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Access to rural mental health care gets innovative boost

Author: Paula Van Brocklin

The COVID-19 pandemic has shone an even brighter light on a prevailing darkness in rural Iowa—lack of access to mental health care. Warren Phillips, associate teaching professor in psychology and a practicing psychologist, aims to address this malady by developing a network of mental health professionals who provide virtual consultations to medical facilities, schools and businesses across the state.

A shortage of mental health resources is not new to America. Prior to the pandemic, Phillips said one in five people in the United States were experiencing mental health challenges. He added that by 2025, the U.S. Department of Health and Education predicts the nation will be 250,000 short of the mental health professionals required to satisfy the increasing demand for mental health services.

“There’s a tremendous shortage of resources to meet the need, which puts us in a very difficult spot in many ways,” Phillips said.

Heightened need for kids

While people of all ages suffer varying degrees of mental health issues for numerous reasons, Phillips says that statistics from the American Psychological Association show that Generation Z individuals—today’s children and young adults—have been most impacted by the psychological effects of the pandemic.

“We’re seeing dramatic increases in anxiety and depression and trauma-based difficulties that people are struggling with,” Phillips said. “The hardest hit and the highest rates we’re seeing are in the Gen Z population, so adolescents and young adults. It’s unclear exactly why.”

Phillips said that while psychologists don’t yet know why younger individuals are more impacted by the pandemic, he said studies indicate that they experience chronic stress from multiple environmental factors, including gun violence, divisiveness in our culture, worries about finances, politics and the impact of social media.

“Youth can access information about tragedies and crises immediately and frequently, which can take a toll on anyone,” Phillips said. “But older adults have the advantage of more life experiences, which helps to inoculate them against stress, to some degree. We also know that most youth missed out on several of the typical developmental ‘rites of passage’ like normal graduations and proms. Many are now anxious about their job futures, since young adults had some of the highest unemployment rates during the pandemic and the post-pandemic job picture is still taking shape.”

For Phillips, these statistics are personified in the patients he sees daily. In addition to teaching psychology courses part-time at Iowa State,  he is a practicing psychologist who owns and operates Central Iowa Psychological Services. He joined the practice in 1996 when it had three providers in one West Des Moines location. In 2009, Phillips purchased the clinic and today it employs 30 mental health practitioners in four central Iowa locations, including Ames, Ankeny and two sites in West Des Moines. The practice, which serves about 1,000 patients per month, offers a range of services for anyone struggling with mental health or behavioral challenges.

“I always tell people we go from age 2 to 102 in the developmental span,” Phillips said.

Filling the mental health care void

To address the growing need among youth and young adults, Phillips teamed up with Ashley Scudder, lecturer in the Department of Human Development and Family Studies in the College of Human Sciences, to develop an innovative, virtual mental-health professional network that allows rural Iowans greater, more convenient access to behavioral care. The idea was made possible through a grant from Telligen Community Initiative.

Phillips, along with his operations and clinical team, are currently working to enroll pediatricians, primary care physicians and school districts into the network for free. What those entities get in return is virtual access to licensed mental health care professionals whenever they deem it necessary for the wellbeing of children and their families.

“My goal is to increase access to quality care for people all over Iowa,” Phillips said. “Part of what has driven me in all this is seeing so many people frustrated because they can’t get into mental health services. You have to wait two or three or six months to get in to see a provider, and that’s very frustrating. People should not have to suffer needlessly.”

A good start, but more help is needed

For years, the Iowa Psychological Association has received grants from the Iowa Department of Public Health to train more postdoctoral psychologists and place them in practices across the state. The association reports that since 2008, nearly 50 predoctoral interns and/or postdoctoral residents have served Iowans during their training. Of those, about 80% have stayed in Iowa and are currently practicing as licensed psychologists or are completing their training.

Phillips has mentored and trained several of these practitioners, and believes it’s a helpful program that should continue. However, the need for mental health care in rural Iowa is too great, he says, and other innovative methods and resources to care for Iowans need to be implemented. That’s his goal for the virtual network.

In the building phase

Currently, the virtual network is comprised of mental health professionals from Phillips’ practice who offer their services through local hospitals and schools. So far, the network has provided consulting services to Mary Greeley Medical Center in Ames, Story County Medical Center in Nevada, Ames Community School District and the Davis County Community School District in Bloomfield.

The mental health professionals offer a wide range of services, including presentations to medical providers on how to cope with the stressors of the pandemic; consultations with physicians on how to best provide behavioral support for a patient; one-on-one sessions with medical patients who require mental health assistance; mental health screenings for elementary students; and wellbeing presentations for teachers and parents about how to address behavioral challenges in children. The network also connects patients to behavioral health providers in their area and offers annual training on empirically supported parenting practices to behavioral health providers throughout the state.

This summer, Phillips and his team are working to expand the network into Iowa’s 30 southern counties, with hopes of eventually broadening its reach throughout the state. His team is reaching out to medical facilities via phone calls, emails, presentations and fliers to explain how the virtual mental health services network could enhance services to families in rural areas and fill the mental health care void. The goal is to have more facilities enrolled by the end of the summer.

“We’ve created the model and I’m happy to share this model with other clinics and help other clinics utilize a similar model,” Phillips said.

Add innovator to the resume

Phillips is firmly rooted in his dual-career role of psychologist and professor. But after developing a virtual mental health network of practitioners across the state, he now also considers himself an innovator and entrepreneur.

“If you had asked me this at the beginning I would have said no. I suppose as I look back on it, I would say yes, I consider myself an innovator and entrepreneur,” he said. “For me, the innovation and entrepreneurship are a means to an end that I feel passionate about. It’s not the end itself. It’s just a way to bring about a much-needed change.”