Rural Project Examples Addressing Depression - Rural Health Information Hub

Project ECHO® – Extension for Community Healthcare Outcomes
Updated/reviewed October 2022

Need: Increase medical management knowledge for New Mexico primary care providers in order to provide care for the thousands of rural and underserved patients with hepatitis C, a chronic, complex condition that has high personal and public health costs when left untreated.
Intervention: Project leveraging an audiovisual platform to accomplish "moving knowledge, not patients" that used a "knowledge network learning loop" of disease-specific consultants and rural healthcare teams learning from each other and learning by providing direct patient care.
Results: In 18 months, the urban specialist appointment wait list decreased from 8 months to 2 weeks due to Hepatitis C patients receiving care from the project's participating primary care providers. Improved disease outcomes were demonstrated along with cost savings, including those associated with travel. The project model, now known as Project ECHO® – Extension for Community Healthcare Outcomes — has evolved into a telementoring model used world-wide.

Telepsychology-Service Delivery for Depressed Elderly Veterans
Updated/reviewed December 2021

Need: To provide evidence-based psychotherapy for depression in elderly veterans who are unable to seek mental health treatment due to distance or stigma.
Intervention: Telepsychology-Service Delivery for Depressed Elderly Veterans compared providing behavioral activation therapy via home-based telehealth and the same treatment delivered in a traditional office-based format.
Results: A 2015 study and two 2016 studies show that providing treatment via home-based telehealth to elderly veterans in South Carolina resulted in the same improved health outcomes, quality of life, satisfaction with care, and cost of healthcare compared to those receiving face-to-face treatment.

Chronic Disease Self-Management Program
Updated/reviewed December 2019

Need: To help people with chronic conditions learn how to manage their health.
Intervention: A small-group 6-week workshop for individuals with chronic conditions to learn skills and strategies to manage their health.
Results: Participants have better health and quality of life, including reduction in pain, fatigue, and depression.

Cross-Walk: Integrating Behavioral Health and Primary Care
Updated/reviewed October 2021

Need: To address and treat substance use disorder (SUD) and depression in the Upper Great Lakes region.
Intervention: Cross-Walk, a program that integrates behavioral healthcare into primary care services, was developed in Michigan's Marquette County.
Results: The collaborative efforts strengthened care management services in local healthcare facilities as primary care patients were referred to a behavioral health specialist.

New Horizons Geriatric Counseling Program
Updated/reviewed June 2022

Need: Improved behavioral health care offerings for a community after losing 5 senior-aged men to suicide.
Intervention: A Critical Access Hospital in Yoakum, Texas, created a community-based program focusing on inpatient and outpatient behavioral health care for area residents age 50 and older.
Results: A financially-sustainable behavioral health care delivery model demonstrating positive impacts on physical health conditions, healthcare service utilization, and high patient satisfaction rates.

Medical Home Plus
Updated/reviewed February 2020

Need: To help reduce diabetes, depression, and stroke risk in rural residents.
Intervention: A collaborative care model was implemented in the Idaho counties of Clearwater, Idaho, and Lewis.
Results: Increased number of patients with controlled blood sugar, controlled blood pressure, and higher depression screening rates.

Healthy Men Michigan
Updated/reviewed April 2019

Need: Mental health assistance and resources for men in rural Michigan who struggle with depression and suicidal thoughts.
Intervention: The Healthy Men Michigan campaign was a research study testing online screening for depression, including irritability and anger, and suicide in working-aged men. The Healthy Men Michigan campaign website also offers referrals to local and national resources specific to men's mental health.
Results: More than 5,000 individuals completed anonymous online screenings and 550 men enrolled in the study. Healthy Men Michigan secured partnerships with over 225 individual and organizational partners, including healthcare facilities, small businesses, and recreational groups across the state. Together, their efforts have helped to promote screenings, reduce stigma, and encourage help-seeking behavior to prevent suicide.

Rural Project Examples: Depression