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Volume 50 Number 2
Edited by Susana Helm, PhD
University of Hawai`i at Mānoa,
Co-Editors Cheryl Ramos, PhD
and Suzanne Phillips, PhD
The Rural IG column highlights rural resources as well as the work of community psychologist, students, and colleagues in their rural environments. Please email Susana if you would like to submit a brief rural report or if you have resources we may list here.
Rural Resources: Rural Suicide Prevention & Treatment
Literature Review on Rural Suicide.
Although it is a decade old, the Hirsch review article is a great resource. The article “examine[d] the current body of literature on rural suicide and investigate[d] differences between rural and urban suicide, including socioeconomic, psychological, and cultural variables. Prevention and intervention strategies specific to rural communities are discussed.”
Hirsch JK. (2006). A review of the literature on rural suicide. Risk and protective factors, incidence, and prevention. Crisis, 27(4), 189-199. DOI: 10.1027/-5910.27.4.189.
Special Issue JRMH (2014).
More recently, a special issue of the Journal of Rural Mental Health focused on rural suicide (2014, volume 38.2): http://psycnet.apa.org/journals/rmh/38/2/. In addition to leading with a review article, the special issue provides both a national and international perspective on rurality. Articles describe organizational efforts at the national level, specific articles on veteran’s and indigenous concerns, and strategies for intervention, among other points.
The American Foundation for Suicide Prevention (http://afsp.org/our-work/research/apply-for-a-grant/).
Brief Report: WICHE Mental Health Program: Six Decades of Community Engagement
Written by Dennis F. Mohatt,
Vice President for Behavioral Health, WICHE
The Western Interstate Commission for Higher Education (WICHE) was established by Congress in the early 1950s, as an interstate compact. It currently includes 15 western states and the Pacific Territories and FreelyAssociated States. The partnership works collaboratively to expand educational access and excellence for all citizens of the West. Per the US 2010 census, the vast majority (over 80%) of all WICHE state geographic area is considered rural. By promoting innovation, cooperation, resource sharing, and sound public policy, WICHE strengthens higher education’s contributions to the region’s social, economic, and civic life. WICHE established its Mental Health Program in 1955, the founders stating that healthy minds are an essential component of access to and su ccess in higher education. For over 60 years, the program has sought to promote innovation and quality in mental health care and ensure a high quality professional workforce.
I was drawn to a career in Community Psychology as an undergraduate at the University of Oregon, mentored by James G. Kelly. My graduate training in rural community psychology, at Mansfield University in Pennsylvania, nurtured by Professors Peter Keller and Denny Murray, focused me on using the tools of community psychology to support rural communities. My work at WICHE is a constant deployment of those skills, and the knowledge gleaned from 30 years of work with diverse people and communities. I wanted to share some examples of our work.
Example 1: Suicide Prevention-Collaborating with Rural Veterans.
Despite successful implementation and effectiveness in other atrisk populations, culturally informed, community-based suicide prevention programs have not been applied to rural veterans – a population for whom health disparities and increased risk of suicide are well established. To address this gap, WICHE is working with the Veteran’s Administration’s Rocky Mountain Mental Illness Research, Education and Clinical center to develop a suicide prevention strategy for Veterans living in rural communities. This project integrates multiple individual and community level interventions into a comprehensive suicide prevention program for rural Veterans, called “Together with Veterans.” Their website may be found at http://www.togetherwith-veterans.org/ (see also 2014 TCP 47(2) Rural column, pages 28-30).
Together with Veterans uses an evidence based, multi-level community participation approach to prevent suicide by improving access to care, resources and support services, and shifting community attitudes about helpseeking. The program emphasizes shared decision-making, community readiness assessment and buy-in, and capacity building at all stages to determine what will work best in individual rural communities. The program is innovative because it allows for some flexibility within an evidencebased framework. Instead of using a one-size-fits-all approach, the program supports customization and allows community planners to focus on practices that meet the specific needs and resources of that community. WICHE has supported the development of this model, and is now assisting the VA in piloting the program in six counties in Southern Colorado, bringing to bear our expertise in program modification for successful rural community outcomes. WICHE does not steer this effort, instead the local veterans utilize WICHE as a resource and expert consultant.
Example 2: Mental Health Professional Development.
A shortage of mental health professionals is a chronic challenge in the WICHE West. Every WICHE state has significant areas federally designated as health professional shortage areas for mental health (see also https://bhw.hrsa.gov/shortage-designation/hpsas). Psychology has had a significant shortage of accredited internship sites for doctoral students. The University of Alaska, in 2008, had launched a doctoral clinical community psychology program and no accredited internship slots were available for their students. WICHE saw opportunity in the alignment of these challenges. Alaska feared students forced to leave the state for accredited internship would not return to be a part of the workforce solution for their state. In 2009, WICHE began a process of engagement with community based organizations to explore the development of an internship training program that supported the vision of preparing psychologists to serve rural and indigenous people. The participatory process led to the creation of the Alaska Psychology Internship Consortium. This multisite consortium is unique in its use of technology to connect sites (some separated by more than 1000 miles) and interns, ensuring each intern has an immersion in crosscultural village based behavioral health. To date this program has graduated 45 interns, and over 70% remain in Alaska. The effort has been such a success that WICHE has replicated the model in Colorado, Hawai`i, Nevada, and Oregon. The hallmark of the initiative is working and supporting local partnership and training interns to promote community behavioral health settings such as schools and health clinics.
These are just two examples, of over 30 projects WICHE Mental Health is involved in from South Dakota to the Northern Mariana Islands in the Pacific (http://www.wiche.edu/). Routinely, we are using data analysis to help local groups make data driven decisions, using community participatory methods to build enduring partnerships to improve systems, and providing technical assistance in a manner that strengthens local capacities.