September 21, 2018

Rural communities face many challenges.  

Ninety out of Iowa’s 99 counties are designated as mental health professional shortage areas, and there are more than 130 primary care health professional shortage areas. Rural mental health practitioners are often overwhelmed and understaffed. Schools in rural communities lack the resources that urban and suburban schools have, including access to Advanced Placement classes.  

College of Education faculty and students are partnering with communities to help solve these issues.  

Saba Rasheed Ali, associate dean for research, hopes to improve the lives of people in rural communities through a new grant.  

The $1.3-million-dollar federal grant “Integrating Behavioral Health into Rural Medicine” is a collaboration between the College of Education Counseling Psychology program, the UI Mobile Clinic, and Grinnell College.  

Over the course of four years, the grant will train and fund the placement of 28 counseling psychology Ph.D. students in a dozen different locations across the state.  

Charles Bermingham (Ph.D. ‘16), clinical assistant professor in Counseling Psychology, works with six of those students to provide mental health resources to Grinnell College since there are no private practitioners near the college.  

The grant will provide practicum experiences and training focusing on serving rural, veteran, and Latinx communities, with the hope of retaining these counseling psychology graduate students in rural communities.  

“We are trying to get students to realize how they can be successful by practicing in rural areas and understanding the needs of people there,” says Ali. “We want them to think about the ways that they can contribute to the mental health of rural residents and consider a career providing services in rural areas.”  

This grant has given counseling psychology doctoral student Aurora Pham special training and knowledge to work with veteran and Latinx populations in Iowa.  

Throughout her graduate experience, Pham has trained at the U.S. Department of Veteran’s Affairs Community Based Outpatient Clinic in Coralville and the Shelter House in Iowa City, helping homeless veterans obtain and retain long-term employment.  

Pham also worked to provide evidence-based treatments to veterans through telemental health, which uses a variety of technologies including video teleconferencing technology to communicate and provide health services to veterans. This allows veterans residing in rural and medically underserved areas to access quality healthcare, without having to leave their communities.  

“I’ve realized the importance of taking a preventative approach in reducing the number of homeless veterans,” says Pham. “Having culturally competent professionals working in rural settings will increase access to health- care services and positive veteran outcomes.”  

Access to preventative care and other services are exactly what Ali aims to provide.  

“There is a lack of access, very few practitioners, and not enough availability of necessary psychotropic medications,” says Ali “People have to drive long distances to receive necessary care, and often when they do, practitioners are overwhelmed because they have so many clients. It’s a big issue of high need.” 

Ali also believes that the stigma surrounding seeing a mental health practitioner contributes to the lack of mental health resources.  

“Often times, we have a ‘Pull yourself up by your boot- straps mentality’ or we try to keep the problems in the family and don’t trust other people to talk about it,” Ali says. “This contributes to not being able to get the kinds of resources people need. It is important to respect rural cultural values while also trying to find ways to help with access.”  This feeds into a larger economic issue in rural communities, says Ali. The economic life of many rural communities is connected to agriculture, which creates significant stress on people in the communities when livestock and crop prices are low. Ali explains that often times there are not enough job opportunities, which causes residents to leave and does not allow for an influx of people.  

Lauren (Levy) Welter (Ph.D. ’15) saw the need as an opportunity to help, taking her knowledge and training to rural Iowa.  

While a doctoral candidate in the counseling psychology program, Welter completed her pre-doctoral internship and post-doctoral fellowship at the Iowa City Veteran’s Affairs Clinic, gaining advanced training with trauma-focused treatment and diverse clinical populations. She worked with veterans who had varied clinical needs, including several Vietnam veterans who were seeking mental health care for the first time after suffering silently for 40 years.  

“Helping several of these men begin to let go of guilt they’ve held for decades, think complexly about good and evil, connect more deeply with loved ones, and regain hope and faith in their fellow man was inspiring personally and professionally,” says Welter. “These experiences drive my passion for the importance of mental health care, and desire to work to break the stigma in rural communities where many others do not know or believe that it is possible to grow and heal from trauma and loss.”  

