KNOX COUNTY, Tenn. — The Knox County Health Department released a report on the state of mental health in the county, presenting data on issues and barriers from Knox County mental health providers and offering recommendations to address them.
According to the report, a lack of access, homelessness, substance misuse and childhood trauma were all listed as top issues. Transportation, awareness of existing services and workforce availability were considered the most pressing barriers to mental health care.
“Mental health affects every aspect of our lives and is a critical component of overall health,” said KCHD Senior Director Kevin Parton. “This report provides a starting place to evaluate our current mental health landscape and looks at ways the most urgent barriers to accessing mental health care can be improved.”
Top Three Urgent Issues
Childhood trauma is the number one most urgent issue impacting mental health in Knox County, according to the report.
44% of Knox County Schools high school students reported having adverse childhood experiences (ACEs), such as experiencing abuse or witnessing violence. 19% of KCS high school students reported having two or more ACEs. This can lead to increases in depression or other negative mental and physical health outcomes, the report states.
According to the report, anxiety is the second most urgent issue. Respondents ranked anxiety as the most urgent issue in the inner city.
Homelessness is the third most urgent issue, the report states.
"Some people are homeless because of mental health disorders," said Dr. Corinne Tandy, Division Director of Epidemiology at the Knox County Health Department. "Some people have manageable mental health disorders or none when they become homeless and develop it later... It's a complicated situation."
2% of Knox County's population is homeless with mental health being one of the top five causes of homelessness in the county. Results from the Knox County Mental Health Survey ranked those experiencing homelessness in the top two groups in greatest need of mental health services.
Mental Health and Substance Abuse
According to the report, 19% of KCS high school students drank alcohol on one or more days during the past 30 days in 2022. 17% of students used some form of an illicit drug during the past 30 days.
Substance use disorder and alcohol use disorder are common co-occurring conditions with many mental health disorders, the report said.
In 2022, the Knox County District Attorney General's Office reported 502 suspected overdose deaths in the county.
Top Three Barriers
Mental health providers in the county identified transportation as the most commonly reported barrier to receiving mental health services. Providers acknowledged that telehealth has helped address the transportation barrier and suggested increasing in-home services and similar options that take services directly to clients, according to the report.
The second barrier is the lack of knowledge of available services. This issue was of particular concern to providers in South and East Knox County, the report stated.
"There's already great community services that do kind of help people navigate transportation for health appointments," Dr. Tandy said. "It's just clear that we need to at least supplement that or add to it, make that a larger initiative."
According to the report, the third barrier is access to services. Although access is ranked third for barriers, it is the most common theme among respondents. Nearly 90% of Mental Health Survey respondents said there's a lack of available appointments and more than 50% stated they weren't able to get needed mental health services in their area.
In addition to limited availability, cost is also a major barrier. Half of the respondents said they didn't receive needed mental health care because they couldn't afford it, according to the report.
Recommendations from the report
The report stated that strategies to eliminate barriers preventing access to services must be developed.
"We think that a lot of really productive conversations can come next whether whether we're in them or it's community partners or partnerships," Dr. Tandy said. "We're really excited to see where that goes next."
Addressing immediate concerns found in the report would include: developing or expanding transportation services, addressing the area's mental healthcare workforce needs to meet the demand for services from residents and increasing awareness of currently available services in the area.
You can read and access the full report here.