Medicine and Health Sciences Commons^™

Use Of Electronic Health Records To Manage Tobacco Screening And Treatment In Rural Primary Care, Jean A. Talbot Phd, Erica C. Ziller Phd, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Researchers at the Maine Rural Health Research Center, University of Southern Maine examined whether the use of electronic health records by rural primary care physicians facilitates their use of best practices in addressing tobacco dependence. The study used the National Ambulatory Medicare Care Survey (2012-2015) to explore how rurality and use of tobacco-related electronic health record functions were related to smoking status documentation and cessation treatment at adult primary care visits. Rural-urban comparisons were also examined.

The authors conclude that rural primary care physicians were at least as successful as their urban counterparts in leveraging electronic health records to enhance …

Opioid-Related Visits To Rural Emergency Departments, Erika C. Ziller Phd, Jean A. Talbot Phd, Deborah Thayer Mba, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Increased rates of acute opioid poisoning and related emergency department (ED) visits in the United States have occurred at the same time as rural EDs face a number of resource constraints. Researchers at the Maine Rural Health Research Center conducted this study to gain insight about rural ED visits for acute opioid poisoning and how they compare with urban ED visits. The authors used data from the 2006 and 2013 Nationwide Emergency Department Sample to examine rural and urban opioid-related visits (ORVs) to EDs, including rate change over time, and the outcomes of these ED visits (treatment and release, inpatient …

Substance Use Among Rural And Urban Youth And Young Adults, Jennifer D. Lenardson Mhs, Nathan Paluso Mph, Erika C. Ziller Phd

Mental Health / Substance Use Disorders

Rural youth and young adults have historically had higher use rates of alcohol and other substances than their urban counterparts. Recent research suggests that rates of youth and young adult alcohol and other substance use have declined over the past two decades, but we have limited knowledge of whether and how current rural and urban substance use patterns may differ. As national substance use rates decline, it is important to re-assess differences in use among rural versus urban youth and young adults. This study uses data from the National Survey of Drug Use and Health (NSDUH) to examine rural-urban differences …

The Role Of Rural Hospitals In Addressing Opioid And Other Substance Use Problems, John A. Gale Ms

Mental Health / Substance Use Disorders

Webinar presentation to the Small Rural Hospital Transition project addressing issues of rural opioid and other substance use issues, focusing on the role of rural hospitals, and the importance of community engagement. Component parts of an effective opioid/substance use system of care include prevention, treatment, and recovery. Models must be adapted to the geographic, resource, and cultural realities of rural areas. Examples of strategies are provided.

Strategies To Combat Opioid Use In Rural Communities, John A. Gale Ms

Mental Health / Substance Use Disorders

Webinar presentation discussing

• Opioid use across rural settings
• Drivers of rural opioid use
• Burden of opioid use in rural communities
• Evidence-based prevention, treatment, and recovery strategies to address rural opioid use

Rural Opioid Prevention And Treatment Strategies: The Experience In Four States [Working Paper], John A. Gale Ms, Anush Hansen Ms,Ma, Martha Elbaum Williamson Mpa

Mental Health / Substance Use Disorders

Although opioid use rates are comparable in rural and urban counties, rural opioid users tend to be younger, unmarried, have lower incomes, and are more likely to lack health insurance, all vulnerabilities that may negatively impact their ability to seek treatment and recover. Additionally, the rural health care system is characterized by numerous resource, workforce, access, and geographic challenges that complicate the delivery of specialized care for OUDs in rural communities. The nature and scope of the opioid crisis vary across rural communities and require multifaceted, community-based strategies to address the problem. Based on interviews with key stakeholders in Indiana, …

Prevention Of Drug Use And Treatment Of Drug Use Disorders In Rural Settings, John A. Gale Ms

Mental Health / Substance Use Disorders

This Guide on Prevention of Drug Use and Treatment of Drug Use Disorders in Rural Settings was prepared by the United Nations Office on Drugs and Crime (UNODC) Drug Prevention and Health Branch (DHB), in the context of the global project Treatnet II: OFID-UNODC Programme to prevent HIV/AIDS through Treatnet Phase II, with the aim of providing an awareness-raising tool and guidance for policymakers, public health officials, local authorities and other stakeholders in dealing with substance use issues in rural settings in their respective countries. This Guide will serve as an awareness-raising tool and guidance for policymakers, public health officials, …

Rural Opioid Prevention And Treatment Strategies: The Experience In Four States [Policy Brief], John A. Gale Ms, Anush Yousefian Hansen Ms,Ma, Martha Elbaum Williamson Mpa

Mental Health / Substance Use Disorders

Little is known about what states with large rural populations are doing to combat opioid use disorders (OUD) in rural communities. This qualitative study identified rural challenges to the provision of OUD prevention, treatment, and recovery services and explored promising strategies to tackle the opioid crisis in rural communities.

