WICHE Mental Health Report
March 05, 2007
Volume 1, Number 2
In this Issue:
- InFocus: What is 'Rural'?
- Selected Highlights of Recent Staff Activities
- WICHE MH Staff Writings and Publications
InFocus: What is ‘Rural’?
WICHE Mental Health Program Mission:
1) to assist states in improving systems of care for mental health consumers and their families; and
2) to advance the preparation of a qualified mental health workforce in the West.
The WICHE Mental Health Program mission may seem rather broad in an age of fine-tuned mission statements. The major reason is that among the Western states there are potentially large differences in needs for mental health services. We do not limit the type of programs and services we offer. Instead, we bring to the table a wide array of skills and experiences that can be crafted and molded into unique programs and services tailored to fit the individual needs of our member states. The one unifying theme in all of our work is our extensive focus on rural and frontier areas. So what is rural? We define it for you here. In the next issue, we will elaborate on why we focus on rural areas so faithfully across all of our projects.
‘Rural’ is defined in a myriad of ways, using different subjective and objective measures, different criterion, and different analyses. There is a general stereotype of Rural America as being idyllic farmland, separated physically from the bustle and purposeful activity of urban areas. Many organizations have attempted to define rural with varying success. Each definition utilized has a profound impact on the economic, political, educational, and funding realities of rural and frontier populations and each paints a very different picture. Researchers and policy makers need to be aware of which definition is used and how it affects their work.
There are three major Federal definitions which are used for most research and practical purposes:
- Department of Commerce's Bureau of the Census, which roughly defines rural as being a population cluster of less than 2,500 people with the density of the surrounding areas taken into account. For example, a small town of 2,000 people with an adjacent suburb of 800 people would be designated as an urban cluster with a population of 2,800. And a town of 5,000 people with 500 residents living in thinly settled portions, the 500 would be classified as rural and the urban population would be just 4,500.
- White House’s Office of Management and Budget (OMB), which uses a complex system for defining “core-based statistical areas” and divides the population into three types: metropolitan areas (50,000+), micropolitan areas (10-50,000), and noncore counties (everything not classified as micro or metro). OMB will classify a micro area as metro if more than 25 percent of its workers commute to a nearby metro area OR if more than 25 percent of work in the micro county is performed by metro commuters.
- Department of Agriculture Economic Research Service, uses rural-urban continuum codes which define rural (nonmetro) as between 4 and 9 where 4 = urban population of 20,000 or more, adjacent to a metro area, and 9 = completely rural or urban population of fewer than 2,500, not adjacent to a metro area.
These three definitions can create vastly difference pictures of rural America. For example, in 2000 according to the OMB definition, rural America comprised 17 percent (49 million) of the population, compared to 21 percent (59 million) by the US Census definition and 48.8 million by the USDA/ERS definition. In our work, we break down the definition of rural a step further to emphasize ‘frontier’ areas. Frontier appears to have a fairly consistent definition of areas with a population density of less than seven people per square mile.
FIGURE 1: One can easily see by looking at the map that the majority of the WICHE member states have vast areas with less than
seven people per square mile!
Historically, the majority of mental health service models, treatments, and policies were based on research conducted in urban settings. In all of our projects, we are well aware that the demographics, economics, and cultural values of rural America have a complex impact on mental health and mental health care. In our next issue, we will discuss why emphasizing rural/frontier areas is so important to the WICHE Mental Health Program by examining the three variables that may prevent rural Americans from receiving the mental health care they need.
Selected Highlights of Recent Staff Activities
Mimi McFaul and Jenny Shaw recently traveled to Washington, DC to attend the National Association of State Mental Health Program Directors Research Institute (NRI) annual meeting. NRI's annual conference provides one of the primary national forums where public mental health agency researchers can share their work with colleagues from other states. Immediately following this meeting, Chuck McGee and Jenny Shaw attended the Annual Meeting of the State Data Infrastructure Grantees (DIG). The members and grantees of DIG work with data and planning staff in each of the 55 states and territories and with CMHS to compile and generate reports on mental health performance measures. Chuck, along with Mariah Coe from Alaska, presented on the State of Alaska Behavioral Health Prevalence report, which is a result of an intense project that Chuck has worked on in Alaska.
http://www.nri-inc.org/conferences/index_nriconf.cfm
http://www.nri-inc.org/projects/SDICC/
WICHE MH Staff Writings and Publications
Mental Health and Rural America: 1994-2005:
An Overview and Annotated Bibliography
Edited By: Dennis F. Mohatt, M.A., Scott J. Adams, Psy.D.,
Mimi M. Bradley, Psy.D., and Chad D. Morris, Ph.D.
This important reference book presents a summary of the current knowledge base surrounding mental health issues in America’s rural and frontier areas, as a solid resource to assist with Federal, State, and local efforts to improve mental health and substance abuse policies and services. It highlights the environment of mental health in rural areas over three decades with hopes of being a valuable resource across the spectrum of rural mental health from the perspectives of local community planning to national policy development. The book includes annotations and a user’s guide to the annotated bibliography.
Copies may be requested via the HRSA Information Center website at: http://www.ask.hrsa.gov/detail.cfm?PubID=ORHP00369
Prepared under HRSA Contract #03H1163080D, U.S. Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy.
The Annapolis Coalition on the Behavioral Health Workforce is pleased to announce the release of An Action Plan for Behavioral Health Workforce Development. This is the culmination of a two-year effort of work to create a national strategic plan to strengthen the mental health and addictions workforce. More than 5,000 individuals were engaged in the planning process. The plan is available for download without charge at the Coalition’s website (www.annapoliscoalition.org). In addition to the full plan, an Executive Summary is also available. The plan was funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and can also be accessed through its website. Dennis Mohatt, M.A. and Mimi Bradley, Psy.D. authored Chapter 17, Rural Issues in the Behavioral Health Workforce.
WICHE MH Personnel
Dennis Mohatt, MA Mental Health Program Director
Scott Adams, Psy.D. Associate Program Director
Chuck McGee, MA Project Director
Mimi McFaul, Psy.D. Research Associate
Candice Tate, Ph.D. Research Associate
Fran Dong, Statistical Analyst
Jenny Shaw, Administrative & Project Coordinator
Jeanette Porter, Administrative Assistant
Tell Us How the WICHE Mental Health Program Has Impacted You
The Western Interstate Commission for Higher Education is seeking your comments on how our services have affected mental health services in rural communities. Please send an e-mail telling how WICHE has influenced you to ctate@wiche.edu. We would also love to hear your nominations for promising rural practices. Feel free to also contact us with requests for state-specific rural assistance or to just ask us a question about our experience with rural mental issues and public policy.
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