WICHE Mental Health Program Publications
This report covers the work done between July 1, 2018–June 30, 2019 by the WICHE Behavioral Health Program.
"The past year has seen significant positive change and program growth. Our Oversight Council voted unanimously, in November, to change our name from the Mental Health to the Behavioral Health Program. After 65 years, the change reflected our growing work across the spectrum of mental health, substance use, addiction, and integration with primary care. "
—Introduction excerpt, from WICHE Behavioral Health LeadershipPages: 20 ~ Media Type: PDF ~ File Size: 14,962 KB
In the six-plus decades since the Western Interstate Commission for Higher Education established its Mental Health Program (MHP) in 1955, we have striven to improve the quality of behavioral healthcare throughout the West. Though some may ponder why a higher education organization focuses on behavioral health, the answer is very simple: A healthy mind is essential to learning and success across the entirety of our lifecycles.
Our efforts support improvements in care and help build and sustain a quality behavioral health workforce. Like other programs in WICHE’s broad and deep portfolio of work, we accomplish this by promoting innovation, cooperation, resource-sharing, and sound public policy. The WICHE MHP extends the capabilities of our partners, whom we support through technical assistance, research and evaluation, and professional development. The WICHE MHP seeks to add value through collaboration.
Our dedicated staff have been busy in 2017–18. This annual report provides you with a snapshot of our efforts across the West.Pages: 16 ~ Media Type: PDF ~ File Size: 1,820 KB
The WICHE Mental Health Program’s mission is very simple, focusing on improving services and building a qualified workforce responsive to, and informed by, persons with behavioral health challenges and their families. In the past sixty years much has changed, but our mission has remained consistent. Our job is to support our member states and territories in a manner that extends capacities and informs action.Pages: 16 ~ Media Type: PDF ~ File Size: 17,118 KB
This study examines funding for public behavioral health services in Colorado. A key focus of the study is funding provided by the Colorado Office of Behavioral Health (OBH) for indigent (non-Medicaid) individuals. The study reviews the state systems for providing public behavioral health services, including the funding allocation and reimbursement methodologies utilized by the Colorado Department of Health Care Policy and Financing (HCPF), OBH, and behavioral health service providers. Funding is analyzed in the context of the impacts of Medicaid expansion and the Affordable Care Act. An in-depth examination of the clinical characteristics of the OBH indigent populations is provided in an attempt to identify any unique or distinct needs of the indigent population in an effort to inform the allocation of state funds for this population.Pages: 193 ~ Media Type: PDF ~ File Size: 4,589 KB
In February of 2014, the Colorado Department of Human Services’s (CDHS) Office of Behavioral Health (OBH) released a request for proposals (RFP) to conduct a study of existing behavioral health resources in the state of Colorado and to project future needs. The intent of the study was to identify and assess existing state and community resources and to recommend strategic future planning, taking into account the many constituent variables associated with the changing behavioral health care system. The Western Interstate Commission for Higher Education Mental Health Program (WICHE MHP), in partnership with the National Association of State Mental Health Program Directors Research Institute (NRI) and Advocates for Human Potential (AHP), formed a team of Colorado and national behavioral health experts to complete this study for OBH. The Colorado OBH Needs Analysis: Current Status, Strategic Positioning, and Future Planning study began in August 2014 and concluded with the final report submission in April 2015. During this time, the project team worked on the 17 specific tasks that were part of the study.Pages: 719 ~ Media Type: PDF ~ File Size: 19,237 KB
The term “outcome evaluation” has become one of the most popular terms among human service providers and those whose jobs it is to evaluate the impact of human service programs. State and federal legislators, state and federal officials, and private accrediting organizations rarely finish a day without bemoaning the lack of appropriate outcome evaluation data. Almost everyone in the human service field would agree that there is not sufficient information about whether or not most human service programs are doing what they are supposed to be doing. Hard copies are available for purchase by Clicking Here.Pages: 96 ~ Media Type: PDF ~ File Size: 2,260 KB
The Colorado Health Foundation and the WICHE Mental Health Program joined forces to produce The Behavioral Healthcare Workforce In Colorado: A Status Report 2010. The report details current behavioral healthcare workforce issues in Colorado and discusses how to capitalize on the existing energy and expertise in the state to develop a more coordinated and focused effort to enhance Colorado’s behavioral healthcare workforcePages: 67 ~ Media Type: PDF ~ File Size: 2.94 MB
