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Building provider capacity and shifting the culture of mental health in the Great Lakes Bay Region

by | Jan 18, 2021 | Uncategorized

THRIVE Partner Spotlight  
The THRIVE Partner Spotlight is a monthly editorial series that highlights efforts being made to advance the health and wellbeing of residents within central Michigan. Through the dedication and commitment of our many valued partners, we are working to create a community where people thrive.

The region gained 112 mental health providers from 2018 to 2019 in an effort to address a mental health provider shortage, with gains seen across four counties and all provider types.

An objective of THRIVE is to increase access to mental health providers in the region, growing the number of resources.

In order to rank in the top ten percent of communities for mental health resources, a community needs to have a ratio of one provider to every 330 residents.

In 2018, the Great Lakes Bay Region Mental Health Partnership identified a gap in the number of providers (including psychiatrists, psychologists, social workers, certified mental health counselors, psychiatric nurse practitioners, substance counselors, etc) using County Health Rankings data.

Based on annual data from county health rankings, the region has seen a significant increase in the number of mental health providers across all licenses from 2018 to 2019, for a total increase of 112 health providers in just one year. Progress was recorded throughout the region, with each county showing individual gains compared to 2018. Data for 2020 is expected by April 2021.

 

In 2018, a gap of 311 providers was identified.

“We’ve seen some really remarkable gains in mental health providers in just one year since the need was identified by the Great Lakes Bay Region Mental Health Partnership,” says Dr. Matt Samocki, portfolio director for THRIVE and steering team member of the Great Lakes Bay Mental Health Partnership. “It was great to see increases across all provider types and all four counties, a comprehensive step forward for mental health resources in the Great Lakes Bay Region. We still have a lot of work to do, but the initial trends have been very positive.”

Beyond just the numbers, a component is also making a culture shift in prioritizing mental health in the region.

“These are proactive efforts that are contributing significantly towards shifting the culture around mental health in our region,” says Samocki. “We are working with our partners to reduce mental health stigma and increasing the focus of employee wellness programs and services.”

In 2019, the gap narrowed to 199 providers.

Building our local mental health workforce

Several institutions have focused on adding licenses and study programs for current students and postgraduate study, particularly Saginaw Valley State University and Central Michigan University’s College of Medicine.

In May 2019, SVSU started a post-graduate Psychiatric Mental Health Nurse Practitioner (PMHNP) certificate program for nurse practitioners looking to extend their awareness and education in behavioral health.

The program is four semesters in length and graduates are eligible to sit for the PMHNP national certification exam.

“Our first cohort of 13 graduated in August of 2020 from the program, with six graduates taking and passing the exam so far,” says Dr. Kathleen Schachman, H.R. Wickes Endowed Chair of Nursing and PMHNP Coordinator.

The second cohort of the program nearly tripled in size at 38 students who will graduate in August 2021 and SVSU is in the process of completing admissions for their third cohort for August 2022 completion.

“Two of the unique things about our program is we have a specific focus on rural mental health, looking at differences within rural communities and their access to behavioral healthcare, and also taking into account addressing the stigma of behavioral healthcare within rural communities,” says Schachman. “The second aspect is our clinical focus on addictions. We have an entire semester dedicated to teaching students more about treating addictions, and they also complete their Buprenorphine Waiver Training, so by the time they graduate, they are able to provide medication for addiction treatment.”

     Dr. Kathleen Schachman

The current program is supported in part by an Advanced Nursing Education Workforce (ANEW) Grant from the Health Resources and Services Administration (HRSA). The grant runs for four years and covers about half of tuition and fees for eligible students, making it a substantial contribution to continuing education. To meet eligibility requirements for grant funding, students have to be either living or working in a rural setting or have been raised in a rural community.

The program is one of only two or three other programs in the U.S. that also have a focus on addiction and the only one that has a dual focus on the rural and addiction components of behavioral health.

“The grant funding has certainly driven additional interest for our second year of the program, but beyond the four years of the grant timeline, we see this program continuing to grow,” says Schachman. “About half of our students now receive grant support, but behavioral health is where we are seeing the most growth in our nursing program. There is tremendous interest, even without the grant stipend, as nurses are recognizing this is a tremendously important skillset to have.”

“We expect the demand in this program to be quite high, even once the grant funds run out,” says Schachman. “So, we are looking at options of expanding the program and possibly making it a doctoral program for nurse practitioners who are interested in pursuing their doctoral degrees.”

Gains in mental health resources have been made across all four regions and among all providers.

Central Michigan University has taken steps to expand their education pipeline across disciplines to help address this need as well. For health, CMU has shifted the psychiatry residency in recent years to a community-based program, where residents and students work in Federally Qualified Health Centers (FQHCs) and a broad spectrum of other community-based organizations with a focus on underserved populations.

As the accredited program has grown over the last five years, CMU has doubled the number of residents per year, thanks in part to collaborative efforts with Ascension St. Mary, Covenant Healthcare and HealthSource in Saginaw.

The shift and additional provider capacity has helped address the dire need for mental health services in the region and state.

“It has been an honor to help impact the way we look at mental health in the region and increase the number of providers. Looking at the nature and makeup of our emotional and behavioral states is complex” says Dr. Furhut Janssen, director, Psychiatry Residency Program and assistant professor, Psychiatry CMU College of Medicine . “Through this work, we have been able to participate in initiatives in the region to help increase access, increase quality of care, and help develop innovative models for the future.”

Mental health at work

The need for awareness and resources is one that Fisher Contracting Company has championed as part of a pilot program that started in 2019. “Mental health was always one of those things we knew was important, but

 

Dr. Furhut Janssen

there weren’t outward and easily-accessible resources to help our employees,” says J.W. Fisher, president of Fisher Contracting. “Then it really hit home in 2018 when we tragically lost an employee to suicide. Since then, I’ve made it my mission that all of our employees have easy and affordable access to care.”

That effort has led to scaling their Workplace Mental Health Program to companies across the Great Lakes Bay Region, so that it is easier for people to identify and connect with quality mental health resources and providers through their workplace health plans.

Through Fisher Contracting’s pilot program in 2019, which covered the organization’s more than 200 employees, the program has been expanded to all of the Fisher Companies. Employees and their families now have mental health coverage equal to their medical coverage. Fisher’s Employee Assistance Plan (EAP) provides each family with five free visits to mental health providers, and after that insurance is billed after a $30 copay.

Through the effort, now more than 700 people have access to affordable mental health providers. The company’s next step is to implement a training in 2021 for supervisors created by Dr. Ann Date of Partners in Change in Midland, that was previously put on hold due to social distancing. The company expanded the program to Fisher’s Southern Division union employees with approximately 100 additional union employees covered. Fisher plans to help scale the program as a model for other employers throughout the region in the years to come.

“The program has been hugely successful with our employees and their families,” says J.W. Fisher. “But beyond that, it has brought about a culture shift within our compnay, where it is ok to ask for help when you need it.”

 

 J.W. Fisher

For more information about statistics and progress on mental health providers in the broader Great Lakes Bay Region, see the dashboard here.