke and Senate President Pro Tem Chuck Winder announced the Legislature will come back into session on November 15th to consider legislation on federal vaccine mandates, as well as house ethics charges against Representative Priscilla Giddings.

Idaho reports will have full coverage of the November 15th session online and on our November 19th broadcast.

In August, the House Ethics Committee recommended the House censure Giddings and remove her from a committee after Giddings linked to an article that shared the full name and photo of a House intern who had accused former representative Aaron Von Ehlinger of rape.

On Friday, Von Ehlinger appeared in court for a preliminary hearing.

For coverage of that hearing, visit the Idaho Reports blog.

You'll find the link at IdahoPTV slash Idaho Reports.

Across the state, Idahoans seeking mental health care often run into barriers like long wait lists, transportation issues and a lack of providers who accept Medicaid.

That's especially true for families seeking help for their minor children, and even more so in rural parts of the state.

Last month, Ruth Brown visited Idaho's Public Health District two in the Lewiston, Orofino and Grangeville area to explore those challenges.

When it comes to youth, mental health, access to health care remains problematic in the state.

The Idaho Behavioral Health Council recently drafted recommendations on behavioral health, many of which revolved around youth mental health care.

Idaho reports visited health and welfare region two of Idaho, which included Idaho, Clearwater, Latah, Nez Perce and Louis counties, an area that provides a unique set of problems ranging from connectivity to a lack of available providers.

>>It leads us to having longer waits to get into treatment, which you know is a compounding problem if you are currently experiencing a mental health issue or you need treatment and you're not able to access it for six weeks.

You know, sometimes those issues can compound and become more of a crisis, and then you might end up in the hospital.

And so sometimes hospitals get backed up and then, you know, it's just getting access to the appropriate level of care can be really difficult in the time when you need it.

>>In Grangeville and across Idaho County, the shortage of providers is even more noteworthy.

>>I think we are in Grangeville and our surrounding area is one of the few places left in Idaho where we don't even really have adult crisis services closer than Lewiston.

We certainly don't have any youth crisis services.

And then, of course, if someone is like suicidal in crisis needing inpatient care, that's very difficult to access here.

>>The state does use telehealth, but that's not an option for all Idaho families.

>>I just don't think there's any way to understate how long geographic distance impacts health care, not just mental health, but we're specifically talking about mental health.

So the idea of telehealth is fantastic.

It's not fantastic if a family doesn't have access to internet right service provider, and there's a lot of places in Idaho county where you just can't get service, period.

>>The sense of independence across rural Idaho has both pros and cons.

>>On one hand, that's super positive that I think in Idaho, we love to work hard and we love to accomplish things on our own, and that drives our productivity and our pride in our communities and ourselves.

On the other hand, I really think there is a skill deficit in being able to ask for help when you need it.

Nobody knows everything.

Everyone needs help sometimes and to know how to ask for help and to actually ask for help.

I think is something that we struggle with.

>>Peer support specialists are one of the best tools region two uses amid a shortage of health care professionals.

>>The peer will work with and help the family advocate and know and be able to navigate the system.

Navigating the system is one of the most complicated pieces to the puzzle.

Sometimes knowing who to call, who to ask for help, where to go can be one of the biggest barriers for families, I think, in accessing the services that they need, so a peer will help walk them through that.

A peer has also experienced either a mental health or substance use issue or had a child with a mental health issue in the past.

And so they have firsthand personal knowledge and experiences that they will offer and provide.

And so they have been really helpful in personalizing the treatment that we have.

The Idaho Federation of Families for Children's Mental Health works with Idaho families in need of resources for their children.

>>When a youth has a serious emotional disturbance, there are a variety of resources that are needed.

So counseling once a week or even twice a week is frequently not going to be enough to help that youth.

What we are facing a shortage of in Idaho is the more intensive, community based services.

We don't have the workforce for it.

We just don't even really have the infrastructure that built out yet.

