Session Descriptions

Agenda at a Glance

Below are the agenda session descriptions. To view the agenda at a glance, visit https://www.narmhconference.org/agenda.

Pre-Conference

Pre-Conference 1

Chorus Innovations

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09-19-2023

1:00 PM

2:00 PM

Dr. Armen Arevian

Dr. Armen C. Arevian, MD, PhD is Founder and CEO of Chorus Innovations. Prior to Chorus, he was Assistant Professor-in-Residence in the Department of Psychiatry at UCLA; Director of the Innovation Lab at the Semel Institute at UCLA; and Director of Consultation-Liaison and Telepsychiatry at the UCLA Santa Monica Hospital. He received his medical degree and PhD in Neuroscience at the University of Pittsburgh and completed residency training in Psychiatry at UCLA.

Dr. Arevian’s work can be broadly described as “participatory informatics” – the intersection of health, technology, and community-partnered participatory techniques. His peer-reviewed publications focus on the development and implementation of participatory and community-partnered technology projects, as well as the ethical considerations around today’s digital health environment. While at UCLA, Dr. Arevian created the Chorus platform, a foundation for supporting rapid, inclusive and secure technology development. Through this work, Chorus has supported a wide array of clinical, research and public health technology solutions at the community, county and state levels.

Pre-Conference

Pre-Conference 2

Beyond the Call: Empowering Crisis and Warm Line Interventions with Digital Mental Health Tools

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09-19-2023

2:30 PM

3:30 PM

Sara Forist, Phil Evans

This presentation is a case study of Protocall Services’ six month's of experience integrating our digital mental health app (Welltrack Boost) within the call center interactions of the New Mexico Crisis and Access Line and Warmline. We will explore the evidence base for CBT style interventions and homework and the role digital mental health solutions can have to improve outcomes and help reduce barriers to access and treatment. Our panel will present our experiences in preparing call takers for this integration, the call taker’s experience, the caller’s experience and our initial findings. We will make recommendations for others considering this approach and identify additional areas for research.

Pre-conference (Recorded Presentation)

Pre-Conference 3

Podcasting as a Mechanism for Reaching Rural Stakeholders on School-Based Mental Health and Related Services

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9/19/23

12:00 AM

12:00 PM

Stephen Rush

*Note: This presentation is being recorded and the link to the recorded presentation will be shared with all conference attendances after the conference. School and Community Mental Health Professional Shortage: There is a shortage of school psychologists across the United States that is at a crisis level (National Association of School Psychologists [NASP], 2023a, b). The shortage of school psychologists is particularly problematic in rural areas (Beebe-Frankenberger & Goforth, 2014). In addition to the school psychologist shortage in rural areas, there is also a widespread shortage of mental health professionals and pronounced barriers to accessing mental health services in rural communities across the country (Rural Health Information Hub, 2023).

Reaching Rural Stakeholders via Podcasting: Podcasts have become increasingly popular in recent years, not only for entertainment purposes (Podcast insights, 2023) but also as a burgeoning resource for learning and information dissemination (Drew, 2017; Kay, 2012). Despite the growth of podcasting on these fronts, research on the modality regarding its efficacy for reaching stakeholders on rural school-based mental health and psychological services and other rural issues is almost absent from the scholarly literature.

Purpose of the Study: Therefore, the purpose of this research study is to examine the perceptions of podcast listeners regarding podcasts as a mechanism to reach people in rural areas and other concerned stakeholders about rural school-based mental health and psychological services and related rural issues.

Project Design: The study population are listeners of a podcast series on rural school psychology and mental health produced and delivered by the principal investigator. Data will be collected via an online survey consisting of demographic and open-ended questions that will be accessible via a link on the podcast’s description via the Spotify app. Analysis of these data will consist of a combination of content analysis of the narrative data and quantitative analysis of demographic and non-narrative responses.

Results: Although data collection is in the beginning stages, preliminary outcomes suggest a strong listener base in a variety of rural and non-rural locale.

