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Transylvania County is a vibrant, engaged community that offers resources and leverages its inherent strengths to support the lifelong physical, emotional, and social well-being of all its residents.

Why It Matters?

Mental health and substance use are interconnected to each other and to issues that include suicide deaths, overdose deaths, adverse childhood experiences, depression, anxiety, liver disease, alcohol-related motor vehicle crashes, lung cancer, COPD, and employment. However, residents have limited options for treatment and counseling options, especially for those who have lower incomes, no insurance, or transportation issues. Despite promising community efforts to address substance use and suicide, there is still much work to be done in this area.

Experience & Importance

How would we experience lifelong physical, emotional, and social well-being of all residents in Transylvania County?

Community members said that we could experience the following conditions:

  • People getting the help they need
  • Abundant resources
  • Kids in the “best place” to learn (mentally, physically, socially)
  • Education and awareness about mental health and substance use
  • Less stigma, more acceptance and understanding
  • Programs across the lifespan
  • Engagement and connectivity
  • People supporting each other
  • Proactive efforts, with a focus on wellness
  • Building on kinship and friendship relationships
  • Expertise from a variety of lived perspectives
  • Less homelessness
  • Lower suicide rate
  • Less crime
  • Fewer involuntary committals
  • Stable families
  • Less truancy
  • More high school graduations
  • Emergency department only being used for medical emergencies
  • Higher employment
  • Fewer overdoses
  • More healthy births
  • Less poverty
  • Less hunger
  • Fewer medical crises
  • Fewer shut-ins, more “getting out”
  • More social infrastructure
  • More people using parks, libraries, etc.
  • People able to get to places they want to go
  • Transportation for students
  • More affordable housing
  • More quality affordable childcare
  • More accessibility of healthcare
  • More civic engagement

What information led to the selection of this health issue and related result?

Transylvania County residents reported more “poor” mental health days; some said they were unable to get the care they need. Suicide rates are higher than the state rates and residents are being treated for mental health symptoms through emergency department visits and hospitalization. Mental health concerns are linked to substance use and ACEs. Key informants named both general mental health and depression/anxiety/stress as top concerns and said that additional treatment resources were needed. Mental health was a priority health issue in 2015.

Substance use is related to overdose deaths, liver disease mortality, and motor vehicle crashes. Smoking rates among pregnant women and breathing someone else’s cigarette smoke at work are concerns. Substance use is connected to mental health and ACEs. Many residents reported their lives being affected by substance use and it was the #2 top community concern named by key informants. It was the top priority health issue in 2015.

In the 2019 Community Health Assessment process, community members identified many connections between mental health and substance use, and determined that they should be addressed as a single priority in Transylvania County.

According to the US Office of Disease Prevention and Health Promotion, "Several factors have been linked to mental health, including race and ethnicity, gender, age, income level, education level, sexual orientation, and geographic location. Other social conditions—such as interpersonal, family, and community dynamics, housing quality, social support, employment opportunities, and work and school conditions—can also influence mental health risk and outcomes, both positively and negatively."1 In addition, "Several biological, social, environmental, psychological, and genetic factors are associated with substance abuse. These factors can include gender, race and ethnicity, age, income level, educational attainment, and sexual orientation. Substance abuse is also strongly influenced by interpersonal, household, and community dynamics. Family, social networks, and peer pressure are key influencers of substance abuse among adolescents."2 Within Transylvania County, individuals with low incomes; those without stable, adequate, and affordable housing; those who may be socially isolated due to geography and lack of transportation; and those with a family history of mental health or substance use issues are at higher risk for poor outcomes in the areas of mental health and substance use. Individuals with high ACE scores are more likely to experience negative health behaviors such as substance use and suicide. In addition, those without access to health insurance are less likely to be able to access care when needed, and resources are limited for mental health and substance use treatment within Transylvania County.

Alignment

Mental Health and Substance Use and the related conditions of well-being are aligned with the following Healthy NC 2020 Focus Areas

  • Mental Health: "Mental health, an integral component of individual health, is important throughout the lifespan. Individuals with poor mental health may have difficulties with interpersonal relationships, productivity in school or the workplace, and their overall sense of well-being. Depression is linked to lower productivity in the workplace, is a leading cause of suicide, and has been associated with increased use of health care services." (North Carolina Institute of Medicine. Healthy North Carolina 2020: A Better State of Health. Morrisville, NC: North Carolina Institute of Medicine; 2011.)
    • Objective 1. Reduce the suicide rate (per 100,000 population)
    • Objective 2. Decrease the average number of poor mental health days among adults in the past 30 days
    • Objective 3. Reduce the rate of mental health-related visits to emergency departments (per 10,000 population)
  • Substance Use: "Substance use and abuse are major contributors to death and disability in North Carolina. Addiction to drugs or alcohol is a chronic health problem, and people who suffer from abuse or dependence are at risk for premature death, comorbid health conditions, injuries, and disability. Therefore, prevention of misuse and abuse of substances is critical. Furthermore, substance abuse has adverse consequences for families, communities, and society, contributing to family upheaval, the state’s crime rate, and motor vehicle fatalities." (North Carolina Institute of Medicine. Healthy North Carolina 2020: A Better State of Health. Morrisville, NC: North Carolina Institute of Medicine; 2011.)
    • Objective 1. Reduce the percentage of high school students who had alcohol on one or more of the past 30 days
    • Objective 2. Reduce the percentage of traffic crashes that are alcohol-related 5.7%
    • Objective 3. Reduce the percentage of individuals aged 12 years and older reporting any illicit drug use in the past 30 days

Measures

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Current Actual Value
Current Target Value
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% Change

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