>>Her concern revolves around youth with serious mental illness and the strain that puts on families.

>>People are faced with.

My child is out of control.

They may harm themselves.

They could harm us.

They could harm a family member or a friend.

They're just simply not in control of themselves.

And there are very real reasons that have to do with mental illness, where you cannot simply talk a person back into, Hey, get control of yourself, and let's do this differently.

So you have to have some resources at that point when you arrive at an E.R.

because you are very scared that your child is going to harm themselves.

Or your family is not safe, your family environment is not safe, it's just awful when you sort of are turned away because this child is medically stable, I'm not sure what you want us to do about this child.

Do you need to call the police?

I mean, typically that is the decision that parents are making from their home.

Do I call the police because things are dangerous or is there help for me in an emergency room?

There are just some really dedicated people in very small numbers trying to cover a very big population.

I mean, Idaho is somewhat sparsely populated compared to most states.

But if you look at the amount of workforce compared to the amount of need, it's staggering and there's a lot of youth and adult need in region two.

So you've got people stretched really thin and you've got families who have both adult and youth need and that really can compound the issues in a family.

So I think the best thing we could do for Region two is help them get more workers there, and we need to do that all over Idaho.

But that's definitely something I'm concerned about for region, too.

>>There is a system of care in place through youth empowerment services.

>>Some people are working very, very hard to try and make the system better.

We need a workforce desperately.

We need people to understand that it's it's a slow journey to where we need to get.

So we need as much compassion and support around families while we don't have all the resources in place.

>>Region two isn't the only part of Idaho that is struggling with a shortage of mental health care providers.

On Friday, I spoke to Dr. Chad Yates, associate professor in the Department of Counseling at Idaho State University, about efforts to recruit and retain the next generation of mental health professionals and what the Legislature can do to help.

Thanks so much for joining us today.

Can you talk about the different factors in the shortage of mental health care providers across the state?

>>Yeah, I can, and this is a great question.

What we're seeing is really a supply problem and a demand problem.

I think I'll start with demand first, and we've seen a couple factors increase the demand for mental health services in the state.

Number one, obviously, is COVID.

COVID has been a big stressor in many people's lives and we know that a lot of folks are actually reaching out for help, reaching out for support, not just for grief and loss and depression.

Anxiety increased substance use during that COVID pandemic, but we're also seeing it's a great benefit is that the stigma around counseling is less so.

I think that's another big thing.

Some of our public campaigns to reduce that stigma for counseling is paying off because we know more people want it.

And unfortunately, right now we have a quite a bit of a waitlist.

A lot of folks in the community are saying that, you know, they just aren't available to treat all the clients that are interested in their services.

I think it adds to the extra factor is that I know Idaho has seen tremendous population growth.

So with that population growth, I think we're also trying to adapt and kind of fix this.

You know, actually meet the demands of Idahoans for their mental health needs, go into the supply side.

I think that's a little bit more of a complicated problem because it takes time to produce highly qualified counselors at ASU.

We actually have a counseling program that's probably the largest in the state.

We're actually located in Pocatello, in Meridian campuses.

We have an almost, I think, 50 students every single year that are attracted to our program and stay within and graduate.

But to go through that program, it takes two to three years and it's a 60 hour master's level program to get licensed.

So we're really trying hard to kind of keep that supply side up to kind of meet the present demand.

But there's other efforts that are being done with actually counseling specifically, and one of those is our interstate compact.

Our National Association, the American Counseling Association is sponsoring a lot of support for many states across the nation that they want to enact this interstate compact so we can break down interstate barriers between practice.

And that really means that somebody in Idaho could actually practice in Ohio, practice in Washington, practice in Wyoming if they were to join this compact in the same could be said for those other individuals in the states.

And I think if we can actually join this compact, we're going to see a lot of success in getting counselors from outside the state hopefully help to meet some of the needs for Idaho.