The most recent data from the National Comorbidity Study Replication (NCS-R) indicate that rural individuals with MH problems are significantly less likely to receive any MH care for their disorder than individuals in urban and suburban areas. The NCS-R also reports that of those patients who do receive mental health care, rural patients are significantly more likely to receive general medical care only and significantly less likely to receive specialty mental health care. Because patients receiving care in the specialty mental health sector are substantially more likely to receive adequate care (45.4%) than patients receiving care in the general medical sector only (12.7%), this indicates that rural individuals are receiving poorer quality care. Reduced access to MH care in rural areas are undoubtedly due to an inadequate supply of MH specialists. Additionally, primary care (PC) providers, who provide the vast majority of MH care to persons living in rural areas, do not have the training necessary to provide evidence based psychotherapy, thus eliminating one of the primary treatment modalities for people with MH problems. The lack of MH specialists in rural areas is likely due to inadequate incentives for these specialists to practice in rural areas. Furthermore, previous research has shown that health plans are more likely to rely on demand side cost containment strategies for rural enrollees than supply side strategies. This may result in rural residents paying more out-of-pocket for mental health services. Additionally, the source of funding for MH services may differ depending on the type of mental illness.Pages: 21 ~ Media Type: PDF ~ File Size: 129 KB
The Comparison Tool is an aid for reviewing curricula or other competency sets to determine the extent to which they cover the Alaskan Core Competencies for Direct Care Workers in Health & Human Services. Based on the comparisons, those curricula or competencies can then be updated to incorporate the core competencies.Pages: 8 ~ Media Type: PDF ~ File Size: 175 KB
The Colorado Population in Need (COPIN) 2009 generated indicators of unmet need and penetration rates for behavioral health services for low income Coloradans with serious behavioral health disorders (SBHD). SBHD includes children and adolescents with serious emotional disturbance (SED), and adults with serious mental illness (SMI), substance use disorders (SUD), and co-occurring disorders (SUD and SMI). Children and adolescents with co-occurring disorders are included with SED. “Unmet need” is defined as the estimated number of individuals who have a SBHD minus the number of individuals who have accessed services. The difference represents those who “need” but have not accessed any type of behavioral health service. Penetration rates are calculated by dividing by the number of individuals utilizing behavioral health services by the number of individuals with a SBHD. This represents the percent of the population in need who have received services and conversely the percent who have not received services. These indictors provide standardized data that may be used to inform policy planning decisions.Pages: 72 ~ Media Type: PDF ~ File Size: 1,357 KB
The purpose of this research is to examine possible differences in the prescription of psychotropic medications to youths in rural and urban areas. Multiple studies have indicated a dramatic increase in the number of youth being prescribed psychotropic medication over the past 15 to 20 years. For instance, data indicate that the overall annual rate of psychotropic medication use by children increased from 1.4 per 100 persons in 1987 to 3.9 in 1996, with significant increases found in the use rates of stimulants, antidepressants, other psychotropic medications, and polypharmacy of different classes of psychotropic medications. In a later study, rates of visits by youth resulting in a psychotropic prescription increased from 3.4 percent in 1994-1995 to 8.3 percent in 2000-2001, with annual growth rates rapidly accelerating after 1999. These trends were evident for males and females, and also significant across drug classes. Additionally, there appears to be an increase in the percent of visits by youth to outpatient clinics and emergency rooms that include prescriptions for psychotropic medications. Similar trends have been found in other countries.Pages: 15 ~ Media Type: PDF ~ File Size: 165 kb
This working paper assesses the association between rurality and depression care.Pages: 21 ~ Media Type: PDF ~ File Size: 128 KB
