When it comes to access to health care in rural areas, the disparities and inequities are easy to spot, especially in the area of mental health. Rural areas have fewer primary care providers, and they often lack a psychiatrist or psychiatric nurse practitioner.
Nationwide, a major push is being made to try and address the health disparities and inequities, and researchers at the Texas A&M University School of Public Health are part of those efforts.
Heather Clark, DrPH, MSPH, research assistant professor in the Department of Health Behavior and director of Public Health Practice, is the principal investigator on a project that was recently awarded a five-year, $500,000 grant from the Hogg Foundation for Mental Health to evaluate community-driven solutions to the mental health disparities in five Texas counties.
The Hogg Foundation’s project is designed to strengthen efforts to transform the environments where people live, learn, work, play and pray, bringing a population health approach to support resilience, mental health and well-being through new, or building on existing, community collaboratives.
Central to the project is the commitment of each community to foster participation by historically excluded groups in every phase of the project. Clark’s team will assist the communities in the development and implementation of county specific evaluation plans to document their successes along the way.
“We are serving as a technical resource by helping the communities build their own evaluation capacity and determine the best way to be able to document that and show their success,” Clark said. “What they are doing in each community looks a little different, but of course, they all have the same goal in mind: supporting the resilience of community members and improving community mental health and well-being.”
The Hogg Foundation, whose mission is to transform how communities promote mental health in everyday life, has uniquely committed to each community for eight years. Focusing on building a collaborative and assessing community strengths and needs, the initial three-year, $4.5 million planning phase award was made in 2017. The current five-year, $3.75 million implementation phase award has just entered its second year.
The organizations Clark’s team is working with include Bastrop County Cares (Bastrop County), Community Action Corporation of South Texas (Brooks County), Northeast Texas Community College (Morris County), Stephen F. Austin State University (Nacogdoches County), and Victoria County Public Health Department (Victoria County).
“Each community was funded through different mechanisms, so some are working with local universities, others are working with the local health department, and another is working with a non-profit agency,” Clark said. “How we work with each community will also look a little different because each community has different needs based on the available resources.”
Clark and her colleagues will be working with the awardees to identify key indicators or measures of success in the creation of their evaluation plans. To do this, the researchers will utilize a community-based participatory framework by working side by side with the communities to review their implementation plans and facilitate a process where they prioritize the measurable project objectives and determine how best to collect data. The team will also work with each community to identify any already available information to use as baseline data that can also inform the collaboratives’ evaluation plan processes.
“The communities have been charged by the Hogg Foundation with addressing health disparities and inequities around resilience and mental health in their communities, so they want to see improved mental health and well-being,” Clark said. “Our grant is to provide evaluation and technical assistance and is really about building the capacity of the communities to be able to appropriately measure and demonstrate change throughout the initiative in each county.”
Clark’s co-PIs on the project are David Matarrita-Cascante, PhD, associate professor in the Department of Rangeland, Wildlife & Fisheries Management, and Sara Mendez, DrPH, MPH, research scientist at the School of Public Health.
The Hogg Foundation for Mental Health was established in 1940 by the children of Texas Governor James Hogg. The original $2.5 million endowment came from the estate of Will C. Hogg, the oldest of the Hogg children. Upon his death in 1930, his sister Ima and his brother Mike established the Hogg Foundation for Mental Hygiene (the organization’s original name) in his memory.
Over the decades, Texas has made considerable progress in realizing that vision, in no small part thanks to the work the Hogg Foundation and its allies have accomplished.