Access To Obstetric, Behavioral Health, And Surgical Inpatient Services After Hospital Mergers In Rural Areas

2021 ◽  
Vol 40 (10) ◽  
pp. 1627-1636
Author(s):  
Rachel Mosher Henke ◽  
Kathryn R. Fingar ◽  
H. Joanna Jiang ◽  
Lan Liang ◽  
Teresa B. Gibson
Keyword(s):  
Behavioral Health ◽  
Rural Areas ◽  
Hospital Mergers ◽  
Inpatient Services

Barriers and Facilitators of Using Telehealth to Identify and Manage Behavioral Health and Substance Use Disorder Conditions in Rural Areas: An Environmental Scan (Preprint)

2020 ◽  
Author(s):  
Naim Naim ◽  
Laura Dunlap
Keyword(s):  
Substance Use ◽  
Behavioral Health ◽  
Substance Use Disorder ◽  
Rural Areas ◽  
Primary Care Providers ◽  
Care Patient ◽  
Direct Patient Care ◽  
Care Providers ◽  
Provider Education ◽  
Opioid Use

BACKGROUND Access to behavioral health services, particularly substance use disorder (SUD) treatment services, is challenging in rural and other underserved areas. Some of the reasons for these challenges include local primary care providers without experience in behavioral health treatment, few specialty providers, and concerns over stigma and lack of privacy for individuals from smaller communities. Telehealth can ease these challenges and support behavioral health, specifically SUD treatment, in a variety of ways, including direct patient care, patient engagement, and provider education. Telehealth is particularly relevant for the growing opioid epidemic, which has profoundly affected rural areas. OBJECTIVE We sought to understand how telehealth is used to support behavioral health and SUDs, with a particular focus on implications for medication-assisted treatment for opioid use disorders. The intent was to understand telehealth implementation and use, financing and sustainability, and impact in the field. The results of this work can be used to inform future policy and practice. METHODS We reviewed literature and interviewed telehealth stakeholders and end users in the field. The team identified a diverse set of participants, including clinical staff, administrators, telehealth coordinators, and information technology staff. We analyzed research notes to extract themes from participant experiences to answer the study questions. RESULTS Organizations varied in how they implemented telehealth services and the services they offered. Common themes arose in implementation, such as planning for technical and organizational impacts of telehealth, the importance of leadership support, and tailoring programs to community needs. CONCLUSIONS Telehealth is used in a variety of ways to expand access to services and extend service delivery. As the policy and reimbursement landscape continues to evolve, there may be corresponding changes in telehealth uptake and services provided. CLINICALTRIAL NA

scholarly journals The Current Psychiatric Mental Health Registered Nurse Workforce

2019 ◽  
Vol 25 (1) ◽  
pp. 38-48 ◽  
Author(s):  
Bethany J. Phoenix
Keyword(s):  
Mental Health ◽  
Behavioral Health ◽  
Health Workforce ◽  
Health Professionals ◽  
Rural Areas ◽  
The United States ◽  
Institutional Settings ◽  
Registered Nursing ◽  
Data Limitations ◽  
Behavioral Health Workforce

OBJECTIVE: To define and describe the current psychiatric mental health registered nursing (PMHN) workforce providing care for persons with mental health and substance use conditions, evaluate sources of data relevant to this workforce, identify additional data needs, and discuss areas for action and further investigation. METHOD: This article uses currently available data, much of it unpublished, to describe the current PMHN workforce. RESULTS: The available data indicate that PMHNs represent the second largest group of behavioral health professionals in the United States. As is true of the overall nursing workforce, PMHNs are aging, overwhelming female, and largely Caucasian, although the PMHN workforce is becoming more diverse as younger nurses enter the field. PMHNs are largely employed in the mental health specialty sector, and specifically in institutional settings. Similar to other behavioral health professionals, a significant shortage of PMHNs exists in rural areas. Because of data limitations and difficulty accessing the best available data on the PMHN workforce, it is often overlooked or mischaracterized in published research and government reports on the behavioral health workforce. CONCLUSIONS: Although PMHNs are one of the largest groups in the behavioral health workforce, they are largely invisible in the psychiatric literature. Psychiatric nursing must correct misperceptions about the significance of the PMHN workforce and increase awareness of its importance among government agencies, large health care organizations, and within the broader nursing profession.

scholarly journals Lost in the Rush to National Reform: Recommendations to Improve Impact on Behavioral Health Providers in Rural Areas

