CINCINNATI, Ohio — A new initiative in Adams County, Ohio, is testing a collaborative care model aimed at addressing the mental health crisis among youth in rural communities. The University of Cincinnati (UC), Adams County Health Department (ACHD), and local partners have received a $1.75 million grant from the Health Resources and Services Administration (HRSA) to fund the Operation Better Together project, which focuses on expanding access to telemental health care for students.
A Growing Need for Mental Health Services
The COVID-19 pandemic highlighted the growing reliance on telehealth, but challenges such as long waitlists and poor internet connectivity still hinder many rural communities from accessing mental health services. Adams County, located in south-central Ohio, has faced significant barriers to care, including the absence of any psychiatrists in the area and transportation difficulties for residents needing mental health support.
In 2017, the ACHD conducted a community health assessment revealing that mental health and substance abuse were the county’s leading public health issues. According to Danielle Poe, director of behavioral health at ACHD, the assessment showed that mental health was a “local public health crisis” exacerbated by limited resources and access to care. With Adams County being the second poorest in Ohio, Poe said the county faced challenges that left families without options for mental health services.
“We recognized we could have telehealth services available, but for our community members to have real access, we needed to be in the places where they are,” Poe said.
Collaboration Leads to New Care Model
The project gained momentum following an emergency community meeting called by Judge Brett Spencer of Adams County Common Pleas Court. Local leaders from various organizations, including schools, ACHD, and small businesses, came together to address the mental health impact on local youth. This collaboration set the stage for Operation Better Together to expand its reach.
William Hablitzel, MD, former county health commissioner, approached UC’s Melissa DelBello, MD, to explore how UC’s Department of Psychiatry could support the effort. As a result, UC faculty began providing telemental health services for adults in partnership with ACHD and Adams County Courts. Over time, the program grew to include students from the Adams County Ohio Valley School District.
The new HRSA grant will help expand the youth-focused portion of the program, particularly through a tiered approach to mental health care.
Tiered Approach to Care
The three-tiered approach of Operation Better Together was designed to ensure that mental health care is accessible to as many students as possible.
Tier One is the most widely accessible and involves school counselors, resource officers, and school-wide initiatives that provide initial mental health support. This tier aims to identify and support students who need basic assistance or early intervention.
Tier Two offers more intensive support for students needing one-on-one therapy. Local licensed therapists are embedded in schools, courthouses, and the health department to provide counseling services directly within the community.
Tier Three involves telehealth services with UC experts, including specialists like Dr. Melissa Wagner and Dr. Kaitlyn Bruns. Students in this tier may receive medication prescriptions, regular check-ins, and additional therapy, all via telehealth appointments. These appointments are conducted using a HIPAA-compliant version of Zoom, and occur during school hours, eliminating the need for students to leave school or travel for care.
“Not every Tier One student needs to access higher-tier services, and once we stabilize them, they can move down the tiers to make room for other students,” said Dr. Wagner, Associate Professor in UC’s Department of Psychiatry and Behavioral Neurosciences.
Removing Barriers to Access
The program’s use of telehealth appointments during school hours is a key feature that helps overcome barriers like transportation and unreliable internet connections, which can be particularly challenging for rural families. By conducting appointments at school, the program ensures that students can access care without leaving the classroom or facing logistical hurdles.
“This removes the burden from families in a high-need community, where reliable internet and transportation are often challenges,” Wagner said.
Operation Better Together is setting a precedent for how rural communities can address mental health needs among youth, and with continued support, it could serve as a model for other regions facing similar challenges.
Related topics:
