ISU Psychology and Community Partners Forge Stronger Mental Health Care in Southeast Idaho

Over the course of four years, and in collaboration with some outstanding community partners, Idaho State University trained 23 clinical psychology doctoral students in interdisciplinary evidence-based care for rural Idahoans...

The project was funded through the Idaho Rural Interdisciplinary Health Collaborative (IRIHC), which was a $1.1 million community-based learning collaborative project funded by the Health Resources and Services Administration that ended in Summer 2023. 

Dr. Steve Lawyer, Professor of Psychology and Director of Clinical Training at ISU served as Director of the IRIHC. Dr. Samuel Peer, also a Professor of Psychology, served as Co-Director of the IRIHC.

Lawyer says that this program has been very important to the psychology students, the community, and community partners in benefiting mental health care and outcomes in Southeast Idaho rural communities.

“ISU offers the only PhD program in Clinical Psychology in the state of Idaho,” Lawyer says. “We are dedicated to improving mental health in Idaho. We are training the next generation of clinical psychologists.”

The grant provided stipends for ISU doctoral psychology students so they could focus on training, travel, and resources for evidence-based practices in helping with behavioral health issues, with a particular focus on those suffering from Opioid Use Disorder (OUD) during this four year project. 

Lawyer and Peer decided to model the project as a Community-Based Learning Collaborative (CBLC)

in order to create the best experience and outcomes for ISU students, area practitioners, and community members.

Martin Blair, Vice President for Research and Economic Development says, “This model is very community-based. It’s an intriguing model that’s working.”

Peer says that they “shaped and expanded the program to create long-lasting change for clients, to ultimately help individuals.”

Those involved in the CBLC included 35 behavioral clinicians (23 ISU clinical psychology students and 12 community clinicians), seven of their senior leaders and supervisors, five agencies that provide mental health services and mental health referrals and case management services, and three prescribing clinicians. The purpose was to help all involved work together to have shared goals and vision.

Students were placed at Pearl Health Clinic, State Hospital South, Health West, High Country Behavioral Health, and Cognitive Restructuring. Over time, other organizations began to participate, showing there was a trickle-down response. Participation and training expanded to mental health care workers at ISU Counseling and Testing Services, ISU Master in Social Work program, ISU Family Medicine, Hope and Recovery Center, North Canyon Medical Center, Psychological Assessment Specialists, Pacific Rim Counseling, and School District 25.

“The grant was focused on the students,” Peer says, “but we wanted to do more, and we’re so grateful to the involvement from our community.”

So what exactly did the CBLC do during these four years? They assessed behavioral health care needs in the community regarding effective treatment of OUD and access to medically-assisted treatment training, telehealth, and trauma-informed care and conducted workshops on Motivational Interviewing, which is an evidence-based multi-disciplinary intervention for substance use disorder. Students were placed in training settings with their community partners where they received interdisciplinary clinical training for behavioral health and OUD. The CBLC also worked with community partners to increase the number of trauma-informed OUD and Medically-assisted Treatment (MAT) providers, since there is a shortage of OUD providers  nationwide, and especially in Idaho. 

During the planning phase, the CBLC talked to the agencies to find out who they serve and who the group could focus on. Peer says that overwhelmingly community partners reported that there was a need to focus on adults. Some of the community partners also work with youth, for example, SD25 participated, but the main focus was on working with adult populations.

The long-term goal was to sustainability ameliorate OUD, behavioral health, and healthcare disparities in rural Southeast Idaho and to increase the number of ISU psychology graduates who can work in healthcare shortage areas around the state.

At a celebration for the event, Peer and Lawyer reviewed some of the promising outcomes of the project. They reported sustained improvements in reported community practices, sustained increases in reported telehealth, sustained decrease in reported barriers to use of motivational interviewing, sustained increase in reported clients receiving treatment, and a significant increase in clinicians reporting competence with evidence-based treatments.

“We saw large increases in individuals’ acceptance of telehealth,” says Peer, which he says is important for those in rural communities, many of whom do not have access to in-person mental health care and must rely on telehealth services.

Peer says that organizations were already doing great things. They just needed to help make people aware of what was available.

As a result of the collaborative, Anne Stegenga, Licensed Psychologist at State Hospital South, says, “When I supervise students here I oversee assessments so I’m more intentional of making sure the students who come here are aware of the common problems that can occur or how to be sensitive when working with patients with a trauma-informed lens.”

Lyn McArthur, Health West Behavioral Health Director, and ISU Psychology alumna,  has observed that the service extender providers who participated in IRIHC show improvement in their willingness to speak and share with medical providers in a way that is well-received and collaborative. 

“It was helpful to have our providers involved in using MI,” McArthur says. “We’ve also expanded our MAT services, offering more trainings, talking about OUD. We had many providers who were skeptical about learning about MAT. Talking about it helped the stigma around OUD. Many of our providers are providing MAT as part of their standard care now.

An overarching goal of the project was to provide sustainable training to future psychologists. 

“What occupies a lot of my time is thinking about how to train the next generation of clinical psychologists,” Lawyer says. “These sorts of interactions of training individual psychologists in a context of a regional community and the state, to do it well, it’s important to have engagement at all those levels.”

Dr. Dan McGrath, clinical psychologist at Pearl Health Clinic, says he was impressed with how the students who worked with the clinic stepped up to the challenge, doing work that many providers don’t have the bandwidth to accomplish.

“We had students providing social and emotional skills training for at-risk youth,” McGrath says. “I was impressed with how the students made it their own”. 

Another benefit McArthur noticed is that students seemed less intimidated in reaching out to coordinate care with other providers. “In the past, students have seemed more intimidated by reaching out to coordinate care with other providers,” McArthur says, “and I suspect that this could be a result of the multidisciplinary focus of IRIHC.”

Stegenga says that “because often the students were in an earlier stage in their training, they felt more prepared for their subsequent training positions.”

Lawyer says that students were able to benefit from working with community partner, Health West. He says, “The community mental health focus that they have was so critical for us.”

Associate Vice President for Research and Psychology faculty member Michele Brumley thanked the group for their work. “Not only did you implement this project, but we’ve seen it come to fruition with its outcomes.”

“For those who participated for the last four years, thank you for collaborating with us,” Dr. Lawyer says. “When we see the outcomes where we generated change, it’s really gratifying to know we’ve made a change in our community and in our students. We’re very hopeful that the people who serve and whom we serve will be better, healthier.”