2012 ◽  
Vol 23 (2) ◽  
pp. 842-856 ◽  
Author(s):  
Rafael Semansky ◽  
Cathleen Willging ◽  
David J. Ley ◽  
Barbara Rylko-Bauer
Keyword(s):  
Behavioral Health ◽  
Rural Areas ◽  
Health Providers

Training to reduce behavioral health disparities

2017 ◽  
Vol 52 (3) ◽  
pp. 298-312 ◽  
Author(s):  
Jennifer S Robohm
Keyword(s):  
Health Disparities ◽  
Behavioral Health ◽  
Rural Areas ◽  
Behavioral Science ◽  
Emotional Health ◽  
Family Physicians ◽  
Health Behavior Change ◽  
Mental Health Stigma ◽  
Behavioral Skills ◽  
Science Training

Family physicians are a critical part of the healthcare system in rural areas, but little is known about the training they need to more effectively address behavioral health disparities. Practicing family physicians in Montana were surveyed about the behavioral health needs of their patients, the behavioral resources at their disposal, their prioritization of a number of behavioral skills and interventions in the training of family physicians, factors that limit their own use of behavioral skills, and the extent of their behavioral science training. Respondents across the state reported high rates of mental/emotional health issues and high need for health behavior change in their patients. Surprisingly, although rural family physicians reported access to significantly fewer behavioral health resources, they did not rate any of the behavioral skills as higher training priorities than their urban counterparts and they were more likely to identify limitations (lack of patient interest, lack of confidence or competence, and inadequate knowledge or training) on their own use of such skills in practice. Family physicians, both rural and urban, whose residency programs had a higher emphasis on behavioral science felt better prepared to use behavioral skills in practice. Consequently, rural training programs are encouraged to emphasize behavioral science training for their family medicine residents, particularly training that focuses on mental health stigma reduction, emphasizes time savings and practicality, covers more severe psychiatric presentations, promotes cultural sensitivity to rural values of autonomy and self-sufficiency, and teaches skills to advocate for individual and community health with regard to behavioral health disparities.

Telehealth May Reduce Rural-Urban Disparities in Accessing Pediatric Psychiatry Services: A Case Study of Trends in Central Ohio from 2020 to 2021 (Preprint)

2021 ◽  
Author(s):  
Ujjwal Ramtekkar ◽  
Jin Peng ◽  
Yungui Huang ◽  
Simon Linwood
Keyword(s):  
Behavioral Health ◽  
Rural Areas ◽  
Rural Families ◽  
Office Visit ◽  
Office Visits ◽  
Child Psychiatric ◽  
Rapid Transition ◽  
Pediatric Psychiatry ◽  
Urban And Rural Areas ◽  
Rural Patients

BACKGROUND The rural-urban disparities in access to child behavioral health services are well known and are further exacerbated by the COVID-19 pandemic related restrictions on travel and in person visits. Fortunately, regulatory flexibilities allowed rapid transition of telehealth to reduce contagion while maintaining continuity of care. However, there has been contradicting evidence on whether telehealth narrows the rural-urban gap. OBJECTIVE To examine the telehealth utilization trends and no-show rates between urban vs rural areas for pediatric psychiatry visits after the public health emergency was declared. METHODS Using 2020-2021 electronic health records (EHR) data from the psychiatry department at a large urban academic pediatric hospital, we calculated the telemedicine utilization rates by patient’s residence area (urban vs rural). We used two proportions z-tests to examine whether the observed differences in no-show rates among 4 types of visit (urban office visit, urban telemedicine visit, rural office visit, and rural telemedicine visit) were statistically significant. RESULTS Telemedicine utilization rates (~80%) are comparable in urban and rural areas. The average no-show rates for telemedicine visits were around 17% for both urban and rural patients, while the average no-show rates for office visits were around 20% for urban patients and fluctuated between 15% and 36% for rural patients. Two proportions z-tests indicated that, for rural patients, telemedicine visits had significantly lower no-show rates than office visits between Sept 2020 and Feb 2021, but such difference turned insignificant after March 2021. CONCLUSIONS Telehealth improved access to child psychiatric services for rural families when primary delivery of services was telehealth-based. Returning to in-person only options and limiting telehealth access would be detrimental to behavioral health outcomes of rural children that have been traditionally underserved. CLINICALTRIAL N/A

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