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Removing barriers to rural mental health care

Though mental health issues are certainly not exclusive to those living and working in rural communities, the barriers to receiving care for those needs are definitely higher for rural residents than their urban counterparts.

In "Mental Health: Overlooked and Disregarded in Rural America," published by the Center for Rural Affairs in May 2009, the barriers to mental health services in rural areas were said to "revolve around issues of availability and accessibility."

In many rural communities, the study says, such services are simply not available. "In fact," it continues, "more than 85 percent of the 1,669 federally designated mental health professional shortage areas are rural."

But in Detroit Lakes and surrounding communities, a group of mental health care providers has banded together in an attempt to improve that situation, both for the providers and recipients of their services.

Since it was first formed in 2002, the Minnesota Consortium for Advanced Rural Psychology Training (MCARPT) has been working to provide opportunities for psychologists to learn the many facets involved in practicing their craft in a rural setting.

Headquartered in Detroit Lakes, MCARPT "is an innovative project designed to reduce the shortage of psychologists practicing in rural communities, due to poor retention of mental health professionals in underserved parts of the state and to enhance access for rural residents to quality mental health services in their own communities," according to information found on its website,

Both of these goals have been met, according to Dr. Jeff Leichter, who serves as MCARPT's clinical director.

"Everyone who has graduated (from the MCARPT program) so far has stayed in a rural community -- and all of them except one are (practicing) in rural Minnesota," Leichter said, adding that the eighth graduate is now in Devils Lake, N.D.

A total of eight psychologists have graduated from the MCARPT program since 2006 -- and two of them, Dr. Brian Gatheridge and Dr. Jon Aligada, are currently living and working in Detroit Lakes.

Gatheridge joined Leichter on the staff of Sanford Health's Behavioral Health Services department, while Aligada works for Essentia Health-St. Mary's.

Both Sanford and Essentia Health-St. Mary's are partners in the MCARPT program, which serves a tri-county region of northwest Minnesota including Becker, Otter Tail and Mahnomen counties, and encompasses the White Earth Indian Reservation as well.

Though the MCARPT training program always consists of a one-year, 2,000-hour post-doctoral fellowship in rural psychology, the agencies and programs served by each crop of trainees varies slightly from year to year, Leichter noted.

"It varies for a number of reasons," he said, citing a lack of office space and supervisor availability (all trainees must be supervised at each host site) as two of the main factors.

Sites served by this year's trainees include the Waubun-Ogema-White Earth School District; Lakeland Mental Health; Becker County Human Services; White Earth Indian Health Services; the White Earth Reservation Tribal D.O.V.E. (Down on Violence Everyday) Program; Lakes Crisis & Resource Center; Essentia Health-St. Mary's Oak Crossing; and the Native Alive Research Project.

The MCARPT trainees do more than just research, Leichter added; most of the work they do involves direct, one-on-one interaction with patients.

"As of Sept. 30, 2010, we have offered 10,673 hours of services to the community," Leichter said.

Those services encompass everything from intake evaluations and psychological assessments to individual and group therapy, consultation and community interventions.

"Ninety-five percent of the services we offer have been at no charge to the consumer," Leichter added, noting that most of the participating agencies are legally unable to bill patients for the services of MCARPT trainees.

Considering that the going rate for psychology services in the lakes area is an average of $175 per hour, that means MCARPT has contributed approximately $1.87 million in free services to the community over the last four full training years.

Many of those patients served through MCARPT, Leichter added, are those who would be otherwise unable to afford the services of a psychologist.

"This puts mental health services within the reach of people who would otherwise not be able to access them, because they are uninsured or under-insured," he explained.

"It's a win-win for everyone -- consumers are able to access quality mental health services, and trainees benefit because they get excellent clinical experience to prepare them for working in rural communities."

Though Leichter serves as the clinical director, and Cyndi Anderson as its executive director, MCARPT is also governed by a board of directors that includes Don Janes of Becker County Human Services; Monte Fox, director of health services for the White Earth tribe; Dr. Donald Preussler, Leichter's colleague at Sanford Health; and Sue Sailer, director of social services for the Perham Memorial Hospital.

MCARPT received a grant to develop its training program in 2004, through the Minnesota Department of Health's Office of Rural Health and Primary Care, and continues to receive some grant dollars each year. But grant money only funds a portion of the cost, Leichter noted.

"We are funded by a combination of grant money and community donations," he said.

For more information about MCARPT, or to make a donation, contact executive director Cyndi Anderson at 218-844-6980.

Vicki Gerdes

Staff writer at Detroit Lakes Newspapers for the past 16 years, currently editor of the entertainment and community pages as well as covering city council and the Lake Park-Audubon School Board. Living in DL with my cat, Smokey.

(218) 844-1454