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When Nancy Edwards brought future nurse practitioners to her weekly rounds at a Lafayette clinic, students would listen to patients talk about struggling with anxiety and depression.
Half of Edwards’ patients, she said, have some kind of mental health disorder.
“The students were kind of alarmed about that,” said Edwards, a nurse practitioner and professor at the Purdue University School of Nursing.
Faced with the nationwide shortage of mental health providers, rural health centers are seen as the front door to basic screenings and treatment for patients who can’t get an appointment with a counselor.
Through a new federally-funded initiative, Purdue will train a group of nurse practitioner students to ask patients about non-complex mental health issues at three area clinics, including Riggs Community Health Center, North Central Nursing Clinics and Valley Oaks Health.
Patients could receive treatment for basic anxiety, depression and attention disorders and be screened for substance use disorders. The students would refer more complicated cases to specialists.
The initiative is supported by a $2.7 million grant from the Health Resources and Services Administration, which supports partnerships between universities and clinics to expand health care in rural and underserved areas.
More than 60% of all counties in the U.S. and 80% of rural counties do not have a single psychiatrist, according to a 2017 study by the Partnership for a New American Economy, a pro-immigration reform group that advocates using immigrant psychiatrists to close the gap.
In 2014, greater than half of Indiana counties, including Montgomery and Fountain, were designated by the Indiana State Department of Health as mental health professional shortage areas, where barriers can include stigma and a lack of transportation. Providers tend to be drawn to higher-population areas, where pay is typically better.
“All of those together make access a little more difficult,” Edwards said.
Telehealth, in which patients consult with psychiatrists or counselors over the phone or internet, have filled some of the void. But not all patients feel comfortable talking remotely with a provider.
“They want a live body,” Edwards said.
Through a separate partnership, students may have the opportunity to build longer-term relationships with patients.
Riggs received a grant from the Health Resources and Services Administration to form an advanced nurse practitioner residency program with Purdue.
“People who come from rural areas and train in rural areas tend to stay in rural areas,” Edwards said.