Breaking Down Barriers

Increasing the Behavioral Health Workforce in Underserved Communities

Published September 1, 2018

Graduate Students to Receive Enhanced Addiction-Focused Training and Practice Through Inter-professional Collaboration in Integrated Care Settings

Erie County has the highest rate of opioid overdose deaths in Western New York – and in Erie and Niagara counties, the rates of opioid overdoses, hospitalizations and deaths are currently higher than in many other regions in New York State.

To help combat the growing opioid epidemic in Western New York, the University at Buffalo has received a $1.92 million training grant from the Health Resources and Services Administration (HRSA) to expand the behavioral health workforce in underserved communities.

Opioid overdose deaths in Erie County, NY in 2017. Confirmed opioid overdose deaths equals 233. 26 percent of population ages 20-39. Population in this age range accounts for 56 percent of the opioid-related fatalities. 26% of the deaths were female and 74% were male. 84% were white and 16% were other races. 44% of the overdoses were in the city of Buffalo, 9% were in rural areas and 43% were in the suburbs. 28% of the opioid-related fatalities were from heroin and 78% were from fentanyl. Source: Erie County Department of Health.

A Multi-Faceted Approach for a Multi-Faceted Issue

Disparity in access to clinical care for substance use disorders has been a persistent problem and at the forefront of concerns for mental health providers for some time. Structural barriers to prevention and treatment include an ongoing workforce shortage in the fields of mental health and substance abuse treatment, inadequate evidenced-based training for behavioral health providers, and a lack of utilization of available services.

Other disparity concerns stem from social determinants of health, such as inadequate education, low income, lack of transportation to treatment facilities, and medically underserved areas, as well as personal factors, such as a resistance to care due to perceived stigma.

Traditionally, services for prevention and treatment of substance misuse and abuse disorders have taken place separately from other mental health and general care services. Most people with substance use disorders do not seek treatment on their own because they do not believe they are in need, are not ready to seek treatment or are unaware of how to access treatment. The ability to integrate prevention, treatment, recovery and follow-up services to address this issue remains key to improving access and quality of treatment.

“Two of the significant, urgent solutions to mitigate the opioid epidemic are to increase access to proper treatment and increase prevention efforts, both of which will require sufficient, well-trained behavioral health providers,” says principle investigator Yu-Ping Chang, PhD, associate dean for research and scholarship and Patricia H. and Richard E. Garman Professor in the UB School of Nursing.

The grant, “Behavioral Health Workforce Education and Training (BHWET) Program: Behavioral Health-focused Interprofessional Education and Practice for Graduate Students in Integrated Care Setting,” is a four-year, interprofessional education grant. It will admit graduate students from the School of Nursing, School of Social Work, Department of Counseling counselor education program and Graduate School of Education educational psychology program into the HRSA Behavioral Health Workforce Education Training Scholars Program.

“By considering the biological, social, behavioral, psychological and spiritual aspects of addictions, our unique, team-based curriculum will train our students to work collaboratively to provide culturally sensitive and comprehensive treatment plans for patients. ”
Yu-Ping Chang, Associate Dean for Research and Scholarship; Patricia H. and Richard E. Garman Professor
UB School of Nursing

This program will provide students with behavioral health education, stipends to offset living expenses, simulated training and clinical placements in integrated care settings in rural and vulnerable communities.

“By considering the biological, social, behavioral, psychological and spiritual aspects of addictions, our unique, team-based curriculum will train our students to work collaboratively to provide culturally sensitive and comprehensive treatment plans for patients,” says Chang.

Psychiatric Mental Health Doctor of Nursing Practice students will be placed alongside students from the other disciplines in settings that offer integrated primary care and behavioral health interventions with an addictions focus. The settings are expected to include BestSelf Behavioral Health Inc., Endeavor Health Services and other local providers.

Special emphasis will be placed on treating patients in underserved areas. They will participate in comprehensive training on the delivery of addictions-related behavioral interventions – specifically,  screening, brief intervention, and referral to treatment (SBIRT) and motivational interviewing techniques – in integrated behavioral health/primary care settings. It is anticipated that 88 students will be trained over the four-year grant period.

By harnessing the collective expertise of faculty and staff from across disciplines at UB, the program provides students with cohesive, interprofessional training that will prepare them to deliver integrated prevention and treatment for substance abuse disorders.

Group photo of grant investigators and researchers.

From left to right: Timothy Janikowski, associate professor of counseling, school and educational psychology; Yu-Ping Chang, Patricia H. and Richard E. Garman Professor of nursing; Christopher Barrick, RIA senior research scientist; Kim Griswold, associate professor of family medicine; Diane Elze, associate professor of social work; Kurt Dermen, RIA senior research scientist. Photo: Douglas Levere

Co-investigators on the grant include Christopher Barrick, PhD, and Kurt Dermen, PhD, both senior research scientists in the UB Research Institute on Addictions; Diane Elze, PhD, associate professor and director of the master of social work program in the UB School of Social Work; Timothy Janikowski, PhD, associate professor and director of the counselor education program in the Department of Counseling, School and Educational Psychology in the UB Graduate School of Education; Kim Griswold, MD, associate professor in the Department of Family Medicine in the Jacobs School of Medicine and Biomedical Sciences at UB; Loralee Sessanna, DNS, clinical associate professor in the School of Nursing; and Nancy Campbell-Heider, PhD, associate professor in the School of Nursing.