Historic buildings line a downtown street in Cañon City. (Faith Miller/Colorado Newsline)
A statewide shortage of mental health and addiction providers is acutely felt in Colorado’s rural communities, many of which have high rates of suicide and overdose.
A new fellowship program, supported by the Colorado Center for Nursing Excellence and funded through United Health Foundation, aims to change that — or at least make a significant dent in the provider shortage.
The foundation will provide a $1.5 million grant to help pay for 39 family nurse practitioners to receive psychiatric mental health nurse practitioner certifications. The program will increase the behavioral health capacity of rural clinics — their ability to treat mental health and substance use patients — by approximately 25%, according to a statement announcing the funding.
“When it comes to rural communities, there is a shortage of mental health providers,” Ingrid Johnson, president and CEO of the Colorado Center for Nursing Excellence, told Colorado Newsline.
For several years now, the center has been working on a “Grow Your Own” program aimed at building primary health care capacity in underserved rural communities. It recruits nurses to receive help paying for more school so they can become family nurse practitioners, essentially filling the role traditionally occupied by a primary care doctor.
With support from multiple foundations, the program has provided funding to educate more than 100 new family nurse practitioners in rural Colorado. They each received up to $22,000 to support their education, Johnson said.
The new United Health Foundation grant will now allow family nurse practitioners to also provide therapy and prescribe medications for mental health needs.
Based on addresses listed on provider licenses, 22 rural counties in the state do not have an active psychologist, according to a 2020 report from the Colorado Rural Health Center. The same report said rural youth are twice as likely to die by suicide as those in urban areas.
Complicating those problems, the Center for Nursing Excellence learned that people in rural communities often won’t seek help treating a mental health or substance use concern, Johnson said.
When someone is having a challenge that they need to seek help on, they often will not go because they don’t want people to know they’re having that challenge.
– Ingrid Johnson, president and CEO of the Colorado Center for Nursing Excellence
But with nurse practitioners who can provide both primary care and psychiatric care from the same office, that could change.
“If someone is having, for instance, a challenge with substance abuse, and they go in to seek care, the nurse practitioner in that community will now have the skills and the ability to provide that care. And no one in town will be the wiser,” Johnson said. “It provides that patient privacy that people need.”
According to Johnson, the nurse practitioners supported by the Colorado Center for Nursing Excellence often find that patients’ physical concerns are linked to unaddressed mental health needs. Depression, for example, can make someone unable to manage conditions like diabetes, obesity or a substance use disorder.
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Amy Leibli, a family practice nurse practitioner in Cañon City and one of the new program’s 39 fellows, decided to pursue a psychiatric certification when she recognized the need in her community.
“I’d really seen how the mental health and the substance abuse went hand in hand when practicing in family practice,” Leibli said, “so I really felt that need to go back and get my certification so I could also help those patients in that way.”
Johnson hopes the 39 nurse practitioners selected for the program will be able to leverage their psychiatric mental health certifications to boost wellness in rural communities and better prevent both physical and mental illness.
“Our bodies are just systems,” she said. “They work as a whole: When one piece isn’t working quite right, it does impact everything else. So this just provides a different sort of holistic view of health care.”
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