Libby Brockman-Knight and Gaurav Kulkarni both work at Compass Health Network in Columbia. Brockman- Knight is the Deputy Chief clinical officer of substance use disorder services and Kulkarni is a psychiatrist who specializes in addiction.
Brockman-Knight spoke with Kulkarni about treatment for substance use disorders - specifically alcohol addiction and the numerous barriers that can exist for their patients.
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Libby Brockman-Knight: There is a shortage right now of therapists and providers, and so, as a collective community, we are really looking at answers for that and utilizing peer specialists as an alternative so that we can continue and be able to serve - helping people become credentialed that maybe have lived experience that they can assist these consumers.
So, I think really a professional shortage is as another barrier for us. For the consumers themselves, depending on where the consumer is, besides not having the kind of health coverage, that biggest barriers for them are... the legal consequences continue to kind of be a factor and sometimes a barrier to finding housing or a barrier to obtaining employment. So, I think that's an issue for them.
Largely in certain communities, transportation is a real barrier for our consumers - being able to seek treatment or even get to a treatment provider. So, that's a big barrier for them, and again, I think feeling disconnected from the community is a real struggle for a lot of them to seek treatment.
I believe that there is support federally, and even statewide, for substance use disorders is growing. It is still stigmatized. There is still a lot of stigma out there, but I think there are a lot of organizations doing a lot to promote the treatment needs statewide here in Missouri.
It would be very, very helpful looking at Medicaid expansion, because although many people that have severe and persistent – most people with severe and persistent mental illness that qualifies them as a disability, substance use disorder, we didn't we don't have that.
And so, a good percentage of our clients really struggle to get their health needs met, and so if they do have a health issue, they're presenting it at their emergency room or if they do have a treatment need, sometimes there are waitlists.
So, that's the biggest, I think, is funding and continually working at promoting that substance use disorders along the behavioral health continuum are as costly if not more so, than mental health, other mental health disorders.
Because then you do have lost wages, you have DWIs. I mean, the cost that it is for legal consequences to use and incarceration as opposed to treatment. The costs are very high. So, it's continually education, but Medicaid expansion would help.
This piece was reported and produced by Trevor Hook.
