MSU Mankato rural mental health center expands to tackle access, shortage issues

A year-old Minnesota State Mankato center focused on rural mental health is expanding with partnerships and money in the wings that could help increase mental health access across rural Minnesota over the next few years.

MSU Mankato's Center for Rural Behavioral Health recently received a three-year, $600,000 donation from Blue Cross and Blue Shield of Minnesota, which is adding its name to the center.

Meanwhile a request at the Minnesota Legislature could garner $1.5 million for a mental health provider training clinic. A soon-to-be-announced partnership with an agricultural group will add more focus on farmer mental health efforts.

It's all part of a larger effort to improve mental health professional shortages across Greater Minnesota. More than 80% of Minnesota counties are classified as having a shortage of mental health professionals, including all but Olmsted County in southern Minnesota.

"The longer we wait, the worse this issue is going to get," said Thad Shunkwiler,director of the center.

Shunkwiler, a professor at MSU Mankato, founded the center last year in response to growing concerns over mental health provider shortages around the state, leading to less mental health access in rural areas.

A report earlier this year from the center and the Mankato-based Center for Rural Policy and Development shows the number of rural Minnesota hospitals with outpatient psychiatric and detoxification services declined by 11% in the past decade. In addition, rural and small-town mental health providers are on average closer to retirement than their urban counterparts: The median age for rural providers is 63, compared to 56 in metro areas.

There are no providers in some parts of the state. No mental health professionals live or work in Jackson County, according to Shunkwiler, even as mental health needs there grow.

Minnesota Student Survey data shows two-thirds of K-12 female students in Jackson County report long-term mental health issues, almost double the state average.

"And yet they don't have a single provider who provides care inside their county now," Shunkwiler said.

Shunkwiler and other advocates hope the Legislature funds a training clinic that would allow would-be providers to serve children and uninsured and underinsured residents in south-central Minnesota. Their proposal already has made the first round of bills to be included in omnibus legislation later this session.

Assistant Senate Majority Leader Nick Frentz, DFL-North Mankato, sponsored the bill in the Senate. He said he believes the proposal has a good chance to obtain funding this session as a strategy to address rural mental health access in the short term.

"When you see an increased demand and increased need for constituents, you want to find a way to meet that need," Frentz said.

That's just one facet to solving the workforce shortage, however. Sue Abderholden of NAMI Minnesota, the state chapter of the National Alliance on Mental Illness, said there still are wage issues spurred by lagging Medicaid reimbursement rates and barriers for college graduates to get training supervision.

Lawmakers have approved grant programs for rural providers to offer training supervision and boosted telehealth service reimbursements, which Abderholden said needs to continue to improve access. NAMI advocates are also pushing for a mental health and substance use disorder office within the Minnesota Health Department, based on a similar office in Nebraska, that could track workforce issues.

"What we want to do is to make sure that we have someone looking at this," Abderholden said. "They are monitoring people coming into the programs in Minnesota. They're making it easier to find supervision and internships."

Shunkwiler said Mankato researchers plan to partner with Wilder Research later this year to study why half of college graduates with mental health-related degrees don't pursue careers as providers. From there, Shunkwiler expects to lay out goals to boost mental health provider numbers in rural areas.

Bukata Hayes, vice president of racial and health equity at Blue Cross, said he expects the insurance company to continue funding the center at MSU Mankato beyond its initial donation.

"This first three years is just the first iteration of our partnership," he said.