Rural Opioid Abuse: Prevalence And User Characteristics, Jennifer D. Lenardson Mhs, John A. Gale Ms, Erika C. Ziller Phd

Mental Health / Substance Use Disorders

This study examined the prevalence of non-medical use of pain relievers and heroin in the past year in rural and urban areas and the socio-demographic and economic characteristics associated with their use. Additionally, we examined opioid use by age at first use as well as dependence and abuse; treatment history and perceived need for treatment; use of alcohol and other drugs; perceived risk of using drugs and availability of drugs; problems resulting from the use of drugs; driving under the influence; and illegal activities and arrest records.

Integrated Care Management In Rural Communities, Eileen Griffin Jd, Andrew F. Coburn Phd

Mental Health / Substance Use Disorders

No abstract provided.

Integrated Care For Older Adults In Rural Communities, Eileen Griffin Jd, Andrew F. Coburn Phd

Mental Health / Substance Use Disorders

Recognizing that traditional models of health care delivery and payment often produce fragmented and costly care and poor outcomes for those with the highest needs, many reforms under the Affordable Care Act (ACA) focus on realigning payment incentives and integrating care. These reforms presuppose the existence of supporting infrastructure and capacity, including dedicated care management staffing and health information technology and exchange. With a focus on community-dwelling older adults in need of integrated physical, behavioral health services, and long term services and supports (LTSS), this brief reviews the opportunities and challenges these reform initiatives present for rural communities: How easily …

Telemental Health In Today's Rural Health System, David Lambert Phd, John A. Gale Ms, Anush Yousefian Hansen Ms, Ma, Zachariah T. Croll Ba, David Hartley Phd, Mha

Mental Health / Substance Use Disorders

Telemental health has long been promoted in rural areas to address chronic access barriers to mental health care. While support and enthusiasm for telemental health in rural areas remains quite high, we lack a clear picture of the reality of telemental health in rural areas, compared to its promise. This Research & Policy Brief reports on the first part of our study—the online survey of 53 telemental health programs—and describes the organizational setting, services provided, and the staff mix of these programs. We draw from our telephone interviews with 23 of these programs to help describe the organizational context of …

Rural Children Experience Different Rates Of Mental Health Diagnosis And Treatment, David Hartley Phd, Mph, Jennifer D. Lenardson Mhs, Nathaniel J. Anderson Ms, Mph, Samantha J. Neuwirth Md

Mental Health / Substance Use Disorders

Research indicates that privately insured, rural adults have lower use of office-based mental health services, but higher use of prescription medicines than their urban counterparts. Patterns for rural children may be different from urban children because of the limited supply of pediatric mental health providers in rural areas, which may lead to reduced access and lower use of mental health services in rural areas versus urban. Using data on children ages 5-17 from the 2002-2008 of the Medical Expenditure Panel Survey, researchers from the Maine Rural Health Research Center find that rural children are significantly less likely to be diagnosed …

Access To Mental Health Services And Family Impact Of Rural Children With Mental Health Problems, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd, David Lambert Phd, Melanie M. Race Ms, Anush Yousefian Hansen Ms, Ma

Mental Health / Substance Use Disorders

Mental health problems have considerable impact on children and their families and some of these impacts are higher in rural than urban areas. Rural children are slightly but significantly more likely to have a mental health problem than urban children, are more likely to have a behavioral difficulty, and are more likely to be usually or always affected by their condition. Compared to urban children, rural children are more likely to go without access to all parent-reported needed mental health services and their families spend more time coordinating their care. This working paper and policy brief provide information on prevalence …

Maine Barriers To Integration Study: The View From Maine On The Barriers To Integrated Care And Recommendations For Moving Forward, John A. Gale Ms, David Lambert Phd

Mental Health / Substance Use Disorders

Following up on the Environmental Scan report (http://muskie.usm.maine.edu/Publications/rural/Barriers-to-Integration-Environmental-Scan.pdf), the authors interviewed representatives from Maine’s business community, payers, purchasers, professional associations, state legislators, advocacy organizations, state government, and provider organizations. The interviews provided a context to understand the barriers to integration in Maine and develop recommendations to overcome them. Our Final Report presents key findings from the study, recommendations for addressing barriers, and next steps for moving forward. This study recognizes the need for integration of behavioral and physical health services in all settings. Although most discussions of integration focus on the development of behavioral health services in primary care settings, …