RALEIGH, N.C. — Access to mental-health care in rural communities continues to shrink, but a team of nurse practitioners aims to change that.

The University of North Carolina-Chapel Hill has received $6 million in federal funding to recruit, train and financially support 70 primary-care nurse practitioners specializing in mental health who will work exclusively in rural areas. Dr. Victoria Soltis-Jarrett, Carol Morde Ross distinguished professor of psychiatric-mental health nursing at the university, is leading the effort and said mental-health needs in the state are outpacing the number of health-care providers.

"The mental-health system in North Carolina is overwhelmed,” Soltis-Jarrett said. “So it's not that it's broken so much as it's just overwhelmed and inundated with referrals because primary care doesn't know necessarily how to manage these individuals."

Suicide is now the second-leading cause of death among the state's young people, and in 2016 more than 1,000 North Carolinians ended their own lives, according to the state Department for Health and Human Services.

Soltis-Jarrett added in the southeastern part of the state, natural disasters have compounded stress from the opioid crisis.

"One in particular is in the southeast of North Carolina where they've had a lot of tragedy with the two hurricanes, flooding, there's a lot of poverty,” she said.

She said allowing nurse practitioners to provide health care without oversight from physicians could allow nurses to expand their services even more.

"I've actually even had physicians say, 'Is there any way we can get rid of this restriction or requirement?' I think is how they put it,” she said.

The SAVE Act, introduced earlier this year by Rep. Josh Dobson and Sen. Ralph Hise from Spruce Pine, both Republicans, would lift state restrictions that now require nurse practitioners to be supervised by a physician.


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The Bipartisan Policy Center has released a new report on reforming the way youth mental health services are delivered, in Michigan and nationwide.

Recommendations from the Youth Mental Health and Substance Abuse Task Force include the need to grow the behavioral health workforce and make it easier for providers to join insurance networks. The report revealed nationwide, teen mental health worsened from 2013 to 2023, with young people reporting feelings of sadness and hopelessness rising from 30% to 40%.

Michele Gazda, health program associate director for the center, shared the thought process behind the recommendations.

"The things that work for adults getting into care may or not work the same for kids and their families," Gazda explained. "Part of what the task force set out to do is make sure that the recommendations were very actionable, that they can be achieved."

The report recommended Congress fund grants of up to $2 million over three years to create 10 regional centers focused on building the behavioral health workforce.

Another recommendation was government agencies should work together to gather better data on young people who are incarcerated and find ways to reduce youth suicide, including in jails, prisons and after release.

Gazda pointed out during the pandemic and the couple of years before, overdose deaths skyrocketed. However, the numbers have since come down and she credited one important change.

"Fortunately during the pandemic, if there's one silver lining, it's that youth mental health has experienced a bit of a destigmatization and folks are much more open and comfortable talking about it than they used to be," Gazda noted. "I think with youth substance use, that's not as much the case."

The task force report also recommended doing more to focus on young people with the most serious mental health needs.


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Thousands of calls to Texas suicide hotlines are going unanswered as funding for call centers is millions of dollars short of what advocates said they need to keep up with demand.

The suicide rate in Texas has grown significantly in the past 20 years and a federal mandate to run the 988 crisis hotline is putting pressure on the system. Mental health advocates said changes to the state and federal system of funding crisis services are urgently needed.

Lyssette Galvan, public policy director for the National Alliance on Mental Illness-Texas, said crisis care needs more respect from the system.

"It's following the successful model of 911 funding," Galvan pointed out. "We're aiming to set up a precedent that 988 should be in parity with 911 and that all emergency services should be treated the same."

A bill filed by state Sen. José Menéndez, D-San Antonio, would create a state trust fund for 988 services similar to how 911 emergency services are handled. Galvan noted the fund, paid by cell phone fees, would expand capacity, increase counselor pay and make the latest technologies available.

Between January and August, 18,500 calls to Texas' 988 system were abandoned. Senate Bill 188, prefiled for the upcoming 89th Texas Legislature, would close the gap for Texans who call a hotline but are put on hold or transferred and cannot talk with a counselor.

"We do have a lot of stakeholder support," Galvan emphasized. "Almost every day I have somebody emailing me and asking me about the bill or if I know about the bill. Even within the local mental health authorities, there's a lot of buy-in."

Galvan added a significant part of the American Rescue Plan Act's funding for the 988 system has expired, and states will need to create permanent financing by the end of 2026.

"As the federal support decreases, it's time for Texans to really step up and ensure that we're helping our fellow neighbor in crisis," Galvan urged. "Our communities deserve nothing less than a complete, accessible, and reliable crisis response system."


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If reducing screen time is your New Year's resolution, a Minnesota expert says it can be tough.

But with increasing concerns about the effects of too much media consumption, learning how to limit access is the best place to start.

The overlap between what's called doom-scrolling and the recent election might have prompted some people to re-evaluate their screen time.

And it isn't just posts about politics that have the academic world worried.

University of Minnesota Duluth Communications Department Chair, Associate Professor Aaron Boyson, teaches about media addiction.

He said electronic devices, streaming platforms, and other digital tools are heavily woven into everyday life.

"I hear a lot from students, especially these days, about fatigue and overuse," said Boyson, "and tiredness and frustration and irritability - and all those things."

Boyson's students are challenged to go a couple weeks media free. He reports a three-to-one ratio of positive effects over negative feelings, but says most go back to normal usage.

Boyson said for anyone, building shields - such as a room in your home free of devices and used only for non-screen activities - can help chip away at bad habits.

But he warned it can take several weeks for your brain to get used to it.

Boyson said one positive aspect of successfully detaching yourself from your smartphone prison is improved communication skills.

He added that if part of your plan is to take more walks, it's best to leave the headphones and podcasts at home.

"It's really, really important that there are non-mediated times where the mind just is free to think," said Boyson. "That is what some cognitive psychologists call the 'default mode network,' when your brain isn't being stimulated by some external source."

He said for younger generations born into a tech-driven world, it's much harder to experience life that way, which potentially affects their emotional development.

As for concerns from parents, research has shown their screen time usage is on par with their kids. Boyson said they'll have to confront their own denial and join the whole family in curtailing access.


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