Program Details

Proposed Sites

Austin, Texas

(and surrounding rural counties)

San Antonio, Texas

(and surrounding rural counties)

Why these sites?

1) Opportunities for more nuanced analysis

Visiting mental health care programs in San Antonio, Uvalde, and surrounding counties offers students a unique chance to understand the implications of living in a mental healthcare desert and its broader impact on both rural and nearby urban areas.
This south-central Texas region houses two large state-sponsored mental and behavioral health centers, which will allow students to see how mental health concerns and disparities vary from county to county.
Students can analyze the effects of a rapid influx of resources into a healthcare desert and determine whether these interventions have made a tangible impact on addressing mental health disparities.
Furthermore, students will be able to perform a comparative analysis of mental health in both rural, urban, and transitory settings, observing the varying levels of care, access, and mental health policies in action.

2) Vulnerable Populations

South-central Texas is home to several vulnerable populations, including veterans, low-income communities, migrant populations, and communities of color. Through this experience, students will gain insight into the unique relationships these groups have with mental health and observe the barriers they face in accessing care.
Additionally, we will engage with community partners that specifically serve these populations, allowing us to learn how culturally tailored services are being delivered and how these efforts are improving mental health outcomes. Further providing insight into how mental health policy can better serve diverse and underserved groups.

We aim to engage with community partners that provide mental health support across several key areas: rural health clinics, rural hospitals, clinical support, social determinants of health and holistic care, as well as emergency and police mental health response. These areas are crucial for individuals facing mental health challenges in rural settings, each exhibiting a unique relationship with the broader context of mental health care.

Many of these factors highlight issues that should ideally be addressed by clinical support; therefore, we are particularly interested in exploring the existing infrastructure and capacity within these various sectors of rural health. Our goal is to understand what resources are currently available and identify potential strategies to bolster the infrastructure of rural communities, enabling them to adequately respond to pressing healthcare needs.

What You Will Learn

1) Context & Background

Participants will learn about the histories of mental health care in rural communities, including:

- - Historical development of healthcare infrastructures in rural versus urban settings, and the disparity that has emerged over time.
  - Cultural attitudes towards mental illness in rural communities, which have often been shaped by close-knit, self-reliant, and sometimes conservative societal norms.
  - The economic and environmental shifts (i.e., farming crises, industrial decline) that have contributed to mental health challenges in rural areas.
  - How systemic underfunding and policy neglect have contributed to the shortage of mental health professionals and facilities in rural communities.

2) Current Approaches

Participants will be able to critically evaluate:

- Current models of mental health care delivery, including the use of telehealth and mobile clinics, and their effectiveness in rural areas.
- Community-based programs that address mental health, such as peer support networks and integrated care models where mental health services are incorporated into primary care.
- Public health campaigns aimed at reducing stigma and increasing awareness of mental health services in rural communities.
- Barriers to implementing these approaches, such as poor internet infrastructure, long travel distances, and lack of qualified mental health professionals in rural areas.

3) Intersectionality

Participants will be able to understand and articulate:

- How different identities (race, gender, sexuality, disability status, etc.) intersect with geography and culture to create unique mental health barriers for individuals in rural areas.
- The ways economic disparities intensify mental health challenges, especially for marginalized groups in rural settings, including rural BIPOC (Black, Indigenous, People of Color), LGBTQ+ individuals, people experiencing language barriers, low-income populations, and migrants.
- The role of stigma tied to gender norms, ethnic identities, and socioeconomic status, and how these shape both individual and community responses to mental health issues.
- How environmental stressors like climate change, drought, and economic recession impact specific rural populations disproportionately and contribute to mental health crises.

4) Policy & Future Solutions

Participants will be able to:

- Examine existing policy frameworks aimed at expanding mental health services to rural areas, such as federal and state funding programs (i.e. HRSA’s National Health Service Corps).
- Explore policy failures and gaps in health care reform that have left rural mental health services under-resourced and underfunded.
- Discuss innovative policy solutions, including increasing federal and state funding for rural healthcare, expanding loan repayment programs for healthcare professionals working in underserved areas, and enhancing mental health education in rural communities.
- Propose and design future solutions based on policy advocacy, community engagement, and technological innovations (i.e., improving telehealth access, incentivizing mental health professional training for rural areas).

Community-Based Learning

Community-based learning is an ideal strategy for addressing urban-rural health disparities because it actively involves local populations in identifying and solving health issues specific to their contexts. This approach empowers communities by enhancing health literacy and fostering local capacity for sustained health improvements. It tailors solutions to fit unique local needs, ensuring cultural relevance and higher efficacy. Additionally, by building stronger community ties and collaboration between residents, healthcare providers, and other stakeholders, community-based learning creates robust support networks. These networks not only improve individual and community health outcomes but also strengthen advocacy for necessary resources and policy changes, making it a comprehensive approach to tackling deep-rooted health disparities in both urban and rural settings.

Ethical Considerations

It is essential for our program to be community-centered, culturally aware, and educational. We must frame the program as an opportunity for students to learn from and support community partners' efforts, rather than as a week-long trip that risks falling into the pitfalls of saviorism. Therefore, it is crucial to provide students with prior knowledge of the issues and communities they will visit, so they can be adequately prepared to engage thoughtfully and respectfully. Additionally, introducing a foundation of what ethical community engagement entails—both for our trip and in healthcare settings—is important.

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