The University at Buffalo School of Nursing received a $1.5 million grant from the U.S. Health Resources and Services Administration for increased mental and behavioral health access in rural Western New York.


What You Need To Know

  • $1.5 million grant expands access to mental and behavioral health care in rural WNY 
  • About 60 percent of rural Americans live in a mental health professional desert
  • The grant incorporates substance use and mental health services at primary care providers to address stigma and other barriers to care in rural communities

Approximately 20 percent of the U.S. population lives in rural communities, but few mental and behavioral health professionals practice there — nearly 60 percent of rural Americans live in a mental health professional desert. 

The three-year grant will help integrated mental health and substance use treatment in two primary care practices in Wyoming County, Yu-Ping Chang, University at Buffalo associate dean for research and scholarship, said.

“One is pediatric primary care and the other is for adults, for older adults. It’s a perfect network, the grant that we received can provide these kinds of services across the lifespan and it’s not just focusing on one set of age,” she said.

This is the second time Chang secured this grant and she has learned that expanding care in rural communities comes with unique sets of challenges — including stigma and prejudice surrounding mental health and substance use conditions.

“In a rural area everybody knows everybody, so when you go to a behavioral health facility or a mental health facility you don’t want people to know you’re there to get help because people might talk about [you],” Chang said. “It’s actually really hard for people who want to get treatment, but are afraid of being recognized.”

In addition to stigma, access to mental and behavioral health services in rural communities can be challenging because of isolation, lack of transportation, and treatment options, according to the Substance Abuse and Mental Health Services Administration.

The program hopes to address these challenges by implementing a collaborative care model in these primary care practices by pay for a behavioral health specialist and supporting administrative changes.

“Having these kinds of services embedded in primary care where everybody goes, everyone one has a primary care provider, it makes people comfortable,” Chang said. “That’s from the patient’s perspective. From the provider’s perspective, it removes barriers.”

The University of Washington developed the collaborative care model to provide both medical and mental health care under one roof removing barriers to care by making it convenient for patients, reducing stigma and building on existing relationships between doctor and patient.

“Integrating behavioral health into primary care is so important to reduce the barriers and stigma associated with mental health and substance use treatment, especially in rural communities,” Chang said. “It is our goal that this project can become a replicable model for other rural communities throughout the country.”

Across Western New York, mental health services saw an increase in need during the COVID-19 pandemic — from overdoses to increases in hotline calls to Crisis Services, burdening the mental health care system, which has been underfunded for decades in the U.S.

"The increase in isolation has really caused difficulties for some of our high risk clients who really need that face to face support, that structure, and that routine," Holli Gass, clinical director at Spectrum Health and Human Services, said. "We have seen more individuals who have not been engaged in services before, start to receive mental health counseling due to increased anxiety or depression surrounding the effects of the pandemic."

Spectrum Health and Human Services implemented a new text line during the pandemic that is available in the county from 7-10 p.m., daily at 585-543-1015. 

The Wyoming County Mental Health Department did not have data about whether the COVID-19 pandemic increased the need for mental and substance use services in the area. 

“If you have those services integrated into primary care you take care of the whole person instead of, ‘I’m going to take care of your physical health here, for your mental health go somewhere else,’ ” Chang said.

For more of Spectrum News Buffalo’s coverage on mental and behavioral health care in rural communities, read about Harmonia Collaborative Care partnership with the JC Seneca Foundation