A project helping transform the mental health landscape of rural Nebraska may soon benefit communities worldwide.
Developed six years ago by Richard Bischoff, chair of child, youth and family studies, and Paul Springer, associate professor, the research project has used distance technology to provide mental health services to communities in need. Now, the research duo is partnering with Cody Hollist, associate professor of child, youth and family studies, to introduce the model in Brazil.
“Many developing countries mirror rural Nebraska with issues surrounding mental health access and the stigma related to it,” Springer said. “Our model is dedicated to overcoming mental health barriers by using technology, mobilizing communities and bringing the right people to the table. We want to bridge the gap.”
The mental health project has two distinct components — community-based participatory research and tele-mental health.
Community-based research assesses resources available in a rural community and relies upon solutions developed by vested stakeholders, including police, teachers, lawyers and healthcare providers. Communities are allowed to develop their own approach; some develop themes, such as bullying, and host school presentations or invite speakers to address mental health issues, while others implement tele-mental health services.
The model is designed to develop community ownership and empowerment. One of the most successful programs was developed two years ago in a community that experienced back-to-back suicides.
The town’s community group — created through community-based participatory research — was mobilized immediately and brought in experts to provide training that helped people ask the right questions and refer individuals at risk for possible suicide.
Springer said the response illustrates that communities can develop competence and confidence in addressing mental health needs.
If a community opts for tele-mental health, UNL graduate students provide the service to rural patients using video conferencing software. The service is provided through local medical clinics, protecting patient anonymity and easing the stigma surrounding mental health care.
The graduate students provide distance services to patients three times per month. For the fourth appointment, students travel to the community and meet with patients in person.
“The innovative use of technology is exciting, because I’ve seen the positive impact that this work has on rural communities and schools,” Bischoff said. “People who previously did not have access to mental health care now have access to culturally sensitive, state-of-the-art treatment. At the same time, students receive a rich, experiential learning opportunity that increases their appreciation of the care culture in rural communities and trains them in the use of videoconferencing technologies.”
Now, lessons learned in small-town Nebraska are playing a key role in cross-cultural translation.
“We’ve learned that, even throughout rural Nebraska, each community is very diverse,” Springer said. “This sensitivity helps us to tailor the ways in which we provide our interventions, because our model is all about honoring communities.”
This spring, Hollist and Springer are providing training and support to Brazilian colleagues who have started collecting data through the community-based participatory research model. The work is part of a 15-year longitudinal study that has followed children from birth to age 15 to assess mental health disparities in an impoverished community. Hollist has been part of the comprehensive study from its inception.
Also working with the UNL research team is a Brazilian medical provider who wants to offer tele-mental health services to rural patients.
Bischoff and Springer are also discussing the application of their mental health model with interested researchers in Portugal and India.
Ultimately, the team plans to expand local and global relationships and implement their model to bridge gaps in accessibility, provide resources and reduce the stigma associated with mental health issues.
