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Mental health

Completed Projects

Access to Mental Health Services and Family Burden of Rural Children with Significant Mental Health Problems
Research center: Maine Rural Health Research Center
Topics: Children, Mental health
The needs of rural children with SED and the burden these needs place on their families are intertwined and may place these rural children and their families at "double jeopardy" of having their mental health and other needs go unmet. Using the National Survey of Children with Special Health Care Needs (NS-CSHCN) and information on community characteristics from the Area Resource File (ARF) we will examine the factors associated with whether children and their families have their needs meet across the rural continuum.

Addressing Suicide Potential and Prevention in Rural and Frontier Areas and Development of a Suicide-Prevention Training Protocol
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
Depression and suicide are especially relevant today in rural areas. This project will determine rural high-risk suicide areas, and develop a suicide prevention training protocol for primary care providers in these rural areas.

Assessment of the Mental Health Funding Marketplace in Rural vs. Urban Settings
Research center: WICHE Center for Rural Mental Health Research
Topics: Health care financing, Mental health
This study will use nationally representative data to assess how mental health (MH) services are paid for in rural areas and determine differences in payment sources between rural and urban areas. If payment sources significantly vary in rural vs. urban settings, then policies that are aimed specifically at sources of funding may have a differential impact on subsequent access to and utilization of care and point to the need for policies that are specifically targeted to rural communities.

Community-Level Risk Factors for Depression Hospitalizations
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
In this exploratory analysis, we examined the association between depression hospitalization rates and community-level socio-demographic, economic, and health care system characteristics.

Depression and Generalized Anxiety Disorder across Rural Populations
Research center: South Carolina Rural Health Research Center
Topics: Health disparities, Mental health, Minority health

Differences In Antipsychotic Medication Prescribing Patterns Between Rural And Urban Prescribers
Research center: WICHE Center for Rural Mental Health Research
Topics: Mental health, Pharmacy and prescription drugs
Second-generation antipsychotics have become the treatment of choice for persons with schizophrenia and other serious mental illnesses. Compared to first generation antipsychotics, many second generation medications reduce symptoms with fewer problematic side-effects and related major health problems. However, one aspect that has seen little empirical attention is how longitudinal trends, benefits, and costs may differ between urban and rural areas.

Differences in Prescribing Patterns of Psychotropic Medication for Children and Adolescents between Rural and Urban Prescribers
Research center: WICHE Center for Rural Mental Health Research
Topics: Mental health, Pharmacy and prescription drugs
This is an investigation of the extent to which psychotropic medication is prescribed to youth (17 and under) by primary care physicians, psychiatrists, or other prescribers in rural versus urban areas. It will also look at the particular types of medications being prescribed by age, sex, and other demographic variables.

Differential Effectiveness of Enhanced Depression Treatment for Rural and Urban Primary Care Patients
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
This project will explore whether rural populations achieve outcomes with depression treatment quality intervention comparable to their urban counterparts, and whether any outcome differences are explained by treatment mediators (e.g., evidence-based care) or psychosocial mediators (e.g., stressful life events and social support). Findings from this study can be used to refine interventions before they are disseminated to rural delivery systems.

Distance Learning in Depression for Rural Primary Care Providers
Research center: WICHE Center for Rural Mental Health Research
Topics: Mental health, Technology
This project will develop effective distance learning methods to train rural PCPs in integrated care models for depression using computer based training as an approach to improving mental health outcomes in rural areas.

Effects of Scope of Service and Reimbursement on Access to Mental Health Services in Rural Areas
Research center: Maine Rural Health Research Center
Topics: Health services, Health services, Mental health

Estimated Mental Health Care Utilization and Costs in Rural Areas
Research center: South Carolina Rural Health Research Center
Topic: Mental health

Financial Impact of Mental Health Services on Rural Individuals and Families
Research center: Maine Rural Health Research Center
Topics: Health care financing, Health insurance and the uninsured, Mental health
This project will use the Medical Expenditure Panel Survey (MEPS) to examine the financial burden that rural residents face in seeking mental health services, compared to urban residents. Implications of financial burden for access to needed mental health services for rural residents will be assessed.

Health Reform-Rapid Response
Research center: Maine Rural Health Research Center
Topics: Health care financing, Health policy, Health services, Mental health
This project will include several projects as requested by ORHP and DHHS as those agencies prepare for national health reform. Responses are primarily in the areas of health insurance and behavioral health.

