Nebraska is primarily a rural state with only two major metropolitan areas. Only 49 of the state's 521 incorporated cities, towns and villages (median size=316) have populations of 2,500+. These 49 municipalities generally have primary care medical clinics and critical care hospitals and serve surrounding smaller towns and villages. Additionally, there are medically underserved communities in inner-city Omaha with significant shortages of behavioral health providers. These rural and urban communities will serve as the “targets” for integrated behavioral health expansion. Our goal is to expand the integrated behavioral health workforce in primary care so that all Nebraskans, across the life span, have access to quality behavioral health services.
This Behavioral Health Workforce Education and Training (BHWET) grant, Meeting the Behavioral Health Needs of Underserved Populations through Integrated Clinical Training in Primary Care, was submitted by UNMC’s Munroe-Meyer Institute (MMI) in collaboration with partners from the UNMC Psychiatric Nurse Practitioner program, Nebraska Medical Center adult psychology program, the Behavioral Health Education Center of Nebraska (BHECN), and the MMI joint psychology M.A. program (with the University of Nebraska at Omaha Department of Psychology) and UNO Counseling.
The purpose of this project is to expand the workforce of behavioral health providers trained and skilled to work in integrated primary care sites in underserved areas, in particular in rural, frontier, and inner-city locations.
Specific objectives of this grant program are to:
- Expand the integrated behavioral health internship training program;
- Evaluate the effectiveness of the MMI “Primary Care Behavioral Health” model of integrated behavioral health;
- Provide “learning through service” training opportunities for interns and psychiatric nurse practitioner trainees;
- Conduct applied research on the replicability of the Primary Care Behavioral Health integrated model; and
- Place, support, and retain behavioral health providers in integrated primary care and disseminate the program to two additional states.
Clinical training in integrated behavioral health will address behavioral disorders and disabilities that commonly present in primary care medical practices. Supervision of trainees will occur within primary care clinics in either rural or inner-city underserved areas. Over four years, 28 doctoral psychology interns, 16 psychiatric nurse practitioners, and 20 master’s-level psychology/counseling interns are projected to participate in a total of more than 25,000 patient sessions with BHWET funding support.
Our Human Resources & Services Administration (HRSA) funded programs at the University of Nebraska Medical Center (Graduate Psychology Education and BHWET) have established and/or supported the creation of 42 primary care behavioral health integrated clinics across Nebraska (24 rural and 18 urban locations), and the program has been disseminated to training programs in Michigan and Pennsylvania. Graduates have also developed or collaborated with integrated clinics in Mississippi, Georgia, Iowa, Delaware, and Florida.