A new report spotlights some of the challenges to accessing behavioral health care for the one in seven Americans who live in rural areas.

Those behind the findings say there are solutions to boosting care access in states such as South Dakota.

Kendall Strong, senior policy analyst at the Bipartisan Policy Center, said integrating behavioral health into primary care can help improve health outcomes and get patients the mental health and substance use treatment they need. She pointed out just like physical health issues, if you do not tackle behavioral problems that arise, it can develop into something much more serious.

"If you are having issues with substance use, or depression, anxiety, and you let it fester, we know it gets worse," Strong noted. "And when that happens, you often need more acute care later on. More acute care, as we know, is often more expensive."

One of the report's recommendations is to boost training and other resources for South Dakota's more than 50 federally qualified health centers, which have pioneered a team-based approach to care. When patients go in for their annual medical checkup, they can also meet with mental-health, dental and even vision-care professionals during the same visit.

The lack of mental health professionals is one of the biggest barriers to accessing care in rural America. The report recommends strengthening workforce development programs, including the Teaching Health Center Graduate Medical Education Program.

Strong emphasized providers are more likely to work in places where they get their training, and most medical schools and residencies are in cities and suburbs.

"And if you don't practice in a rural area, if you're not from a rural area, if you don't live in one already, you're less likely to train there and stay there," Strong stressed. "So we think that allowing the program to be expanded, continued and built upon will allow more providers to train in rural areas."

Strong added the unique challenges in states like South Dakota, such as the ripple effects in tribal areas and the relatively higher percentage of military veterans, really stand out in trying to foster bipartisan support in Congress.

"We think that these ones, that are specific to rural areas are helpful in that even if we're offering them under the idea that they will help rural areas, they're really going to help the system as a whole," Strong contended.

Boulder and Broomfield County residents can now access mental health services the same way they can access urgent medical care.

Dr. Nadia Haddad, medical director of mental health services with Mental Health Partners, said all too often, people can't get help unless they are already connected with an outpatient provider, and many have months-long waiting lists. She said if people have to wait for care, their situation can get worse, and what might have been a manageable issue can turn into a crisis.

"They are going to the emergency room or going to a psychiatric hospital. And so what we're trying to do is fill that gap so that people can get connected with services when they need it, on a walk-in basis," she said.

Mental Health Partners, a community mental health center serving Boulder and Broomfield counties for 60 years, recently launched UrgentPsych Mental Health and Substance Use Urgent Care. The walk-in program provides immediate, in-person support for urgent mental health and substance use needs for anyone, regardless of their ability to pay, whether or not they are an existing client, or speak English. For more information about the 24-hour facility in northeast Boulder, call 303-443-8500.

Mental Health Partners' new Intensive Family Services program provides in-home therapy for K through 12 youth with disruptive behaviors who are at risk of being placed in foster care or the juvenile justice system. The urgent care facility is also available to people of all ages.

"That's another really challenging part of seeking out services. Care for children and adolescents is often even more challenging to find. There are fewer child psychiatrists out there," she said.

Both new programs were created in part to get people the services they need to avoid hospitalization. But Haddad said when people do reach a point where they need 24/7 monitoring and daily visits from a medical provider, it is essential that people can access hospital-level care.

"The vast majority of people who are dealing with mental health-related issues do not require hospitalization. If we can change people's trajectories earlier, we can prevent mental suffering, and they may not have to go through the hospital," she explained.


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This is National Library Week, honoring the many roles that libraries play in their communities.

In central Texas, a pilot program is using the public library system to expand mental health services in rural areas.

Residents in four counties can get assistance at their local public library through the Libraries for Health program.

Trained mental health peer specialists evaluate clients and refer them to clinics for additional help if it's needed.

The program is funded through the St. David's Foundation, working to advance health equity in Central Texas.

The foundation's Senior Program Officer Abena Asante said the initiative works in tandem with the mental health community.

"It's in no way taking the place of clinical-directed psychologists," said Asante. "It's just one community response in addressing the lack of mental wellness resources in rural communities."

Asante said libraries are trusted and accessible gathering places for people living in rural areas. The libraries tailor programs to meet specific local needs based on feedback from the residents.

Data collected during the 3.5-year pilot program will be used to evaluate its success. The nonprofit Via Hope trains the peer specialists who work in the libraries.

Dr. Sandra Smith, vice president of Via Hope, said the staffers use their own life experiences to help them relate to the clients.

"They have to have had a mental health challenge at some point in their life," said Smith. "We don't ask them any specifics about that, we don't ask diagnoses - it's a self-disclosure."

The Libraries for Health program operates in eight libraries in Bastrop, Caldwell, Hays and Williamson counties. If successful, it could be implemented in other parts of the state.





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The Centers for Disease Control and Prevention reported one in 36 children around the U.S. has autism spectrum disorder. Rates are much higher than a decade ago and support organizations hope Wisconsin communities do more to make individuals feel welcome, including adults on the spectrum.

April is Autism Acceptance Month. Not only do advocates want to empower those with a diagnosis to live their fullest possible lives but they also ask those around them to learn more about it.

Katie Hess, executive director of the Autism Society of Greater Wisconsin, said there are some key practices to keep in mind.

"Really, what we're looking for is for people just to be open-minded and patient, and understanding," Hess explained.

Acceptance does not happen only at home or school. Workplaces also are encouraged to foster more inclusiveness, with nearly 60% of people with autism now employed after receiving vocational services. Their advocates said they have many strengths and asking them about their needs creates a better environment for them.

Symptoms of autism can vary widely for each person on the spectrum, including how they interact with others. Hess noted whether individuals are considered "high need" or "low need," having the public pay more attention to the evolution of this disorder is vital.

"We're learning new information all the time, so certainly reach out to your local chapter, your Autism Society," Hess urged. "Ask questions."

Her chapter will soon begin offering a training program to organizations about how to become more autism friendly, including being able to identify a person on the autism spectrum and how to best offer ways to help if they disclose their diagnosis.


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