Identifying At-Risk Rural Areas for Targeting Enhanced Depression Treatment
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
This project will identify characteristics of rural areas that are associated with increased risk of depression-related hospitalizations, and will identify high risk rural areas within the U.S. that should be targeted for early adoption of enhanced depression treatment models based on patient need.

Identifying At-Risk Rural Areas for Targeting Enhanced Schizophrenia Treatment
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
The goal of this project is to identify rural areas that should be targeted for early adoption of evidence-based schizophrenia treatment. This project proposes a scientifically-based method to identify counties in greatest need for quality improvement to inform national, regional, and local decision-makers about distributing scarce resources to areas which would most benefit from improved schizophrenia treatment.

Identifying Stakeholders to Pay for Enhanced Depression Treatment in Rural Populations
Research center: WICHE Center for Rural Mental Health Research
Topics: Health care financing, Mental health
The goal of this project is to identify stakeholders who economically benefit when rural patients receive enhanced depression treatment, which will, in turn, encourage health plans to provide enhanced depression treatment to their rural enrollees without raising premiums.

Impact of Bioterrorism on Rural Mental Health Needs
Research center: ORHP-funded Individual Grantees
Topics: Emergency preparedness, Mental health
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 infectious disease outbreaks.

Impact of Mental and Emotional Stress on Rural Employment Patterns
Research center: Maine Rural Health Research Center
Topic: Mental health
This study will use the National Longitudinal Survey of Youth to investigate how mental health symptoms affect employment patterns, and the extent to which these effects differ by rural and urban residence.

Implications of Mental Health Comorbidity and Rural Residence for Health Care Use Patterns of Individuals with Chronic Disease
Research center: Maine Rural Health Research Center
Topics: Chronic diseases and conditions, Mental health
This study will use the 2005-2010 panels of the Medical Expenditure Panel Survey (MEPS) to compare the prevalence of concurrent mental health and chronic illnesses across rural and urban populations and to describe relationships among comorbidity, residence, and health care use. Findings will inform public and private decisions on how best to allocate new resources available for mental health/primary care integration efforts.

Informing Primary Care Depression Intervention: A Comparison of Hospitalization Rates in Depressed Rural and Urban Patients
Research center: WICHE Center for Rural Mental Health Research
Topics: Mental health, Physicians
The goal in this research was to examine whether or not there is a differential impact of enhanced depression care on patient outcomes in rural versus urban primary care settings and whether differences are mediated by receiving evidence-based care (pharmacotherapy and specialty care counseling).

Locally Managed Behavioral Health Organizations: How Do They Affect The Capacity of Medicaid Managed Behavioral Health Programs to Serve Rural Populations?
Research center: Maine Rural Health Research Center
Topics: Medicaid and S-CHIP, Mental health, Networking and collaboration

Mental Health Encounters in Critical Access Hospital Emergency Rooms: A National Survey
Research center: Maine Rural Health Research Center
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Emergency medical services (EMS), Mental health
This project will survey Emergency Room (ER) managers in a nationally representative sample of Critical Access Hospitals (CAHs) to determine the proportion of ER encounters involving mental health pathology, types of mental health problems most commonly seen in these encounters, and resources available to CAHs to address the problems encountered.

Mental Health Risk Factors, Unmet Needs and Provider Availability for Rural Children
Research center: South Carolina Rural Health Research Center
Topics: Children, Health services, Mental health
The study will examine the prevalence of subclinical problems in rural children, assess risk factors associated with problems in children, and assess the influence of local provider availability on healthcare provider contact.

Mental Health Services in Rural Jails
Research center: Maine Rural Health Research Center
Topic: Mental health
This project will investigate how rural jails manage the mental health and substance abuse problems of their inmates. Through analysis of the National Survey of Jails and semi-structured interviews with state-level and county-level/local officials, barriers to providing such services will be assessed and promising practices will be documented.

Mental Health Services: The Effect of Variations in State Policies
Research center: Southwest Rural Health Research Center
Topics: Health policy, Health services, Mental health
This study will identify variations in state licensure and payment or coverage polices and examine the effect of these variations on the availability of mental health services in rural areas.

Patterns of Care for Rural and Urban Children with Mental Health Problems
Research center: Maine Rural Health Research Center
Topics: Children, Health disparities, Mental health
This study will assess whether use of office-based care and psychotropic medicine by children differs between rural and urban areas, as well as the role of insurance coverage and availability of mental health providers on use of these services.