After receiving her degree, Welter opened her own clinic, Prairie Home Wellness and Counseling, in Monticello, Iowa, a small community of roughly 4,000 people.  

“Because of cultural and logistic barriers to mental health care, many of my current clients simply would not seek care if I did not have my practice here,” says Welter. “I aspire to create a therapeutic space that is sacred and life- transforming. I am hopeful that over the course of my career, I can contribute to reducing some of the cultural stigma against mental health care in our community.”  

Encouraging people like Welter to serve rural communities is critical, along with inspiring the next generation through pipeline programs like Project HOPE (Healthcare Occupations Preparation and Exploration), also directed by Ali.  

In its 10th year, Project HOPE is a STEM-based career education program designed to connect minority and low socioeconomic middle school students to the health science professions early in their education. The program aims to get youth interested in healthcare careers early, so down the road they know how to pursue a future in a health science profession.  

Project HOPE graduate students are active in several Iowa towns including Columbus Junction, West Liberty, Cedar Rapids, and Kalona.  

Ali was inspired by her own experiences in rural communities. Growing up in rural West Virginia, her father was the only endocrinologist in a community highly affected by diabetes. After he retired, Ali’s hometown lacked access to an endocrinologist and still does to this day.  

“We see that students in rural communities don’t have the same access to information because they live in places where there is a restricted range of occupations,” Ali says. “Expanded exposure to health care professions helps students realize what is available and gets them thinking about how they can achieve those careers.”  

The program culminates in a field trip to the University of Iowa, where students receive simulation experience in labs and get the opportunity to build a robot. The field trip helps change students’ perspectives on what a college education is like and what they can do in the healthcare field, says Ali.  

Ali has seen positive short-term results from Project HOPE including documenting increases in student interest, confidence, and student expectations for the future.  

In the long term, Ali hopes to see these students pursue healthcare careers in rural Iowa communities.  

The Belin-Blank Center is also working to improve the lives of students in rural communities.  

Many rural Iowa schools do not have the resources or ability to offer Advanced Placement (AP) courses. To help address this issue, the Belin-Blank International Center for Gifted Education and Talent Development created the Iowa Online AP Academy (IOAPA) in 2001, thanks to support from the U.S. Department of Education.  

The academy makes a concentrated effort to bring AP and advanced learning opportunities to all high schools in Iowa through offering online AP and advanced courses, online AP exam review, professional development for AP teachers, and above-level testing.  

These courses challenge students and help them prepare for future college careers.  

Additionally, the Belin-Blank center recently received a two-year $200,000 commitment from the Jack Kent Cooke Foundation to expand its Stem Excellence and Leadership (SEAL) program.  

The SEAL program offers rigorous math and science enrichment classes before and after school to students in grades eight and nine in 10 different rural Iowa school districts. It also offers professional development for teachers in the enrichment curriculum, math and science content, and gifted education  

More than 500 students have benefited from the above-level testing and more than 200 students have participated in extracurricular STEM programming.  

“SEAL is about opening doors to advanced learning and enhanced aspirations,” says Susan Assouline, director of the Belin-Blank Center. “By opening the door to middle school students and their teachers, we offer service that will impact them in high school and beyond.”  

College of Education Professor Brian Hand and Assistant Professor Gavin Fulmer are also working to make an impact on students in rural communities.  

Thanks to a $2.8 million National Science Foundation grant, Hand and Fulmer will examine how teachers develop adaptive expertise for argument-based science inquiry in their classrooms to help students learn better.  

Along with the University of Alabama, Hand and Fulmer will start collecting data in summer 2019 from teachers and students in third through fifth grades in underserved areas including western Iowa, northeastern Iowa, and Alabama.  

They will also develop a model to inform teacher education programs to help increase teachers’ adaptive expertise when they enter the classroom, yielding improvements in learning environments and student outcomes.  

“The goal is to help understand how teachers can move beyond routines and into a flexible, adaptive approach,” says Hand. “That’s because every classroom is unique, and all students are different and bring different experiences into that classroom.”  

Read more from the 2017-18 College of Education Annual Report.