Addressing mental health in the Ozarks

Wednesday, November 28, 2018

“Buck up buttercup.” “Why would you have a problem?” These may be phrases someone may encounter if they express, they are going through a difficult time. However, you never know what someone else is going through and they may need guidance or to seek help.

Mental health carries a stigma with it and many times, if something is bothering someone, they are often told to push through. However, this is not always the best solution.

Oregon County is ranked number 14 per capita in Missouri out of its 115 counties for suicide and Howell County is number nine. In Arkansas, there are 75 counties and per capita Baxter County is number one, Fulton County is number five and Sharp County is number seven.

Missouri is three percent higher and Arkansas is five percent higher than the national average per capita.

There are many possible factors for this. One being the stigma that still exists and for many areas, there is a “backwoods” mindset when it comes to mental issues, to just push your way through it and not seek needed help.

In addition, boys and men are often raised to believe they should not show emotion that may make them seem “weak.”

“Instead of talking to someone about what is going on inside of them and what is bugging them, it’s not talked about and you just push through it,” said Frankie Smith, therapist and owner of Transforming Lives Counseling in Mammoth Spring.

She also explained many may think there is no help for them or they do not want anyone to know they have this issue.

Other factors include addiction and lack of service including hinderance to treatment as some facilities overbook, making it difficult to find someone to speak to in time of crisis.

Smith explained she has encountered patients who have been told they would have to wait up to two weeks before being seen, which is not ideal for someone who is struggling and needing someone to talk to.

For instance, a person who needed help and medication, could not find help and had difficulty seeking immediate help from an institute, which told the patient there would be a two week wait. However, the individual kept seeking help until someone was found, who ended up being Smith. “I was blessed it was me. She knew what she needed and didn’t stop until she found what she needed and got the help she needed,” said Smith.

Sometimes a person must be their own advocate and not become discouraged when they are seeking help, they know they need. “I try to remind people, there is help,” said Smith. She also stated it is about giving the client what they need.

“One thing I remind my clients is don’t make a permanent solution out of a temporary problem that feels overwhelming at the moment. Just remember that, as the saying goes, ‘this too shall pass,’” said Smith.

When asked, why at times it seems those who someone would least expect commits suicide, Smith pointed out, we all are, at times, going through things that we often do not show the world unless we know them very well. “We frequently show you what you want to see,” said Smith.

If you do have concerns for a loved one, Smith stated to call 911 or go to the emergency room. “The ER is supposed to contact the community mental health, which will assess to determine if they need to go into the hospital or determine something different…If they are feeling like they are not getting what they need, don’t quit, keep seeking until you find what you need,” said Smith.

Other resources include the suicide crisis hotline, where you may call and talk to someone any time at 1-800-273-8255 (TALK). There is also a suicide texting hotline available at This hotline is also available 24-hours a day, seven days a week.

There are also other resources available including: National Hopeline Network for Suicide Prevention at 1-800-SUICIDE (1-800-784-2433), NWA Crisis Intervention Center at 1-888-274-7472, Veterans Crisis Line at 1-800-273-8255 – Press 1, Warm Line for Latch Key Kids at 1-888-723-3255, LGBTQ Help Line at 1-866-488-7386, Teen Line at 1-800-798-TEEN (8336), TrevorText at 1-202-304-1200 or Text HOPELINE or LISTEN or HOME to 7417741.

For a list of additional resources, visit Transforming Lives Counseling Facebook page.

Finding the right counselor is the choice of the patient. “You always have a choice. You are never left alone,” said Smith. Smith encourages to give a therapist at least three sessions before determining whether it is a right fit or not, but also reminds patients that therapists may be fired in order to find the right one for them.

Smith pointed out also that a person may not always like their therapist because they are not there to be a person’s friend but to help them to work on themselves, which is to be done with empathy, not sympathy and pity.

She stated she tells her patients, “You know what you need because you know you, you just have to find it and I am going to help navigate you to find it.” Steps for this process include listening and challenging as well as implementing hypotheticals.

“I love to help people realize they need to breathe. Stop, take a moment and breathe, because even when you think you don’t have that moment, you got that moment. Everybody has a moment to breathe, sometimes it may be 1.5 millimeters of a split second, but you have it. We normally just act on impulse,” said Smith.

“They are there for you to vent and find reasons not to kill yourself. Not to die, not to take that permanent solution that crushes everyone left behind,” said Smith.

Smith explained when someone thinks about suicide, it is not selfish, the person becomes immersed in this “deep dark tunnel and feels like there is no other way out. She wants people to know, there is a way out.

“You love everybody else, but you are in this deep dark tunnel and the sides are slippery and you can’t find a way to dig in and crawl out. You have to find that anchor to be able to put a peg in to prop your foot up on and eventually more anchors to put pegs in to start climbing out. People think suicide is a selfish act. It is a life ending act. You’re not doing it because you don’t care about anyone else around you, you’re doing it because you can’t get out of that tunnel…They see it as the only option,” said Smith.

Smith explained a person doesn’t get in “the tunnel” because they do not care about anyone, it may be caused by a brain chemistry malfunction where someone needs meds to help them through or a feeling of low self-worth and need help finding their self-value and even a person’s guilt in conjunction with someone else committing suicide by thinking they should have known or seen the signs to stop it.

Smith stated the process consists of taking it one day at a time and even, at times, hour by hour or moment by moment. “Whatever it takes to help them to breath,” said Smith.

Smith stressed for people finding difficulty in seeking help to go online and Google resources and call every place you can, but don’t quit.

“I just want people to breathe, reach out and get help because help is there, and everybody deserves it, nobody deserves to be told no,” said Smith.

There are many providers in the area. In Missouri, for Oregon County, resources includes Ozarks Medical Center Behavioral Health and Southern Missouri Community Health Center. There are several resources in Howell County including: Midwest Counseling and Assessment, Family Counseling Center, Genesis Counseling, Mental Health Guidance and Counseling, Linda Christian Counseling, Heal and Touch Counseling, and more as some have opened their own facilities.

In Arkansas, Mid-South in Salem, which replaced Preferred Family Healthcare for Fulton County Community Mental Health and Mid-South in Highland that also replaced Sharp County Community Mental Health that was also with Preferred Family Healthcare. These are places that can see a person even if they do not have any coverage. Other facilities include Families Inc. and Hope Behavioral Healthcare. There are also some small independent providers available in Sharp County.

Some have concerns with payment such as their insurance not being accepted or only thinking counseling is available to only those on welfare, but many insurances will pay for counseling.

Smith stated in Arkansas, through Marketplace insurance, BlueCross BlueShield and AM Better for Arkansas are providers who cover counseling. There is also free transportation available to and from appointments, if needed. OMC Behavioral Health is community mental health for those who do not have insurance.

Smith has been a therapist for six years. She started at the VA in Poplar Bluff where she was the counselor and organizer for the substance abuse treatment program from 2012 to 2014. She worked at Health Resources in Salem from 2014 to 2016 and in February 2017, she opened Transforming Lives Counseling.

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