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To address the substantial shortage of mental health providers in Nebraska, a pair of Omaha doctors came up with, what is believed to be, a first-of-its-kind project. Primary care and non-psychiatric specialists are trained to provide early mental health treatment in places where patients and the public already come for care. Nebraska Public Media’s Dale Johnson talked with Clarkson Regional Health Services CEO Dr. Bill Lydiatt, a co-founder of the Bridges to Mental Health Workforce Expansion Project, to find out why it’s so groundbreaking.
Bill Lydiatt: Several things. One is we are trying to use the existing workforce to expand the care of Nebraskans with mental illness, and we do that through two novel groups. One is recently retired physicians and nurse practitioners, and the second is through group specialists, people that are doing, for example, cancer work or I'm a head and neck surgeon. My partner, John Mitchell, is a gastroenterologist, so getting people that are seeing a lot of patients but don't necessarily focus on mental illness to have a better awareness and more confidence and competence in dealing with them.
Dale Johnson: A primary care doctor or nurse knows what to do with a physical problem, say a broken bone or a stomach ache. Give me examples of mental health skills that can be taught to those day-to-day doctors and nurses.
Lydiatt: Yeah, that's a great question. So the way we try and do that is really through recognition of symptoms and recognition of signs, as you say, so it's how to have conversations, for example, that will initiate this more easily for the patient. How to elicit the information that gets to these particular questions, what some of the physical signs might be, as well as some of the psychological complaints.
Johnson: I read where patients in Omaha have had to wait eight to 12 weeks for a mental health provider. Now, I realize that no two mental health cases are the same, but what effect can waiting two to three months have on a person needing a mental health professional?
Lydiatt: Really good point, Dale. The key, and that's one of the things that got us interested in Bridges in the first place, during that time that you wait to get treatment, most people are going to worsen in their symptoms, and even if they stay the same in their symptoms, they're suffering during that time. And the reason for this long delay in getting people in is just the sheer number of people that need help and the relative few providers that provide it; 88 out of 93 of the Nebraska counties are mental health shortage areas. So it is widely dispersed across our entire state that we just don't have enough People doing it, and that's really what got us interested in Bridges, is, how do we use that existing workforce and train them to increase their competence and their confidence in managing particularly mild to moderate mental illness? But certainly severe illness exists as well, and that also requires therapy. That's where the psychiatrists are really critical and managing those severe patients, we want to be able to take many of the mild and moderate and handle them in in the communities so that patients don't have to travel and so that they can have their care given by their own providers.
Johnson: To your point about the number of counties that are short on mental health professionals, I read where the Bridges to Mental Health Workforce expansion project has reached more than 400 health care practitioners across Nebraska and western Iowa, and that seems like a lot to me, but how many health care practitioners would truly be needed to move the needle?
Lydiatt: It is a lot, and actually that is getting to a point where we can start to move the needle. We feel like when you consider the number of Nebraskans at even up to close to 2 million, you're going to need at least 20,000 that are more aware of mental illness and able to treat it. Obviously, there are a number that are doing that now, but we'd love to get up to 1,000 for example, we have two more sessions coming up, one in Kearney, the 14-15th at the Museum of Nebraska art, and another at the Lauritzen gardens in Omaha, the 18-19th of August. And we have over 100 people registered for these and so we're really excited about, you know, increasing that number now to hopefully over 500 and as we continue to have these sessions, which we plan on doing about every quarter, we want to increase that number again into the 1,000s.
Johnson: In Nebraska, 62,000 adults have a serious mental illness. That's more than the entire populations of Scottsbluff, Kearney and Beatrice combined. Dr. Lydiatt, thank you so much for the conversation.
Lydiatt: Dale, It's really been a pleasure talking with you. Thank you for your time and for your interest.
Johnson: Thank you everybody for listening to Nebraska Public Media. I'm Dale Johnson.