The University of Minnesota’s Masonic Institute for the Developing Brain (MIDB) is strategizing ways to address the shortage of mental health workers in Greater Minnesota and the growing need for pediatric mental health care, according to a press release from MIDB. 

Twenty-eight percent of 8th to 11th grade students reported experiencing emotional, behavioral or mental health issues lasting longer than six months, according to the Minnesota Department of Health’s 2022 Student Reports.

According to the Minnesota Center for Rural Policy and Development, only 18% of mental health providers work in Greater Minnesota, where nearly half of Minnesota youth under 18 live. Due to the lack of mental and behavioral health care in rural Minnesota, many children and families wait months to receive care, sometimes having to take off work and school to drive to the Twin Cities to see specialists.

Jessica Simacek, the program’s principal investigator and director of the TeleOutreach Center, said there is already a shortage of providers around the state. She added the problem is worse in Greater Minnesota where communities are smaller and there are fewer mental and behavioral healthcare providers. 

“It’s not unique to Minnesota, but we certainly feel it a lot,” Simacek said. 

The average wait time for an autism evaluation is about 18 months statewide, and wait times for early intervention services are around nine months, Simacek said. 

“So you add that together, and that’s years that kids are waiting for things that would be supportive to them,” Simacek said. “And that’s not unique to only children with autism.”

Simacek said it can be difficult for primary care providers to treat children with autism, attention-deficit disorders or other behavioral and mental health issues because they do not have the proper guidance or supervision to give informed treatment and recommendations to their patients.

According to Simacek, the program strives to tackle this disparity in a few ways, both by training primary care providers and developing telehealth programs to eliminate wait times. The program hosts online training sessions led by different healthcare professionals to help guide providers.

“So the supervision piece where the child is still receiving 100% in-person care, but the person supporting them is being supervised or trained in a way that involves telehealth,” Simacek said.

This allows providers in rural areas to consult with another professional about how to care for a patient when they may not know the best course of action, Simacek said.

Emily Borman-Shoap, director of the pediatrics residency program at the University’s Medical School leading a program incorporating specialized mental health training into the primary clinics, said tools like these will help providers gain confidence in starting treatment plans, such as referring them to a therapist for mental health concerns.

Simacek said another strategy is using telehealth to provide supplemental support for families with newly diagnosed children while waiting for their in-person care to start. 

“There’s a lot of families we’ve supported who live in greater Minnesota who drive their children up to two hours once a week to access a speech-language pathology appointment,” Simacek said. “They might have to take time off work, or time away from school to do that. So another consideration is finding ways to help increase someone’s access to care where they’re experiencing challenges.”

Borman-Shoap said using telehealth can also help with patients’ comfort. 

“Some kids and teenagers do quite well with telehealth,” Borman-Shoap said. “Some do better, I would say, because they can be in the comfort of their own home.”

Others still find it harder to connect with a therapist over a video call, so telehealth should not be the end all be all, Borman-Shoap said. This is another reason why integrating mental and behavioral health care into primary care remains an important solution.

Borman-Shoap said finding ways to get children treatment for their conditions earlier generally prevents them from needing inpatient treatment. 

“Some people just have a significant illness that’s going to end up needing inpatient treatment, even with really good support,” Borman-Shoap said. “But there are a big number of patients where if we were able to put high-quality care in place early, then hopefully we’ll never get to the point that they need inpatient.”