And so this ties into a lot of the red tape reduction efforts that the Legislature and the executive branch have been working on for the past couple of years.

>>It seems like there are a lot of bonuses to this.

Are there any downsides or any ways that this could be problematic for Idaho?

>You know, it's a great question in terms of what could be problematic.

I think what we're looking for is how can we actually protect the people in Idaho to get them to have the best services by well-trained professionals?

And you know, there's so many different efforts about how we might go about that, but we really think that the best way to do it is actually through the compact by actually creating legislation in place that would reduce those interstate barriers.

We do get people from outside of the state and then we also are giving our same people the chance to practice out of the state.

So I think it's more fair than actually what we've seen in the kind of deregulation process or proposals for that.

So I think that that's really hopefully what we want to see is the way to go.

That that means that Utah or Wyoming or these other states would also have to sign on.

So there's reciprocity.

We're not just losing Idaho mental health professionals, but we're also gaining.

Yes, and.

>>Right now, I know Wyoming is actually making significant strides in their efforts to actually pushing the compact their state legislator.

You know, we we spoke earlier in the program about the shortage of mental health professionals in north central Idaho.

That district to reach in rural areas, not just in region two, are really struggling with recruitment and retention for these mental health professionals.

Is there any role for either Idaho State University or the Legislature to help attract these new professionals to go to these rural areas?

>You know, there has been a lot of effort at ISU to actually.

Look at grant funding for telehealth services and expanding the role of telehealth.

And I think what we're finding is that the need to actually meet the needs of these communities involve many different factors, actually having the providers, having the infrastructure in place, like broadband internet , having the capability for the clients in these rural areas to actually connect with somebody through that.

That's a big challenge.

And I think Idaho is is starting to, you know, take that challenge seriously and invest in some of that infrastructure.

But I think maybe more personally for what we're doing at the university through our accounting department is we're growing quite a bit and we're belong to the casket division of Health Sciences ICU, and we're tasked a kind of meeting the health care needs of the state of Idaho.

And for the counseling side, what we're doing is creating in growing our program.

We included a many more faculty over the years and we're upping our enrollment.

And really, I think which is great to see is that we're having a lot more applicants apply to our program every single year.

So and I think that, you know, for folks that are interested in becoming counselors looking at our profession, you can do it in so many different ways.

We have five specialty tracks.

You can become a clinical mental health counselor, a school counselor, marriage couple, family counselor, Student Affairs Council, which works in university settings.

But there's also a clinical rehabilitation counselor which works with disability and helps people with disability.

>>You know, as I'm listening to this, I'm curious when we're talking about the specific mental health needs of certain populations, whether they're LGBTQ or, you know, our our tribal members within the state, the Latino community.

What is Idaho State University doing to address some of those populations?

Yeah.

>>So ISU is really devoted and especially our country to training ethical counselors and multicultural, competent counselors.

We have a lot of coursework that is involving how do you work effectively with diverse populations?

And we actually try to actually work with our interns going to these rural areas or areas where they may be able to serve these kind of populations, such like the Latinx population.

And how do you work to develop programing or, you know, and I think there's been talks about actually including more Spanish language acquisition for, you know, counselors and training.

And I know I issue as other programs that have actually benefited from that kind of, you know, Spanish language kind of acquisition .

Yeah.

>>Is there anything more that the state can do to help with recruitment and retention for mental health professionals, especially in those rural areas?

Yeah, I think what we need to do is invest in mental health.

I think that is key.

We know over the years that mental health has the same impact as physical health in individuals, and we need to take it more seriously.

We need to look at, you know, how are we actually supporting mental health counselors and is to a degree that, you know, in school systems, we often have school counselors that have huge ratios of 500 students to one school counselor, and we actually think that's really it's a disaster because each student does not get the proper need and support they could get to be successful.

So there's that at the school level, but also supporting higher education.

