Protecting the mind and body of rural America
A Publication of the APA Practice Directorate
Vol. 3, No. 1, Spring 1996
Rural Health Bulletin





Table of Contents

  • Rural Women's Work Group Meets
  • Rural Task Force Continues Its Work
  • A Perspective from CAPP
  • Rural Women's Group Lists Strategic Plan
  • APA, National Rural Health Work in Cooperation
  • A Step into Virtual Reality
  • Rural Health Task Force Conducts Interdisciplinary Training in Collaboration
  • RICHS Provides Rural Information


  • RURAL WOMEN'S WORK GROUP MEETS

    by Mary Beth Kenkel, Ph.D.,
    Chair Rural Women's Work Group

    The Rural Women's Work Group, a subgroup of the APA Rural Health Task Force, met on March 23 and 24, 1996 and made substantial progress in accomplishing two projects to address the needs of women in rural America. The group is composed of eight psychologists from a. variety of ethnic and professional backgrounds. The projects have been driven by a number of findings that were uncovered by the work group in the course of their work including the following:

    At their meeting the work group adopted plans to move forward with a project to address the problem of domestic violence amongst rural populations. This project will utilize a successful model of 'Community Readiness' developed at the Triethnic Center at Colorado State University to devise community solutions for the problem of domestic violence. The group has developed a concept that will be applied to a number of communities in rural West Virginia. The research project will examine the effectiveness of a variety of community solutions to the problems created by domestic violence.

    In addition to the domestic violence project, the Rural Women's Work Group made significant progress in their efforts to develop a major journal article and report on the behavioral health care needs of rural women. The topics to be examined in the article/report on rural women's behavioral health needs include:

    The structure for the article will include, for each topic(where applicable), the incidence/prevalence, the limitations of the data, the unique rural manifestations, ethnic, regional, lifestyle manifestations, and causes and contributing factors. It is expected that the piece will contain a research agenda and a number of policy recommendations that will lead to improved behavioral health care for rural women.


    RURAL TASK FORCE CONTINUES ITS WORK

    by Michael F. Enright
    Chairman, Rural Health Task Force

    The winter meeting of the American Psychological Association's Rural Health Task Force took up the task of continued promotion of access to psychological and behavioral health care for rural and frontier citizens in this time of rapidly changing health care delivery systems.

    The Task Force hosted several important federal agency representatives, including Jeffrey Human, Director of the Office of Rural Health, Policy, Human Resource and Services Administration, and Kathryn N. Magruder, Ph.D., Director, Office of Rural Mental Health Research, National Institute of Mental Health. These officials met with the task force to discuss plans for a potential rural mental health services research conference in the coming year.

    Jennifer Rapp, Government Affairs Director of the National Rural Health Association, presented ideas for collaboration in the delivery of mental health services between psychologists and primary care providers. The development of interdisciplinary teams and training for multi-skilled health care professionals to work in rural areas in this time of shrinking financial and human resources was addressed with the idea of creating new and innovative strategies to meet these existing and growing needs.

    The Task Force continues to be committed to the goal of providing highly trained behavioral health specialists to meet the needs of citizens living in mental health shortage areas across rural and frontier America. Further, the group seeks to propose strategies to assist the American Psychological Association in assessing existing conditions better and preparing training programs to assist students to develop skills for the 21st Century.


    A PERSPECTIVE FROM CAPP

    by Elsie Go Lu, Ph.D.

    I attended the Rural Health Task Force meeting on December 10, 1995 as a member of the Committee for the Advancement of Professional Practice whose 'portfolio' includes rural health issues. The Task Force was originally authorized and funded by the APA Board of Directors and has been administered and resourced by the Practice Directorate with support from CAPP. For the past two years I have followed the work of the Rural Initiative. CAPP recognizes the number of psychologists who practice in rural settings, who conduct research, and provide training for a new generation of rural psychologists. There continues to be a growing need for psychologists to practice in rural settings, especially as the health care system changes. Organized delivery systems for health care in rural settings may be implemented differently in rural than in urban settings, This is recognized by members of the Task Force and will be an agenda item for further deliberation.

    In its four years, the Rural Health Task Force has accomplished numerous innovative projects and, for many of these projects, has obtained outside funding. Among these are:

    CAPP views the activities of the Rural Health Task Force as critical for the development of practice in rural settings and has included continuation of the Task Force meetings in the 1996 budget.


    RURAL WOMEN'S GROUP LISTS STRATEGIC PLAN

    The Rural Women's Work Group continues to make progress on its 1995 Strategic Plan that is designed to address common problems that rural women encounter.

    General goals for the group this year are:

    The initial tasks of the group will be to:


    APA, NATIONAL RURAL HEALTH WORK IN COOPERATION

    by Jennifer Rapp
    NRHA Government Affairs Director

    I am the newly appointed Director of Government Affairs for the National Rural Health Association (NRHA) in Washington, D.C. Headquartered in Kansas City, MO, the NRHA is a membership organization whose mission is to improve the health of rural Americans and to provide leadership on rural health issues through advocacy, communications, education, and research.

