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Letters to the Field

About the Network

The basic mission of the Frontier Mental Health Services Resource Network is the collection, analysis, and synthesis of knowledge regarding needs for and delivery of mental health services in "frontier" rural U.S. counties (nonmetropolitan counties with population densities of less than seven persons per square mile). It also offers technical assistance to rural agencies and advocates on mental health/substance abuse topics as they impact upon or exist within such isolated rural areas.

Not sure if you live or work in a frontier area? Check our list of U.S. counties with less than 7 persons/sq.mi. -- Frontier Counties

The Network is a consortium of nine university-based, state/local government-based and independent experts from a variety of mental health/substance abuse-related fields. The fields represented include rural health services research, rural mental health services research, mental health epidemiology and needs assessment, delivery of services, program evaluation, mental health administration, mental health finance and cost effectiveness, and mental health work-force issues. An eleven member Advisory Committee assists the Network members in developing high quality syntheses and summaries of available knowledge.

The Network started out under the leadership of Dr. James Ciarlo at the University of Denver with this WebPage orginally designed by Pearlanne Zelarney.  It was administered at the Western Interstate Commission's Mental Health Program in Boulder especially by Mary Obata.  Upon the retirement of Dr. Ciarlo, the network has passed to Dr. Courtenay M. Harding, Director of WICHE's Mental Health Program and CO-Principal Investigator of the Network.  The Network has been supported by the Center of Mental Health Services, at the Substance Abuse and Mental Health Services Administration under contract 280-94-0014, "Center for Support of Mental Health Services in Isolated Rural Areas" (Ronald Manderscheid, Ph.D., Project Officer).  Dr. Harding is pursuing continuing funding and a wider consortium of collaborators.

Defining Frontier

• Focusing on "Frontier": Isolated Rural America
• Defining and Describing Frontier Areas in the United States: An Update - DRAFT
• States with Frontier populations
• Frontier Counties - Check here for a list of all continental U.S. counties with less than 7 persons/sq.mi.
• US Maps of Frontier Counties
  - Population Density map produced by the Network, 5 categories
  - US Frontier Counties map from the Census Bureau, 2 categories
  

Telemental Health Services and Frontier America

Network Publications

The "Letters to the Field" are informational newsletters published periodically by the Network. Topics will include recent developments in the field of rural mental health as they apply to isolated "frontier" rural areas.

• Letter to the Field No. 1 New Rural Mental Health Services Resource Center Being Established (Date of Publication: December 2000)
• Letter to the Field No. 2 Focusing on "Frontier": Isolated Rural America (Date of Publication: December 2000)
• Letter to the Field No. 3 Telemental Health Services In U.S. Frontier Areas (Date of Publication: December 2000)
• Letter to the Field No. 4 Access to Mental Health Services in Frontier America (Date of Publication: December 2000)
• Letter to the Field No. 5 The Role of Rural Primary Care Physicians in the Provision of Mental Health Services (Date of Publication: December 2000)
• Letter to the Field No. 6 Frontier Mental Health Strategies: Integrating, Reaching Out, Building Up and Connecting (Date of Publication: December 2000)
• Letter to the Field No. 7 Delivering Mental Health Services to the Seriously Mentally Ill in Frontier Areas: Evidence from Five States (Date of Publication: December 2000)
• Letter to the Field No. 8 General Models for Delivering Mental Health Services to the Seriously Mentally Ill in Frontier Areas (Date of Publication: December 2000)
• Letter to the Field No. 9 Managed Behavioral Health Care in the Frontier (Date of Publication: December 2000)
• Letter to the Field No. 10 The Role of Rural Primary Care Providers in the Provision of Mental Health Services: Voices from the Plains (Date of Publication: December 2000)
• Letter to the Field No. 11 The Availability of Health and Mental Health Providers by Population Density (Date of Publication: December 2000)
• Letter to the Field No. 12 Cost Dynamics Of Frontier Mental Health Services (Date of Publication: December 2000)
• Letter to the Field No. 13 Client Outcomes And Costs In Frontier Mental Health Organizations (Date of Publication: December 2000)
• Letter to the Field No. 14 Effective Management Strategies For Frontier Mental Health Organizations (Date of Publication: December 2000)
• Letter to the Field No. 15 Surveillance of Demand for Mental Health Services in Frontier Areas (Date of Publication: December 2000)
• Letter to the Field No. 16 Organization and Delivery of Mental Health Services to Adolescents and Children in Frontier Areas (Date of Publication: December 2000)
• Letter to the Field No. 17 Delivering Mental Health Services to Children and Adolescents in Frontier Areas: Parent and Provider Views (Date of Publication: December 2000)
• Letter to the Field No. 18 Low Density Counties with Different Types of Sociodemographic, Economic and Health/Mental Health Characteristics (Date of Publication: December 2000)
• Letter to the Field No. 19 Telemental Health Services in Frontier Areas: Provider and Consumer Perspectives (Date of Publication: December 2000)
• Letter to the Field No. 20 Mental Health Service Utilization in Rural and Non-Rural Areas (Date of Publication: December 2000)
• Letter to the Field No. 21 Aging, Mental Illness, and the Frontier (Date of Publication: December 2000)
• Letter to the Field No. 22 Defining and Describing Frontier Areas in the United States: An Update (Date of Publication: December 2000)
• Letter to the Field No. 23 Problems Faced By Consumers Of Mental Health Services Out In A Frontier Community (Date of Publication: December 2000)