You know, I think higher education is we are going to be the vehicle that is providing the mental health workforce for the future and we need to kind of support and encouragement.

And I think from legislators, but also a community to kind of recruit and continue to train these high qualified counselors.

>>All right.

Dr. Chad Yates Idaho State University Thank you so much for joining us today.

Joining me today to talk about the upcoming session and public education is Kevin Richart of Idaho Education News.

Kevin, we talked earlier in the show about the not special session that they're coming back into the session that never adjourned.

Earlier, we heard that they would come back if they had consensus on the need to come back in a piece of legislation.

Do you get the sense that that's the case?

>>No, I really don't.

I mean, just based on what we're hearing from the House caucus plan is legislators can turn in their proposals to Speaker Bedke's office by close of business on the 10th.

Then you kick in the session on the morning of the 15th with House Ways and Means meeting to discuss who knows how many bills , which would then have to go through the committee process.

And that's that's just the House.

So my quick sense of the matter is no, there isn't one bill.

There isn't a going home vaccine mandate bill.

It could be a bit of a free for all.

>>Within that free for all.

What are you expecting to see?

>>Well, what I expect and what I think is going to be a little bit different than maybe we originally expected.

You know, this dialog about vaccine mandates has been centered so much on the hospitals and private businesses in general.

Well, we're hearing now that the implications of the Biden administration's actions on vaccine mandates could be much more far reaching than that and could touch into higher education and college campuses.

>>Well, that's so interesting because we have the executive order from Governor Little from earlier this year saying that state agencies cannot mandate vaccines as a requirement of either employment or accessing state services.

>>Those universities, of course, are state institutions, but they also receive federal grants and federal dollars, right?

And that's the crux of the matter.

Maybe the most important of the Biden administration moves is one that involves federal contractors and universities are federal contractors to the tune of $89 million of contracts.

Now the question is to what extent does that affect vaccine requirements on the college campuses?

What we're seeing in other states, colleges and universities going to full vaccine requirements because they are federal contractors, including colleges and universities in red states like Arizona and Tennessee.

Arizona is really an interesting example.

A few days ago, I was listening to Education Writers Association seminar.

And Arizona State University law professor was saying we have determined that we have to comply with this with this ruling, with this edict from the Biden administration, even though the governor in Arizona who a Republican, the attorney general in Arizona, who's a Republican, both oppose vaccine mandates, which ought to sound familiar to anybody who's watching this issue in Idaho.

And what maybe is most interesting about the Arizona situation is those universities are interpreting this directive from the Biden administration to mean that if you are a federal contractor, your whole apparatus, your whole operation has to comply with the vaccine mandate, not just the little corner of the campus that might be working on a federal contract.

>>The whole campus?

Does that include students as well?

>>Yes.

I anticipate that if that ends up being the case, this is going to end up in court, whether that case starts in Idaho or elsewhere.

Well, we know that all of these directives from the Biden administration are going to end up in court and that's going to be tied up in court for a good long time.

And now you're going to see in states like Idaho, you're going to see legislators weighing in as well.

>>Well, I wanted to ask you too on the school.

The public school level school board elections are coming up next Tuesday, something you've been covering closely for years now.

These school board elections are sometimes contentious, but most of the time not.

That's not necessarily the case this year.

>>Right.

And you have sort of an interesting confluence of circumstances here.

first, and most obviously, you have the pandemic and you have so much concern about the pandemic and so much concern about pandemic protocols in schools, whether you're talking about masking or social distancing.

That's one big factor that's making the school board elections a little bit different.

Another factor is the timing.

These are elections that now will take place in November.

Wasn't too long ago that these elections took place in May.

Extremely low turnout.

Extremely low interest.

So what does that mean?

In some cases, we're seeing school board races that are looking a little bit more like legislative races.

Frankly, they're Partizan.

They're more strident and there's more money involved, West Ada.

You have one candidate who's raised more than $20,000, another one that's raised more than $12,000.