Preventing Hospitalization in Depressed Rural Patients
Research center: WICHE Center for Rural Mental Health Research
Topic: Mental health
This project will explore whether depressed rural patients are more likely than their urban counterparts to be hospitalized for depression and other health reasons over the course of two years; explore whether any current rural-urban hospitalization differences are reduced in models which control for previous intensive outpatient specialty care utilization; and explore rural-urban differences in the prevalence and consequences of administrative constraints on intensive outpatient specialty care use.

Provision of Specialty Mental Health Services by Rural Health Clinics
Research center: Maine Rural Health Research Center
Topics: Health services, Mental health, Rural Health Clinics (RHCs), Substance abuse
This project will document the extent to which Rural Health Clinics (RHCs) are employing mental health staff nationally, understand why more RHCs are not employing specialty mental health staff, and analyze the barriers to and opportunities for the delivery of mental health services by RHCs. The results will identify opportunities and interventions to encourage RHCs to offer this important service.

Role of Advanced Practice Registered Nurses in Addressing Mental Health Workforce Shortages
Research center: Maine Rural Health Research Center
Topics: Mental health, Nurses, Workforce

Role of Community Mental Health Centers as Rural Safety Net Providers
Research center: Maine Rural Health Research Center
Topics: Federally Qualified Health Centers (FQHCs), Mental health

Role of Inpatient Psychiatric Units in Small Rural Hospitals and Rural Mental Health Systems
Research center: Maine Rural Health Research Center
Topics: Health services, Hospitals and clinics, Mental health
This is a descriptive, exploratory study which will investigate the role of the small rural hospital IPU from the perspectives of both the rural hospital, in terms of scope of services and revenue enhancement, and the regional mental health system, meeting the needs of outpatient mental health and primary care providers, law enforcement, and human services.

Rural E-Mental Health: Models That Enhance Access, Service Delivery, and Integration of Care
Research center: Maine Rural Health Research Center
Topics: Mental health, Telehealth
E-mental health programs have been developed in rural areas as a promising approach to address the chronic challenges of low availability of mental health clinicians, long travel distances, and stigma surrounding mental health care. The literature has established the technical feasibility of these programs and interest remains strong in developing and implementing them more broadly. However, we lack a clear understanding of the viability of current rural e-mental health programs - both the business case for starting and sustaining them and the clinical case for what services and functions may be provided _ and what impact they have had. The current rural health environment is changing significantly and it is important to understand where and how e-mental health programs have been established and sustained, what impact they have had, and what value they may add to other initiatives. To address this gap we will conduct interviews with between 24-30 current rural e-mental health programs.

Rural-Urban Comparison of Mental Health Care Treatment and Costs
Research center: South Carolina Rural Health Research Center
Topics: Health care financing, Mental health

Rural-Urban Differences in Access to Children's Mental Health Services
Research center: Maine Rural Health Research Center
Topics: Children, Health services, Mental health
This study uses data from the Urban Institute's National Survey of America's Families to examine and compare the use of mental health services by rural and urban children, age 6 to 17, relative to their need for mental health care, family income, and insurance status.

Rural-Urban Differences In The Use, Type, And Quality Of Depression Treatment
Research center: WICHE Center for Rural Mental Health Research
Topics: Aging, Health disparities, Mental health, Minority health
As access to evidence-based treatment for affective disorders (major depressive disorder, dysthymia, and bipolar disorder) improves in urban areas, it is critical to monitor rural-urban differences in the use and quality of treatment over time to identify and address rural disparities, especially for vulnerable populations such as the elderly and ethnic minorities.

Teen Violence
Research center: South Carolina Rural Health Research Center
Topics: Children, Mental health, Physical abuse and domestic violence
This study will use national data to assess the prevalence of violence among rural youth, define risk factors for violence exposure among rural youth, and assess the current ability of rural school systems to provide appropriate mental health care and/or referrals for youth exposed to violence.

Webcast: What Rural Primary Care Physicians Need to Know about Treating Patients with Mental Health Diagnoses
Research center: WICHE Center for Rural Mental Health Research
Topics: Frontier health, Mental health, Physicians, Technology
Training via distance learning technology that promotes collaborative care models in primary care is consistent with federal and state policy recommendations.

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