Managed Mental Health Care in Frontier Rural Areas - presented by James Ciarlo at the 11th Annual WICHE Decision Support Conference and published in the November 1996 issue of WICHE WestLink

"Federally-Funded 'Frontier Rural' Technical Assistance Center Is Developing Rural Mental Health Service Reviews & Policy-Relevant Papers" - Article published in the Newsletter of Division 18 (Psychologists in Public Service), American Psychological Association -- Volume 22, Number 1 (Spring issue), 1997, pp. 1,7-9.

Knowledge Synthesis Papers in Preparation

One of the major efforts of the Network is the dissemination of information on mental health topics in frontier rural areas through knowledge synthesis papers. Papers in preparation include (some are now available in draft form):

• The Tapestry of Rural and Frontier America - Pearlanne T. Zelarney, M.S.; James A. Ciarlo, Ph.D.; Morton O. Wagenfeld, Ph.D., John H. (Jack) Wackwitz, Ph.D; Dennis F. Mohatt, M.A.; and Frank D. McGuirk, Ph.D.
• Estimating and Monitoring Need for Mental Health Services in Rural Frontier Areas - James A. Ciarlo, Ph.D.
• The Availability of Health and Mental Health Providers by Population Density and Urban-Rural County Type - Charles E. Holzer, III Ph.D. & Harold F. Goldsmith
• Frontier Mental Health Care and the Integral Role of the Primary Care Physician - Jack M. Geller, Ph.D. & Kyle Muus, M.A.
• Frontier Mental Health Strategies: Integrating, Reaching Out, Building Up, And Connecting - Jack M. Geller, Ph.D., Peter Beeson, Ph.D., and Roy Rodenhiser, Ed.D.
• Mental Health Services in Frontier Areas: Models of Services Delivery and Special Populations - Morton O. Wagenfeld, Ph.D.
• Costs, Outcomes and Effectiveness in Frontier Mental Health - James E. Sorensen, Ph.D., CPA
• Providers of Mental Health Services to People in Frontier Areas: Strategies for Work Force Development - Frank D. McGuirk, Ph.D., Andrew B. Keller, Ph.D., & Mary L. Obata, M.A.
• Telemental Health Services in U.S. Frontier Areas - Walter F. LaMendola, Ph.D.
• Managed Behavioral Health Care in the Frontier: Will the Frontier Manage and How? - Andrew B. Keller, Ph.D.

Advisory Committee Members

• Peter Beeson, PhD, Nebraska Department of Health and Human Services Finance and Support;
  
• Liz Breshears, MEd, MSW, Nevada Rehabilitation Division;
  
• H. Ed Calahan, MEd, Texas Department of Mental Health/Mental Retardation;
  
• Sheila Cooper, Consumer and organic farm proprietor;
  
• Michael Enright, PhD, private psychology practice, Jackson, Wyoming;
  
• Richard Lippincott, MD (psychiatry), Louisiana Dept. of Health and Hospitals, Office of Mental Health;
  
• Arthur McDonald, PhD, Psychological Services Dept., Dull Knife Memorial Foundation, Montana;
  
• Carol Miller, EMT/MPH, Mountain Management, Ojo Sarco, New Mexico;
  
• Mike Romero and Mary Van Pelt, San Luis Valley Mental Health Center consumer/outreach worker team, Alamosa, CO;
  
• Roger Schauer, MD (family medicine), University of North Dakota School of Medicine

How to contact the Frontier Mental Health Services Resource Network