Based on the Colorado Health Institute's 2008 RN Survey, approximately 14 percent of the Colorado RN workforce was employed in a rural area for their primary nursing position in 2008. There were no discernable differences in the demographic characteristics of RNs based on where in the state they were employed. Differences were found in the basic RN training between rural and urban practicing RNs—those practicing in rural areas were significantly more likely to have an associate degree (45%) as their basic RN educational preparation than RNs residing in an urban community (31%). More than half of RNs working in an urban area had a baccalaureate degree, compared to 40 percent of their rural counterparts.
There are 64 counties in the state, ranging in size from 34 square miles (Broomfield) to 4,773 square miles (Las Animas), and in population from 551 (San Juan) to 596,582 (Denver). Forty-seven counties are designated as either rural or frontier; 17 are considered urban. Colorado has a diverse population with striking differences from county to county. For example, approximately 10.9 percent of Coloradans live in poverty, but this percentage differs dramatically across the state, from a low of 2.9 percent in Douglas County to a high of 31.3 percent in Crowley County. These statistics demonstrate the geographic and population diversity in the state and illustrate some of the inherent difficulties in providing high quality, equitable public health services to every Coloradan. (CDPHE 2009 Annual Report).
We find that training programs do not explicitly identify rural practice as a target for their
curricula, but that the curriculum content of these programs is appropriate preparation for rural
practice. More specifically, many programs focus on outreach to those with poor access to
mental health services, which we believe is a key to effective rural practice. Unlike other mental
health professions, without a background in advanced physical assessment skills, the APPN is
equipped to provide a full range of services to clients, combining psychiatric assessment skills
with primary care and medication management.
Concern in Montana has grown over the ability of the
healthcare workforce to keep up with demand, especially
given the aging of the baby boom population. According
to the 2004 American Community Survey, Montana
already ranks tenth in the nation in the percentage of the
population over 65. Th is is an issue that has not escaped the
attention of policymakers.
As nurses rise through the public health ranks, they are bringing the knowledge and experience they have acquired in the field back to the policy table with tangible results. Across the country, they are crafting and implementing innovative strategies to advance the health of the public.
In largely rural states, such as Alaska, there have been historical difficulties in recruiting and retaining an effective behavioral health workforce. Additionally, the recent report of the Presidentâ€™s New Freedom Commission on Mental Health described in detail the significant problems facing mental or behavioral health systems throughout the country, particularly in rural areas. These include critical gaps in accessibility to services, critical shortages in the availability of providers and programs, impaired acceptability of care due to urban-based models and strategies, and establishing mental health policy without consideration of its rural impact.
PURPOSE AND METHODS
Rural communities suffer disproportionately from a shortage of mental health professionals. As of September 1999, 87 percent of the designated Mental Health Professional Shortage Areas in the United States were located in non-metropolitan counties. These areas are home to over half of the countryâ€™s non-metropolitan population. Variations in the supply of mental health professionals may be a key factor in explaining differences in access to and use of mental health services in rural versus urban areas. This paper reviews efforts to address mental health workforce needs in underserved rural areas and seeks to answer the following questions
â€¢ How is health and mental health workforce adequacy currently measured?
â€¢ How do unique characteristics of rural communities and the mental health service delivery system challenge current methods for determining workforce adequacy?
â€¢ What role has the federal government played in addressing health and mental health workforce needs in underserved rural areas?
In obtaining information, we relied on a review of the relevant literature, an analysis of federal regulations and data, and interviews with experts on mental health workforce and rural mental health issues.
No date available
Foundation Center is a good source of information on foundations. The Foundation
Center's mission is to support and improve institutional
philanthropy by promoting public understanding of the field and
helping grant seekers succeed. For more information see: Foundation Center.
June 1, 2008
The vision for Virginiaâ€Ÿs revised SRHP (referre