Plenary Session

Keynote

A comprehensive approach to rural mental health care and governance: Recent advances and challenges in Australia and internationally.

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09-20-2023

9:00 AM

10:00 AM

Dr. Russell Roberts

People living in rural communities experience poorer mental health and worse physical health than those living in larger cities. This presentation provides a brief overview of four initiatives in Australia (tele-health, workforce development, service enhancement and service redesign) that have proven effective in addressing this systemic inequity. Most importantly, it distils the key leadership and governance processes and principles underlying their success.
The presentation will also discuss the next major challenge facing mental health leaders: The poor physical health and premature death of people living with mental illness. People living with mental illness have over 2 times the risk of dying of preventable physical health conditions, and for those in rural communities this increases to over 3 times the risk. With a life expectancy gap between 13 and 23 years, people with severe mental illness are 11 times more likely to die of sudden cardiac failure, and 8 times more likely to die prematurely due to cancer (even though the incidence of cancer is the same or lower than the general population). Further, poor physical health is the factor most often associated with completed suicides. This presentation will summarise current research findings and international initiatives designed to improve health and increase the life expectancy for people living with mental illness.

Plenary Session

Flash Talk

How are rural veterans doing? What rural veterans have to say about their needs and access to care

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09-20-2023

11:00:00 AM

11:30:00 AM

Heidi Radunovich, Jon Parker

This presentation aims to increase understanding of the health and mental health needs of rural veterans. Information will be provided about the demographics of rural veterans and the challenges they face. Results from qualitative interviews with rural veterans across two states will be provided, including their lived experiences regarding access to care and reported needs. Suggestions will be made regarding how to better serve rural veterans to enhance their well-being.

Breakout Session

1A

Communicating with Farmers Under Stress

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09-20-2023

01:45:00 PM

02:45:00 PM

Chi Catalone, Sonya Nace

In this session, you will gain insight into the stressors that farmers and their families experience. This will include discussing the current market trends and farmers' financial stressors. You will learn about:
•the effects of stress on the body and mind
•how to recognize the signs and symptoms of anxiety
•the warning signs of suicide in the farming community
•how to connect people to local, state, and national resources
This presentation is based on a program developed by Michigan State University Extension.

Breakout Session

2A

Revolutionizing Rural Mental Wellness: Bridging the Gap Between Policy and Reality

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09-20-2023

1:45 PM

2:45 PM

Jason Haglund, Renee Schulte

Over the course of the past three years, Mr. Haglund (the khaki farmer) and Ms. Schulte (the recovering politician) have experienced first hand the struggles of antiquated behavioral health systems and policies. The growing need for structural behavioral health system overhaul is influenced by a growing epidemic of anxiety, depression and isolation plaguing rural, remote and frontier America. This is compounded with the increased substance use and abuse. The facilitators in this session will address the challenges between the policy as designed and written by policymakers and implementation realities.

Breakout Session

3A

Rural Graduate Medical Education Expansion to Address Rural Workforce

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09-20-2023

1:45 PM

2:45 PM

Daniel Elswick

Rural Americans face many well-documented health disparities. Although drivers of these disparities are multifaceted, a key determinant of poor health in rural populations is limited access to medical providers. There are also well documented deficits in mental health care access in most of rural America. Evidence for a residency program-based strategy to improve rural healthcare workforce supply is strong. Despite this evidence, GME in rural areas remains very limited. The Government Accountability Office estimates that only 1-2% of residents across all specialties train in rural areas. This is due in part to the unique challenges that face rural health organizations in the Unites States, which often operate on thin financial margins with limited providers and staff. As a result, both HRSA and ACGME have adopted strategic policies and resources to support development of rural GME programs including psychiatry.

This workshop aims to provide background and historical context for expanding and enhancing rural behavioral health and psychiatry training programs. The goal of the workshop will be to enhance understanding and advocacy needs for rural training in order to ultimately enhance access into generate more providers for rural and underserved areas.

