UI telepsychology training clinic takes grassroots approach to reaching rural communities

By: Brooklyn Draisey – August 22, 2024 2:01 pm

Aubrey McEnroe was manning a county fair booth for the University of Iowa’s Telepsychology Training Clinic when a fairgoer approached her, teary-eyed.

The individual had sought mental health services in the past with no luck and had just learned about the clinic, where McEnroe, other UI students, staff and faculty work to provide mental health services to rural communities through telehealth. The fairgoer wanted to share how grateful they were.

McEnroe is a doctoral student entering a new role as a graduate assistant in her second year with the Telepsychology Training Clinic (TPTC). She said it was touching seeing the realization in those she and others spoke to this summer at fairs across the state that they’re not alone in their mental health battles. Growing up in a farming family in Algona, these interactions also hit close to home.

“That was very impactful for me and moving for me, and really reinforced the whole reason behind TPTC,” McEnroe said.

Clinic team members spent this summer traveling to county fairs and the Iowa State Fair, getting the word out about the free individual and group counseling programs they offer, as well as career services and workshops. McEnroe said she led the outreach initiative with the mission of destigmatizing mental health services and showing people that these services aren’t a luxury only provided to those with plentiful resources in their areas.

Martin Kivlighan, co-director of the clinic and a professor in the UI College of Education’s counseling psychology program, said many of the people approaching their booth expressed both appreciation and skepticism. That speaks to the lack of services — especially free services — available to those living in rural areas, she said.

All but 11 of Iowa’s counties are designated as mental health workforce shortage areas by the U.S. Department of Health and Human Services, Kivlighan said. While the clinic has worked with more than 200 Iowans in 17 counties in its five years of operation, one of the goals behind the booths was to expand that reach.

“It felt important to get out of our offices and really go out there and just be part of the community,” Kivlighan said.

The telepsychology clinic, led by Kivlighan and professor Saba Rasheed Ali, was created with a Department of Health and Human Services training grant. The grant was aimed at providing training to doctoral psychology students in telehealth, integrated behavioral health care, substance use, prevention and treatment, Kivlighan said, as well as creating a pipeline for psychologists to work with underserved and rural communities.

Kivlighan said the idea was already floating around to create a telepsychology clinic to give students experiential training in rural communities, so this grant allowed them to bring that concept to life.

When the program began, it only involved a handful of students, none of whom had anywhere close to full caseloads, Kivlighan said. But this fall, the clinic will be staffed with three full-time practicum students, McEnroe as a graduate assistant, and a postdoctoral fellow.

With this crew, about 50 individuals can receive services at any time, and Kivlighan is hoping the clinic will see anywhere from 150-200 people served this year. The free counseling lasts anywhere from five to 10 sessions in order to help as many people as they can without creating long waitlists.

Students involved in the clinic come from a mix of rural and urban areas, Kivlighan said, and it’s been interesting seeing the different passions and perspectives they bring to their roles and the clinic itself.

“That has been one of the most enriching experiences … bringing in these conversations about rurality, about rural communities, and gaining that appreciation for rural spaces,” Kivlighan said. “That has just been cool to be a part of.”

Rural communities face unique situations and stressors that can impact their mental health, Kivlighan said, from isolation to lack of employment to the challenges that come with agriculture. Paired with the lack of resources in their area and a stigma around expressing struggles with mental health, McEnroe said these factors make it more difficult for people to reach out for help and for programs like the clinic to find those in need.

Before taking the more grassroots approach of manning fair booths in these communities, McEnroe said the clinic would mainly work through partner organizations and mental health professionals to find clients. But if a town doesn’t have a hospital or other program, there are few opportunities for partnerships. This was another way the booths proved to be a success, as they were able to connect with providers they could potentially partner with.

“Although rural communities are very collectivistic and very community-based, when it comes to health, physical health and specifically mental health, a lot of the beliefs are that you have to be doing this alone, and you can’t reach out for help,” McEnroe said. “And what I’ve just noticed throughout my work, collectively, is that mindset change — that I don’t have to be doing this alone.”

When McEnroe has completed her program, she hopes to bring mental health resources directly to her hometown by opening her own practice. She said she wants to try to work with women farmers, as a woman in agriculture herself, and use what she’s learned in the clinic to help those whose experiences she’s shared.

“I want to translate what I’ve learned from working in this clinic and really apply that into my private practice back home,” McEnroe said. “So I want to be able to offer these services … and offer these resources that might not otherwise be accessible right now, and to continue breaking that stigma.”

This article was originally published by Iowa Capital Dispatch.