This project aims to assess and improve the preparedness of rural primary care professionals to care for mental health conditions in the wake of bioterrorism and other public health emergencies. Relatively little attention has been paid to the mental health needs of rural communities in the wake of such major catastrophic events. Prior experience with natural disasters suggests that first responders typically focus on immediate medical trauma or injury, leaving rural communities to struggle with the burden of unmet mental health needs both in the immediate aftermath and over the longer term.

This project will integrate qualitative (provider and administrator interviews) and quantitative (knowledge-based testing) methodologies to assess existing resources for mental health needs and anticipated resources that would be necessary following bioterrorism and similar mass casualty events. Based on these findings, an intervention will be developed to educate rural primary care providers concerning important aspects of mental health care. The educational intervention will focus on post-traumatic stress disorder (PTSD), since PTSD has high post-event prevalence rates and yet has been neglected in primary care settings relative to other mental disorders such as depression. Education focused on the unique mental health concerns of rural communities will increase the preparedness of rural providers and thereby improve unmet local and neighboring community health needs following bioterrorism. Recommendations will be developed for policymakers to improve preparedness to meet mental health needs in rural communities following bioterrorist events and other public health emergencies. Anticipated products from this project include written educational materials about PTSD and related mental disorders for rural primary care providers and an educational in-service about these psychological disorders to be delivered at rural primary care practices. Anticipated publications from this project include peer-reviewed and white papers describing the existing network of care for mental health needs and how existing care may be improved in anticipation of bioterrorist events, and analysis of the impact of the educational intervention on rural primary care providers' knowledge of likely post-event psychological disorders.

Publications

• Posttraumatic Stress Disorder in Rural Primary Care: Improving Care for Mental Health Following Bioterrorism
  Journal Article
  FORHP-funded Individual Grantees
  Date: 2006
  Describes the need to educate rural primary care providers who will be the frontline providers of mental health services following bioterrorism, given the limited availability of tertiary mental healthcare in rural communities.
• PTSD and Substance Use: Unrecognized Sequelae of Bioterrorism in Primary Care Providers
  Journal Article
  FORHP-funded Individual Grantees
  Date: 2006
  Study looks at rural primary care providers' knowledge of likely mental disorders, their risk factors, and preferred treatment options following a public health emergency.