Access multiplied

$3.8-million grant to UND College of Nursing & Professional Disciplines aims to expand mental health services in rural America

Nearly one in five Americans experience mental illness.

From anxiety and depression to more serious issues such as suicide and its prevention, it can be tough to get help. It’s even harder in rural states like the Dakotas, Montana and Wyoming.

A new UND project will help support, train and expand access to mental health providers in rural areas, who will in turn be able to help more people.

“People worry about their capacity to manage stress”, said Thomasine Heitkamp, professor in the UND College of Nursing & Professional Disciplines. “There are many people with anxiety and depression who require access to quality treatment.  However, these concerns often go untreated due to stigma and lack of access to care”.

“It’s hard to get confidential help and access to professionals,” said Dennis Mohatt, vice president for behavioral health at the Western Interstate Commission for Higher Education and co-director of the project, who noted that there are just two child psychiatrists in South Dakota. “Every rural county in the region, as well as some urban counties, is a mental health shortage area.”

Training the providers

UND and its partners, including the Western Interstate Commission on Higher Education, will train 1,250 mental health care providers in the six-state region the first year alone, using a combination of face-to-face and online training. A total of more than 6,200 unduplicated providers are expected to be trained throughout the course of the five-year grant.

“Our goal is to expand access to information and tools for people serving persons with mental health disorders,” said Heitkamp, who noted that the project also addresses UND’s Grand Challenge to assist rural communities in solving health and social problems, part of the One UND Strategic Plan.

The funding, a $3.8 million, five-year award to UND’s College of Nursing & Professional Disciplines, will fund training in the six states – North and South Dakota, Colorado, Montana, Wyoming and Utah – which make up the Region 8 Mountain Plains Mental Health Technology Transfer Center. The funding comes from the Substance Abuse & Mental Health Service Administration.

“There is a need for this,” said Mohatt. “There are a lot of generalists who need access to tools and evidence-based practices to better serve people who need help.”

UND faculty who are part of the project include trainers Andrew McLean, chair of psychiatry and behavioral science at the UND School of Medicine & Health Sciences; Maridee Shogren, clinical associate professor of nursing; and Sarah Nielsen, associate professor of occupational therapy at the SMHS.  Lynette Dickson, associate director of community outreach & engagement at the Center for Rural Health (CRH), will lead the CRH team, and Shawnda Schroeder, research assistant professor at the CRH, will lead the web team and support curriculum development at the CRH. UND will also sub-contract with the Center for the Application of Substance Abuse Treatment at the University of Nevada-Reno to coordinate training.

Hospitals without walls

One of the most effective treatment methods for mental health issues, said Heitkamp, is assertive community treatment, which wraps together the intensity and array of treatments in a community setting.

“We’re looking at community-based care,” said Sarah Nielsen, associate professor of occupational therapy. For example, she said, they will help schools collaborate with mental health professionals to help children and youth, or provide help with medication. “This will prepare providers to give much-needed services to people in difficulty.”

They will also work with tribal communities and state psychiatric hospitals.

“We will have one place to go for information,” said Schroeder, who is responsible for developing and ensuring easy access to resources, which will include online information.

“This is an efficient and effective way of sharing mental health expertise,” said McLean.

Provost Thomas DiLorenzo congratulated Heitkamp and all those involved in submitting, and being awarded, the grant.

“Not only is an extremely important rural health issue being addressed, but also this award fits squarely within UND’s Grand Challenges,” he said.

“Everyone is touched by mental health issues,” said Shogren. “We want to decrease the stigma and increase the capacity to help people.” She added that she will focus on helping provide treatment for women with pregnancy and post-partum depression. “There is a stigma to it, and it’s difficult for many women to come forward,” she said. “We want to identify it early and help them.”