Nursing receives grant to increase access to behavioral health services in rural communities

The School of Nursing has received a three-year, $1.5 million grant from the Health Resources and Services Administration (HRSA) to increase access to mental health and substance abuse treatment by integrating care in nurse-led primary care clinics in rural and medically underserved areas in Western New York.

The project is led by Yu-Ping Chang, Patricia H. and Richard E. Garman Endowed Professor and associate dean for research and scholarship in the School of Nursing (SON).  Chang, who is also chair of the Department of Family, Community & Health Systems Sciences in the nursing school, is regarded as one of the country’s leading researchers into mental health and addictions.

The purpose of the grant is to integrate evidence-based behavioral health services using implementation science strategies in primary care practices located in rural and medically underserved areas of New York State.

Specifically, the project will apply evidenced-based behavioral health interventions, such as Screening, Brief Intervention and Referral to Treatment (SBIRT) and Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) into two rural primary care clinics in an effort to increase access to mental health and substance abuse treatment. The program also aims to decrease the stigma associated with receiving treatment in rural areas.

“Integrating behavioral health into primary care is so important to reduce the barriers and stigma associated with mental health and substance use treatment, especially in rural communities,” says Chang. “This project will be an important step in improving the way patients dealing with mental health and substance use issues receive care. It is our goal that this project can become a replicable model for other rural communities throughout the country.”

Residents in rural communities face many social and environmental challenges that further contribute to this disparity in behavioral health outcomes and treatment, Chang says. These include high poverty rates, limited access to employment, a lack of transportation, and low rates of formal education and literacy.

These challenges can limit awareness of how to use services and when services are needed, she says. Additionally, behavioral health services can be more difficult to access because of a lack of public transportation, long travel times and poor road conditions in rural communities.

Behavioral health treatment also has a lower acceptability rate in rural communities because of stigma and a perceived lack of privacy due to residing in a small community.

Increasing access to integrated care is especially important in rural and underserved primary care clinics, Chang says.

Integrating behavioral health in rural primary care helps to improve access to behavioral health services and reduces some of the transportation issues associated with accessing behavioral health treatment. Integration can also help reduce stigma for rural patients by offering behavioral health services in a traditional primary care setting where people seek usual care and treatment.

Co-investigators on the project include Linda Paine-Hughes, clinical assistant professor; Chris Barrick, research associate professor; and Nancy Campbell, associate professor, all of the School of Nursing; Sabrina Casucci, assistant professor, UB Department of Industrial and Systems Engineering; and Nicole Roma, project coordinator.