    It is very clear that rural areas are unique. They differ from urban areas in geography, population mix and density, economics, lifestyle, values, and social organization. Rural residents and communities require programs that respond to their unique characteristics and needs.

    A major component of rural health is behavioral health. Mental health, substance abuse, and the behavioral etiology of the principal chronic diseases all have the potential for seriously influencing rural populations. It is crucial that resources to prevent, diagnose, and treat those conditions are part of the rural health delivery system.

    The NRHA is pleased to have the American Psychological Association as one of its organizational members. By working with its own members and other organizations such as the APA, the NRHA builds coalitions of concerned people to address rural health issues and develop and promote effective solutions applicable at national, state, and local levels. I look forward to working with the staff of the APA Office of Rural Health, the APA Rural Health Task Force, and interested APA members in advancing the physical and behavioral health of rural Americans.


    A STEP INTO VIRTUAL REALITY

    by Sally Olsen
    University of South Dakota

    'There is not one way to do things in a rural area. Rural contexts are distinct and we need to understand them to succeed.' This point was driven home by Scotty Hargrove, Ph.D., the keynote speaker for the annual conference of the South Dakota Psychological Association held recently in Sioux Falls. Hargrove, chairperson of the Department of Psychology at the University of Mississippi in Oxford, serves on the Rural Health Task Force of the American Psychological Association. He challenged the participants of the conference to pay close attention to the reality that rural communities are changing, and that rural psychology will need to keep up with those changes.

    The advent of mass communication and transportation has caused rural and urban areas to merge on certain levels. Many rural communities are moving towards diversification of their economies in order to survive. Poverty is still high, the rural population is aging, the labor market is decreasing and doctoral-level professionals are not going into rural areas to practice. This raises the question of who will provide the services needed by rural people who are finding their environment in a state of flux.

    Hargrove outlined the challenges that face the field of psychology in the areas of research, teaching, and application. He sees the public sector becoming the significant provider of mental health care. Psychologists will need to broaden their areas of expertise and forsake exclusionary practices. New relationships will develop, and it will be necessary to collaborate with other professionals with mutual respect. Consumers will become colleagues and psychologists will be forced to consider the potential ethical issues that arise out of the new relationships.

    In closing, he reminded the group that psychological problems happen in a context, and it is our job as professionals in the delivery of mental health services to be cognizant of the changing contexts of rural environments.

    (Ms. Olsen is a graduate student in clinical psychology at the University of South Dakota. She lives with her husband on their farm outside of Viborg, SD, and is interested in clinical work with adolescents. This article is reprinted from the South Dakota Psychologist.)


    RURAL HEALTH TASK FORCE CONDUCTS INTERDISCIPLINARY TRAINING IN COLLABORATION

    The Rural Health Task Force of the American Psychological Association has completed two of three rural interdisciplinary training sessions involving psychologists, social workers, nurses, and physicians.

    The first session was held December 2-3, 1995 at the APA Building in Washington. The second was held January 27-28, 1996 in Kansas City, MO.

    The program brings in 10 representatives of the health professions to provide specialized training for these persons to return to their communities and train local professionals in interdisciplinary collaboration. Participants are expected to conduct similar sessions in their local communities. They are designed to increase the amount and effectiveness of collaborative work between health and mental health disciplines.

    Faculty members of the project include Michael F. Enright of Jackson, WY. William Farley of the University of Utah School of Social Work, Ted Packard of the University of Utah Department of Educational Psychology, Sandra Talley of the University of Utah School of Nursing, and Scotty Hargrove of the Department of Psychology at the University of Mississippi.

    Participants are assigned to interdisciplinary groups to work out service problems to gain greater knowledge of the processes of collaboration in health care settings. The sessions are completed in a day and a half.

    The project is funded by the Bureau of Health Professions.

    The final training sessions will be conducted in May in Salt Lake City, UT.


    RICHS PROVIDES RURAL INFORMATION

    RICHS (Rural Information Center Health Service) is the specialty arm of the Rural Information Center that provides a database and search service for persons interested in rural health and mental health.

    A joint project between the Office of Rural Health Policy of DHHS and the National Agricultural Library of the United States Department of Agriculture, it may be accessed in several ways. By telephone, RICHS may be reached at 1 800-633-7701. Mail address is Rural Information Center Health Service, National Agricultural Library, Room 304, 10301 Baltimore Blvd., Beltsville, MD 20705-2351. Email address is ric@nalusda.gov.


    Rural Health Bulletin is published twice a year by the Practice Directorate of the American Psychological Association.

    Russ Newman, Ph.D., J.D.
    Executive Director for Professional Practice

    Gil Hill 202.336.5857
    Director, Office of Rural Health

    Scotty Hargrove, Ph.D.
    Editor, Rural Health Bulletin

    APA Practice Directorate
    Main Phone: 202.336.5800
    Fax: 202.336.5797

    Persons interested in submitting articles to the Rural Health Bulletin should contact: Scotty Hargrove, 601.232.7383.
    E-mail: pydsh@teclink.net

    Office of Rural Health
    American Psychological Association
    Practice Directorate
    750 First Street, NE
    Washington, D.C. 20002-4242




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