Now that's not huge money, but I'll put it into perspective for you.

It's more money than Sherri Ybarra has raised all year for her possible run for a third term in office.

I mean, it's interesting things are changing.

>>It's interesting that you say Partizan, because these are not Partizan positions, but parties are weighing in.

>>Exactly.

And I think you're definitely seeing that in the West Ada races.

And this isn't really unprecedented.

one of the candidates in West Ada, Angie Redford, has received money from Jim Rice, from Joe Palmer, from Cody Galloway, three Republican legislators.

But like I say, we've seen this in Boise School Board elections, where Boise trustee candidates have received money from prominent Democrats in Boise.

So it's it's not new.

But by the same token, Tom Luna, the state Republican Party chairman, is really urging his membership to get out and vote in school board elections and city council and mayoral elections, even though those are nonpartisan races.

This is coming up in North Idaho, too as well.

There are contentious races up there.

Contentious races Coeur d'Alene has three contested races on the heels of a lot of local controversy over pandemic protocols, and you have a race in Post Falls that has received national attention.

>>Do you know the anti-Semitic tweets that were sent out by one of the candidates, David Riley, since deleted from his Twitter account, but he's tweeting other things.

Any any indication that that candidate has backed away from those anti-Semitic comments he's made in the past?

>>He's not talking about them, but if you look at his tweets, they're not addressing those issues.

But he is still a pretty strident hard line conservative candidate running against another candidate who is basically in the same place in terms of issues like masks in schools and critical race theory there.

And all that a differentiation on issues, maybe on tone and message and tenor.

You know, so much of this energy, as you said, comes from opposition to COVID mitigation efforts like masks and testing.

>>Are you seeing the same energy from voters and parents who might support masks might support the option for testing in schools?

>>Well, that's going to be really interesting to see.

I mean, we don't know what the turnout is going to be in the school board elections, and we don't have much of a sample size to go off of because this is really only the second cycle of school board elections in November.

You'd think you'd see more turnout and you definitely would think you'd see more turnout on all sides of this issue, just because people are are mobilized and energized on the issues.

So we'll watch and see who turns out and who wins on Tuesday.

>>Are there any other local school board elections that you'll be watching around the state, any big issues that might pop up.

>I think you've got a few school districts that are going to be interesting.

We've already talked about Westgate and Cour d'Alene and Post Falls and the others interesting.

You've got three races there.

You know, I think you have to keep this in statewide perspective, though most school board races are uncontested.

A lot of school board races and a lot of school districts.

Districts are really scrambling always to find people to serve in these volunteer roles.

And we've seen a lot of resignations around the state school trustees, you know, just saying that, you know, the job has become too demanding, too stressful, too much on out.

And lots of anger and a lot of these school board meetings, too.

Kevin, this comes, of course, as we are coming down, thank goodness from the peak.

The worst of the surge of the pandemic in about 30 seconds.

Can you give me the latest on the cases among children that you've been tracking school age children?

>>What we're seeing from the case numbers, and they're not conclusive, they're not complete.

There's a backlog in the paperwork.

They do seem to be dropping now.

They're still pretty high.

You know, all of these numbers that are dropping, whether we're talking about cases or hospitalizations or positive test rates, they're still pretty high.

They are showing signs of retreating and receding.

>>All right.

Kevin Richart Idaho Education News Thank you so much for your time, and I'm sure that we'll have you back on to talk about the not special session that is coming up.

Unexpected expected special.

Exactly.

You can read Kevin's work at IdahoEDNews.org.

Thank you for watching.

You can catch us online.

Follow Idaho reports on Twitter and Facebook, and we'll see you next week.

Presentation of video reports on Idaho Public Television is made possible through the generous support of the Laura Moore Cunningham Foundation, committed to fulfilling the Moore and Bettis family legacy of building the Great State of Idaho by the Friends of Idaho Public Television and by the Corporation for Public Broadcasting.