Depression and suicide are especially relevant today in rural areas because of rapid expansion of the aging population in U.S. rural areas, and the fact that persons 65+ have led in suicide rates since 1970. Rural areas have a higher share of aging residents, with more health problems, and more limited access to health services than urban areas. Additionally, DHHS reports indicate that approximately 20% of U.S. residents aged 55+ have a mental disorder, including depression, which has been shown to be highly related to suicide attempts and completions. Accordingly, the increasing prevalence of older residents in rural areas makes these areas prime candidates for training in suicide-prevention interventions that could be extremely helpful to the principal health care resources in such rural areas – namely, primary health caregivers.Pages: 34 ~ Media Type: PDF ~ File Size: 427 KB
This paper assesses the needs of rural primary care providers for trraining on mental health issues.Pages: 25 ~ Media Type: PDF ~ File Size: 204 KB
The purpose of this project was to develop effective distance learning methods to train rural PCPs in integrated care models for depression using computer based training (“E-Learning”) and materials adapted from the MacArthur Initiative on Depression & Primary Care. Rural was generally defined as a county with a population less than 50,000 people.Pages: 10 ~ Media Type: PDF ~ File Size: 122 KB
This article, published in the Chronicle for Higher Education, discusses colleges' need for a new approach to serving students with mental-health problems, whose numbers are likely to rise as a result of the economic crisis.Pages: 3 ~ Media Type: PDF ~ File Size:
This brief assesses the association between rurality and the use, type (pharmacotherapy versus psychotherapy), and quality of care among individuals in the Medical Expenditure Panel Survey with self-reported depression.Pages: 2 ~ Media Type: PDF ~ File Size: 92 KB
This paper assesses the association between rural residence and the use, type, and quality of depression carePages: 24 ~ Media Type: PDF ~ File Size: 96 KB
From the WICHE Center for Rural Mental Health Research, this study investigates whether two of the multiple stakeholder groups (health plans and employer purchasers) in two delivery systems (rural and urban) economically benefit from improved depression treatment by testing whether depression care management results in: (1) a greater reduction of utilization costs in insured rural patients than their urban counterparts (health plan stakeholders), and (2) a greater reduction in work costs in employed urban patients than their rural counterparts (employer purchaser stakeholders).Pages: 21 ~ Media Type: PDF ~ File Size: 84 KB
From the WICHE Center for Rural Mental Health Research, this policy brief summarizes nationally representative data on community-level risk factors associated with schizophrenia hospitalizations. It examines how socio-economic factors and the makeup of local health care systems affect the rate of schizophrenia hospitalizations. It identifies geographic areas with elevated rates. It also presents a discussion about the findings. It should be of interest to government and private health plan administrators, as well as those responsible for designing mental health delivery systems – anyone interested in creating outpatient treatment programs that may prevent costly hospitalizations.Pages: 2 ~ Media Type: PDF ~ File Size: 88 KB
From the WICHE Center for Rural Mental Health Research, this study examines whether depressed rural primary care patients are more likely than urban patients to be hospitalized; it investigates whether differences in hospitalization rates can be explained by differences in the utilization of specialty outpatient care; and it looks at whether rural patients face more “insurance barriers” to outpatient care. This study should be of interest to policy makers and administrators seeking to develop better delivery systems for rural mental health services. It should also be of interest to insurers, self-insured employers and other payers seeking the most effective use of health care expenditures.Pages: 2 ~ Media Type: PDF ~ File Size: 100 KB
This document was produced in response to the pressing mental health needs of an underserved population. It describes the current status of deafness and hearing loss in America, the prevalence of mental health issues in deaf populations, and an overview of the behavioral health workforce as it pertains to both rural and deaf/hard of hearing populations.Pages: 38 ~ Media Type: PDF ~ File Size: 321 KB
From the WICHE Center for Rural Mental Health Research, this study is the first to identify community-level risk factors for depression hospitalizations in urban and rural counties. It also identifies rural and urban areas with elevated hospitalization rates, which should be of interest to government officials, health plans and self-insured employers/payers seeking to control costs by preventing unnecessary hospitalizations.Pages: 21 ~ Media Type: PDF ~ File Size: 334 KB
From the WICHE Center for Rural Mental Health Research, this study explores whether enhanced depression care has comparable impact on clinical outcomes over two years for patients treated in rural and urban primary care practices and whether differences are mediated by receiving evidence-based care (pharmacotherapy and specialty care counseling).Pages: 14 ~ Media Type: PDF ~ File Size: 84 KB