Updated: May 6
Zoe McGhee • Managing Editor
“You get casseroles if you're sick with cancer or you have a heart attack or if you have kidney disease or anything else, but you don't get casseroles when you have mental illness.” President of the National Alliance of Mental Illness of Tyler, Sandie Brazil-Hamilton said.
Let’s face it. The long-appraised Southern hospitality gestures don’t extend to issues people don’t understand or are trying to keep quiet.
East Texans are being left with no access to help or are receiving low-quality help because of under-resourced mental health professionals and lack thereof, along with a strong, multifaceted stigma surrounding the topic due to lack of education.
“I felt like I needed a psychiatrist for my psychiatry appointments because I would leave there just feeling completely lost and completely not helped,” 22-year-old Tyler Junior College music major Jewel Rena’e Kirkendoll said. “I [would] just come home and cry.”
Diagnosed with ADHD at a very young age, Kirkendoll attributes their mental health struggles to a missed autism diagnosis, a toxic familial environment, and largely the lack of available mental health professionals in the East Texas area.
Paired with the largely conservative ideals within the Piney Woods, the immense lack of resources and underfunding for mental health cultivates an environment that resembles a Whataburger without chicken: nearly impossible to thrive in.
“I posted and I was like, ‘Hey, I need help. I don't know if I have PTSD or what's going on with me. I need to see someone.’” Kirkendoll said. “So a lot of people reached out that way and they would message me [about] people that I could go and get in contact with. My problem right now is a lot of people won't return my calls.”
Communication can be crucial to breakthroughs in seeking help, but effective communication requires two parties to be actively involved, something that can be difficult without the necessary medical professionals staying in East Texas.
“When doctors are going through specializing, they end up either going back to their home or staying where they did their training,” Founder of East Texas Human Needs Network, Christina Fulsom said. “I also have a feeling that one of the issues that gives the perception that there are no services is poor communication on the part of the entire behavioral health system.”
The poor treatment of mental health is not just an East Texas issue, but a state of Texas one.
According to an article by The Tyler Loop, Texas rates as having the worst access to mental health care in the country, with Smith County having the highest suicide rate of Texas’ largest 25 counties.
Though logistics play a huge part in the state of mental health in Texas and East Texas, one of the biggest obstacles people face are the stigmas around mental illness, especially when it involves religion or gender.
Growing up in an extremely religious family, Kirkendoll felt alienated as they began to question their own religious beliefs, and continued to feel helpless as they grew older and began to seek help.
“Growing up, it was like, if you're having a problem, you should just pray about it,” Kirkendoll said. “And I don't want to offend anyone, but it didn't work at all. There was not really an available option to get help other than going through church. When that happened, I would go ‘seek help’ through the church and we would talk to church workers.”
With East Texas tucked comfortably within the Bible Belt, religion almost always plays a role in major topics and issues, even in private, supposedly nonpartisan counseling sessions.
“I know that they're supposed to keep their views out of your session, but a lot of people don't,” Kirkendoll said. “A lot of people just attribute your problems to not having a relationship with a deity, and that's just that's a hard thing to have. You know, it’s a very interesting dynamic.”
Even without direct religious influence, there are still hypercritical undertones that are associated with mental illness.
“I just think overall, people judge,” Brazil-Hamilton said. People judge and they call it crazy, you hear it on TV, it's referred to as the loony bin and things like that, and those are terminologies that you would never use with cancer.”
The judgmental aspect can also transfer into gender roles within mental health. According to Mental Health America, more than 4 times as many men as women die by suicide in the U.S.
When doing research for this article, a callout on multiple social media accounts that totaled nearly 3,000 followers for those struggling with mental health only resulted in women reaching out.
In addition to the stigmas and lack of resources, one of the biggest, if not the biggest issue in the space of mental health is the inaccessibility to under-resourced individuals to even seek help in the first place due to lack of insurance or money.
Mother and previous job-holder within the mental health world in East Texas, Lauren Barnes struggled to find mental healthcare that was accessible even without insurance or a higher income.
“I was trying to seek out a counselor and it was really, really difficult at the time,” Barnes said. “I didn't have health insurance yet. Trying to navigate finding a mental health counselor that would be a good fit for where I was at in my counseling journey and then was also affordable because, again, I was a single mom working at a nonprofit that didn't have a ton of disposable income for that.”
Though now insured, Barnes is still struggling to find the right care for her nine and a half year old daughter who was recently diagnosed with ADHD, autism and dyslexia.
“I get frustrated with the lack of mental health resources here, but I know that our family is so incredibly privileged because we do have insurance when we have to pay out of pocket and pay the full amount we can,” Barnes said. “But it's still been so incredibly challenging to truly get the support we need, even with all of that privilege that our family does carry. Even at the end of the day, I cry about it because I feel so helpless and not even with those privileges, we're not able to one hundred percent get the support that our family and particularly our daughter needs.”
There are actions being taken by organizations such as ETHNN in an attempt to solve some of the issues discussed including a residency and fellowship fellowship program for psychiatry and an action team focused on public education and community engagement.
“A lot of people go without care because they think care is not available or is available, they just don't know how to access that care,” Fulsom said. “So that's a second tier of work that we're doing, we have an assessment that shows who offers what services and what the payments are. So some of the services will be only for people who have money or who have health insurance, and some of the services are for people who don't have money and who don't have insurance.”
At the end of the day, mental health is just as serious as any other medical issue, and requires a deeper level of understanding.
“It's not above anybody's understanding of what happens in the brain, the disconnect that it is an illness, that it is not a character flaw,” Brazil-Hamilton said. “It is just like cancer or anything, any other disease you have. And it requires medication and counseling, just like it requires medication and treatment of cancer or any other disease. That's the same for mental illness.”
Remembering that every situation is different is also imperative in fighting against the stigma.
“Everybody shows different sides of all the mental health problems, no fingerprint looks the same, but that's also with everyone's brains,” Kirkendoll said. “Just because someone's PTSD came from war and someone's PTSD came from a car accident doesn't mean one's worse than the other. They can be the same amount of terrible because our brains process things differently.”
Though mental health in East Texas is harrowing, there are actions that can be taken to help end the stigma or provide outlets for people to get help.
“Anyone, no matter what, can definitely educate themselves on mental illness and mental health, and definitely support your local community organizations that are doing it,” Barnes said. “So organizations like Community Solutions or like Samaritan, if you are fortunate enough that you can donate, donate a counseling session so you can cover that as a way to pay that forward. So definitely [help by] learning about it, donating if you're financially able to, and then really just helping advocate for it.”
Everyone is struggling with something. Remembering that and promoting awareness for help and resources can save someone’s life.
“There's just a number of things that could be better in East Texas,” Kirkendoll said. “I think my main thing was I wish people would talk about it more, because if we open up a conversation, then other people will be able to seek help and be comfortable seeking help or asking questions. If we start asking questions, then someone's going to have to find answers somewhere.”