School of Nursing awarded $1.5 million for mental health, substance abuse treatment in rural communities

BUFFALO, N.Y. – The University at Buffalo School of Nursing has received a $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 UB project is led by Yu-Ping Chang, associated dean for research and scholarship in the School of Nursing. Chang is also the chair of the Family, Community & Health Systems Sciences Department, as well as the Patricia H. and Richard E. Garman Endowed Professor.

The purpose of this 3-year 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, this 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.”

Rural community residents face many social and environmental challenges that further contribute to this disparity in behavioral health outcomes and treatment, according to Chang. 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, Chang 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, resulting from residing in a small community. Increasing access to integrated care is especially important in rural and underserved primary care clinics.

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 in the School of Nursing; Chris Barrick, research associate professor, School of Nursing; Nancy Campbell, associate professor, School of Nursing; Sabrina Casucci, assistant professor, UB Department of Industrial and Systems Engineering; and Nicole Roma, project coordinator.