A Victorian-style brick house on North Congress Street is not only a place of support for adults diagnosed with mental illnesses, but also a refuge from the negative stigmas against them.
That experience has been especially true for Andi Watt, who regularly visits the house — a nonprofit organization called The Gathering Place, 7 N. Congress Street — a few times a week.
Before she moved to Athens County in 2008 to receive treatment for her diagnoses of obsessive-compulsive disorder and anxiety, she lived in nearby Jackson, and said she noticed animosity there toward those with mental illness.
"It’s stigmatized down there,” Watt, 39, said. “It’s very hushed.”
Watt, who is bisexual, said negative stigmas surrounding both mental illness and sexual orientation are common outside of Athens County — a place she believes is “a breath of fresh air.”
“Having to repress that part of myself may have exacerbated my mental health issues,” she said.
The Gathering Place, though, offered Watt a safe alternative. The house offers stigma-free peer support and helps clients feel welcome in the community, executive director Mary Kneier said.
“You feel empowered,” Watt said of the house.
That empowerment is what The Gathering Place and other mental health services hope to provide for those living in Athens and the Appalachian region.
Negative stigmas about mental illness still exist throughout southeast Ohio, however, and the organizations providing mental health care often face funding and logistical difficulties.
One such organization is the 317 Board, formally known as the Athens-Hocking-Vinton Alcohol, Drug Addiction and Mental Health Services Board. The board provides and funds mental health and addiction services — including The Gathering Place — for residents of the three counties.
“We’ve seen a trend over the past 10 years of state money going away,” Earl Cecil, the 317 Board’s executive director, said. “It started with the recession, and then the current administration wanted to do a lot of different tax reductions.”
Funding and logistical problems
The Gathering Place funds most of its operating costs with money from the 317 Board. The board offers assessment and treatment planning, crisis services, case management and one-on-one counseling, among other services.
nnual reports show the board’s budget reductions are ongoing, though. From the 2014 to 2015 fiscal years, state funding to the 317 Board intended for mental health services decreased by about $393,000. All local boards have received cuts from the state in recent years, Cecil said.
Funding cuts made it so that the board had to prioritize those with chronic, long-term mental health needs over those with short-term needs, Cecil said.
Part of the board’s funding comes from local levies, Cecil said, while the rest comes from state and federal funding.
On top of funding complications, the board faces a lack of transportation for its clients, as well as low employment and quality housing opportunities for patients in the region, Cecil said. As of August, Ohio’s average unemployment rate was 4.7 percent, while Athens, Hocking and Vinton counties had an average unemployment rate of 5.5 percent, according to the Ohio Department of Job and Family Services.
Julie Owens, professor of psychology at Ohio University, said a lack of transportation can be a problem in rural areas; some families may live 40 to 50 miles away from the nearest clinic.
In its community plan for fiscal year 2017, the 317 Board mentioned Athens and Logan have limited public transportation, while Vinton County lacks a hospital. That is in addition to a lack of cell phone and internet access in the area.
Watt said the City of Athens’ public transit system has been a big help, though. She lives in Chauncey and uses the bus, adding that most counties in the area don’t have buses like those in Athens.
Beyond transportation issues, the region is lacking in human resources. Owens said there is a shortage of mental health professionals in southeast Ohio.
“Recruiting enough psychiatrists to our region and physicians interested in treating addiction is a challenge,” Diane Pfaff, the 317 Board’s community service manager, said, adding that qualified psychiatrists often “follow the money” to urban areas.
That leaves about 60 percent of rural Americans living in what can be qualified as “mental health professional shortage areas,” according to the U.S. Health Resources and Services Administration, based on their ratio of 30,000 or more persons per psychiatrist.
Athens, which is designated as a “special population” shortage area for its low-income and Medicaid-eligible population, is characterized as needing one psychiatrist per 20,000 residents, according to a statewide primary care needs assessment for 2015 to 2016, via the Ohio Department of Health.
Athens is home to one of six regional Ohio Department of Mental Health and Addiction Services-operated psychiatric hospitals, Appalachian Behavioral Healthcare, which serves a total of 21 counties in southeast Ohio. The facility, located at 100 Hospital Dr., has 92 psychiatric beds.
Local mental health centers can refer patients to Appalachian Behavioral Healthcare and other centers, such as Hopewell Health Centers. Watt said she has received treatment from Hopewell since moving to Athens, for example.
Appalachian Behavioral Healthcare provides services such as intensive psychiatric care, recovery, patient education, occupational and recreational therapy and work evaluation, Ohio Department of Mental Health and Addiction Services spokesman Eric Wandersleben said.
Appalachian Behavioral Healthcare treated an average of 74 patients a day in fiscal year 2015, according to the department’s annual report. It also had an average daily cost per resident patient of about $740, which was the highest of all the department’s six psychiatric hospitals.
Wandersleben said the cost was higher that year because the facility operated 14 beds below capacity due to renovations, and thus had increased expenses and fewer patients.
Organizations see success combatting stigma
Amid the practical limitations on mental health services, stigmas also affect the way people with mental illness are treated.
“There’s that typical stigma that they’ve done something to cause it themselves, or that they’re scary … crazy and unhinged,” Kneier said. “With treatment and support, people can live fairly normal lives, and our volunteers are able to see that people are quite normal.”
About 25 percent of adults in the U.S. with mental health symptoms believe that people are caring and sympathetic toward people with mental illness, according to a 2007 Centers for Disease Control and Prevention study.
Those diagnosed with mental illness can also enforce negative stigmas against mental illness, as some see receiving support as a sign of weakness.
“Some are embarrassed to be struggling with a mental health problem,” Owens said. “The media has contributed to portraying mental illness in a negative light.”
She said many people are uneducated about mental illness, which leads to stereotypes or inaccurate assumptions.
That is why organizations like The Gathering Place exist: to combat stigmas related to mental illness, Kneier said.
That has been the house’s mission since it was formed in 1976, during a time of deinstitutionalization, when states in the U.S. closed many psychiatric hospitals. That process affected The Ridges as well, Kneier said.
“Athens had The Ridges, and a large population of people who were newly released but hadn’t lived in the community for a long time were now in Athens,” she said.
In response to that, residents formed a nonprofit to help the patients, and created The Gathering Place. The three-story house has since been a place for those with mental illnesses to feel welcomed and live meaningful lives, Kneier said.
In addition to other support, the house offers meals, fresh produce, gardening, and other activities. Clients can also become members of The Gathering Place, Kneier said, meaning that they have voting rights and can decide on house policies and procedures.
“Everyone wants to feel worthwhile,” Watt said.