Breakout Session

1B

Addressing Key Workforce Challenges in Rural Mental Health Care through Regionally-Tailored Training and Technical Assistance

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09-20-2023

3:15 PM

4:15 PM

Ricky Canelo, Rachel Navarro, Holly Roberts

This panel includes presenters from the Mental Health Technology Transfer Center (MHTTC) Network highlighting key workforce challenges of rural mental health providers. The SAMHSA-funded MHTTC Network provides free, regionally-tailored training and technical assistance to the mental health workforce. The panelists will represent the MHTTC Network Coordinating Office and two regional centers, including the Mountain Plains MHTTC in Health and Human Services (HHS) Region 8 and the Mid-America MHTTC in HHS Region 7, with expertise in behavioral health workforce challenges in rural and underserved areas. This interactive panel discussion will begin with an overview of the MHTTC Network and specifically focus on the results of a national needs assessment conducted among mental health organizations, practitioners, and key stakeholders. The results will highlight the most frequently requested training and technical assistance (TTA) needs for rural and frontier respondents to implement evidence-based practices in mental health. The results will also describe rural and frontier respondents’ needs and barriers to providing TTA to Hispanic and Latino populations, as well as present information on whether respondents culturally adapt programs for American Indian and Alaska Native populations. Panelists will describe TTA opportunities through the MHTTC Network specific to rural mental health settings and workforce challenges. Presenters will highlight expertise in the use of tele-behavioral health and pediatric integrated primary care as key strategies when addressing behavioral health workforce shortages in rural and underserved areas. Considerations for maximizing the acceptability, availability, and accessibility of tele-behavioral health and integrated primary care approaches will be emphasized. Additionally, panelists will review approaches that support advocacy and collaboration among stakeholders to strategize state and regional behavioral health workforce challenges. This session includes opportunities for the audience to participate in the discussion and share their workforce challenges to assist the MHTTC Network in developing responsive TTA events and services.

Breakout Session

2B

Addressing Ethics as a Rural Behavioral Health Provider

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09-20-2023

3:15 PM

4:15 PM

Paul Mackie

Knowledge of sound professional ethics in behavioral health delivery is critical to achieving good practice, protecting consumers, and providing the highest quality care. To satisfy continuing education licensing expectations, most behavioral health providers are required to complete periodic ethics training. This workshop focuses on practice ethics from a rural perspective where unique dilemmas often experienced by rural providers are discussed (e.g., confidentiality, consumer/practitioner relationships, expertise levels, geography). Here, we will explore some of the elements that create ethical challenges when practicing in rural and small communities. This training may satisfy up to one hour of required ethics training for a variety of licenses. All participants will be provided with materials that show evidence of tested knowledge assessment of presented information.

Breakout Session

3B

Bringing Hypnotherapy to a Rural FQHC Population

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09-20-2023

3:15 PM

4:15 PM

David Arena

Hypnotherapy is a healthcare procedure that has been around since the 1800's. It is both an efficient and effective technique for the treatment of a variety of behavioral health and medical issues such as: smoking cessation, anxiety, panic, drug cravings, headaches, sexual dysfunction, trauma, and chronic pain. This workshop will detail this author's experience providing hypnotherapy for the past 30+ years as well as its application to a rural FQHC population in central Maine. Research on the effectiveness of hypnotherapy will be summarized. The workshop will include some experiential components to assist the audience in experiencing the immediate impact that hypnotherapy can have.

Breakout Session

1C

Bridging the Gap: Data Driven Policy Solutions to the Rural Behavioral Health Workforce Shortage

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09-21-2023

12:45 PM

1:45 PM

Thad Shunkwiler, Tracie Retherford-Self, Marnie Werner

Solving the behavioral health workforce shortage will require an all-hands-on-deck approach from stakeholders. This workshop will explore the results of a 2023 policy paper authored by the Center for Rural Behavioral Health at Minnesota State University in collaboration with the Minnesota Center for Rural Policy and Development. The paper examined the barriers to growing the workforce by engaging both the education and provider communities, the results of which guided policy recommendations to the Minnesota legislature. Participants will leave the workshop with recommendations of how to implement similar solution-orientated research within their respective communities.