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Mental health care in some rural areas may be deficient PDF Print E-mail
By Carolyn Lee
The Imperial Republican

    May is National Mental Health Awareness Month. However, according to the Center for Rural Affairs, over half of the counties in the United States have no mental health professionals, a situation that has changed little in 45 years.
    Not so in southwest Nebraska, according to Shona Heim of Heartland Counseling in Imperial.
    Heartland Counseling is part of Region II Human Services of Nebraska. The Imperial, Ogallala, McCook, North Platte and Lexington offices serve 17 counties.
    In 1972, a federal mental health law was passed where everyone had to have access to mental health services.
    Heim first joined Great Plains Mental Health Center 27 years ago. That then became Richard Young Family Life Center, and then the present Heartland Counseling about 10 years ago.
    “We do a pretty good job of covering the area,” Heim said. “We have a presence in every county we serve, not on location, but in the area weekly.”
    Services provided by the Imperial office include outpatient mental health counseling for all ages, group work, family counseling, education, drug and alcohol counseling, community support, helping clients live independently, and consulting with schools, nursing homes and private businesses.
    The Imperial office is staffed by Nicole Tjaden, a community support worker; Judy Krajewski, a drug/alcohol counselor; Heim as a licensed independent mental health practitioner; and the newest member, Rhonda Osborne as a licensed mental health practitioner.
    Heim said that it may be perceived that rural areas of Nebraska aren’t served as well as urban areas. However, she said that’s probably “a lack of funding to offset the unique problems of rural areas, such as transportation” and telephone charges.
    She said some people have to make a several hundred mile round trip for one appointment.
    The Center for Rural Affairs said in many rural areas a primary physician’s workload may include as much as 20-25 percent in mental health and behavioral health issues.
    It said there is a need for mid-level professionals to provide mental health services and a marketplace for such services.
    According to the Center, “Health care reform legislation can begin to address these disparities by providing incentives and reimbursement mechanisms for mid-level mental health providers (providers at the Bachelor’s and Master’s degree level) in rural areas and by providing resources for a specialty mental heath marketplace similar to what exists for rural medical clinics.”
    Heim said that while the workload for Heartland Counseling’s staff may be heavy at times, it is also seasonal.
    She said in a rural community, with agriculture as the basic economy, the workload is seasonal. Heim explained that at certain times of the year farmers are in the field, and children are in school, thereby making scheduling of appointments difficult.
    However, she feels that Region II and Heartland do a good job of providing mental health services for anyone needing them in the 17 counties they serve.
Rhonda Osborne
    Former Imperial resident Rhonda Bahler Osborne began working for Heartland Counseling about four weeks ago. Prior to that she worked in Holyoke, Colo. as a certified addictions counselor.
    The 1994 Chase County High School graduate received a Bachelor of Science degree in Psychology from Nebraska Wesleyan University in 1998. She then was awarded a Masters degree in Mental Health Counseling from Doane College in 2003.
    Osborne was certified in Colorado in 2006 and in Nebraska this year.
    As a licensed practitioner, she works in mental health therapy and substance abuse treatment in Nebraska.
    She also hopes to establish a private practice this year. Osborne works four days a week for Heartland, with Thursdays in Imperial from 9 a.m. to 6 p.m.
    She and husband Chad live near Amherst, Colo. and farm in Chase County. They have two children; Scott, 12 and Logan, 10.
    Osborne likes to work with horses and garden in her free time.