Thursday, January 2, 2014

The USDA ~ "The People's Department" And Mental Health Care

English: Official portrait of United States Se...
English: Official portrait of United States Secretary of Agriculture Tom Vilsack (Photo credit: Wikipedia)

Headline: USDA Announces Support for Mental Health Facilities in Rural Areas


If you saw this headline would you click on the link to read the story? We were curious because we did not immediately see the connection between the United States Department of Agriculture (USDA) and mental health.  The USDA's press release was issued December 10, 2013, and local newspapers are beginning to share this information with their readers as the New Year begins. Per the press release, here are some key points regarding the USDA's goals when it comes to mental health.
  • Agriculture Secretary Tom Vilsack today announced that the U. S. Department of Agriculture (USDA) has set a goal of investing up to $50 million to increase access to mental health care in rural areas over the next three years. The funding will be used for the construction, expansion, or equipping of rural mental health facilities and will be provided through the Community Facilities direct loan program.
  • This year [2013], USDA invested more than $649 million in 130 rural health care facilities – serving nearly 3.2 million rural residents. These investments included critical access hospitals, rural health clinics, psychiatric hospitals, mental health care facilities, group homes for people with disabilities, assisted living facilities, nursing homes, and vocation and medical rehabilitation facilities.
  • USDA is also investing in innovative healthcare technologies such as telemedicine, to further expand access to health care services throughout rural America.

What is the connection between the USDA and mental health?


It was in 1862 when President Abraham Lincoln established the United States Department of Agriculture by signing into law an act of Congress. During his final speech to Congress, some two and one-half years later, President Lincoln referred to the USDA as "The People's Department." When the USDA was created 50% of Americans lived on farms...now 150+ years later that percentage has dropped to 2%.  The USDA's Mission Statement is straightforward:
We provide leadership on food, agriculture, natural resources, rural development, nutrition, and related issues based on sound public policy, the best available science, and efficient management.
As is their Vision Statement:
To expand economic opportunity through innovation, helping rural America to thrive; to promote agriculture production sustainability that better nourishes Americans while also helping feed others throughout the world; and to preserve and conserve our Nation's natural resources through restored forests, improved watersheds, and healthy private working lands.  
Perhaps the two operative phrases in the Mission Statement and Vision Statement as they each respectively pertain to mental health are: rural development and helping rural America to thrive.

Rural vs. Urban (Metro)


If you have tried to research the definition of rural, there is a pretty good chance that you found a simple definition that says: pertaining to the country, country life, country people. In other words, not urban. But there are, indeed, truly technical definitions. For example,
  • The Bureau of the Census defines an urbanized area (UA):  by population density. According to this definition, each UA includes a central city and the surrounding densely settled territory that together have a population of 50,000 or more and a population density generally exceeding 1,000 people per square mile. A "county" is a political distinction and is not incorporated in the Bureau of the Census' classification scheme, so one UA may cover parts of several counties. Under this definition, all persons living in UA's and in places (cities, towns, villages, etc.) with a population of 2,500 or more outside of UA's are considered the urban population. All others are considered rural.
  • The Office of Management and Budget (OMB) designates areas as metro on the basis of standards released in January 1980. According to this definition, each metropolitan statistical area (MSA) must include at least: one city with 50,000 or more inhabitants or an urbanized area (defined by the Bureau of the Census) with at least 50,000 inhabitants and a total MSA population of at least 100,000 (75,000 in New England). These standards provide that each MSA must include the county in which the central city is located (the central county) and additional contiguous counties (fringe counties), if they are economically and socially integrated with the central county. Any county not included in an MSA is considered nonmetro. OMB periodically reclassifies counties on the basis of Census data and population estimates.
According to the USDA, "the Census Bureau classifies 61.7 million (25 percent) of the total population as rural, OMB classifies 55.9 million (23 percent) of the total population as nonmetro. According to the Census definition, 97.5 percent of the total U.S. land area is rural; according to the OMB definition, 84 percent of the land area is nonmetropolitan. USDA/ERS estimates that, in 1990, 43 percent of the rural population lived in metropolitan counties."

Living in a rural area can be challenging when it comes to basics. You might lack major transportation facilities (airports, trains, buses), Interstate Highways may bypass your community, there may be no providers of higher education, healthcare may be limited to a small community hospital that provides truly primary care, physicians with advanced specialties may be a good drive away, and mental health care could be in the next county or nearest city.

Encouraging words from Secretary Vilsack...


"We need to be sure that every American has access to quality mental health services, including Americans living in rural areas...[as part of the] effort to expand access to treatment for those suffering from mental health problems, USDA investments in mental health care facilities will reduce the difficulty many rural families face in accessing mental health help. These funds can also help expand and improve upon the services already offered by mental health facilities in rural communities, many of which increasingly are focused on helping military veterans."
Here at Cottonwood Tucson we understand how important it is to be aware of where our patients hail from and where they will return following treatment. Our clinical team at Cottonwood's drug and alcoholism rehab and behavioral health center is committed to supporting a tight continuity of care and encourages a continuing relationship between our patients and their community-based treatment providers. Our aim is to forge a helpful, lasting therapeutic alliance with all those in our care, their families, and treating clinicians at home.

Here's to a healthy New Year. 
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