Many individuals across Oklahoma have limited access to behavioral health services, which makes it difficult for life-saving interventions to reach them in sheer moments.

Rural youth, young adults and other subpopulations, including Indigenous people, report elevated rates of suicidal ideation, substance use, anxiety and depression, relative to urban populations.

Dr. Douglas Knutson — assistant professor, training director, and associate head of the School of Community Health Sciences, Counseling and Counseling Psychology at Oklahoma State University — recognized this shortfall and is researching a solution.

As a board-certified counseling psychologist and member of the American Psychological Association Committee on Rural Health, he is well-versed in the subject.

Numerous studies show that one way to meet the elevated, and largely unmet, need for behavioral health support among rural youth and young adults is to create accessible pathways into behavioral health careers for those individuals and expand the behavioral health workforce in rural areas.

Knutson works with tribal nations and other organizations to design modular, community-based, rural-accessible behavioral health education programs to expand access throughout Oklahoma and surrounding states.

Key partners in Knutson’s progress have included Payne County Youth Services, Cherokee Nation Health Services, Southern Plains Tribal Health Board (SPTHB), OSU’s Center for Sovereign Nations and the OSU Institute for Teaching and Learning Excellence (ITLE).

The Bureau of Health Workforce projects massive nationwide shortages by 2038, including a deficit of 99,780 mental health counselors, 99,840 psychologists and 43,810 psychiatrists.

Those figures only represent current service utilization.

When unmet need is considered, an additional 136,350 psychologists alone are needed to close the gap.

Behavioral Health Aide (BHA) models return healthcare to tribal, rural and remote locations, elevating residents of those areas to the role of care provider, recognizing that healing can happen within their own communities — at home.

Dr. Kara Stone, research epidemiologist for SPTHB, is one of many experts working with Knutson to inform and evaluate the development of a BHA micro-credentialing program at OSU.

She helps connect the research, community engagement and workforce development pieces while ensuring that the curriculum aligns with community-based participatory research principles.

“I am drawn to working with [Knutson] because his passion for serving our communities and his general love and respect for others are so apparent in every exchange we have,” Stone said. “I am confident partnering with him to explore how OSU can create an accessible, community-based pathway for training and credentialing BHAs.”

Distance, cost, transportation and a lack of providers who understand cultural context can all create barriers to care for tribal communities.

According to Indian Health Services, Indigenous people experience a lower life expectancy and disproportionate disease burden, rooted in economic adversity and historical trauma. Much of this is avoidable with prevention and timely access to quality care.

Rather than viewing behavioral health in isolation, this work recognizes these factors can intersect and influence one’s ability to access and benefit from care. Developing a local workforce by offering an academically rigorous, culturally responsive, practical BHA program is one strategy to address some of these factors.

The goal is not simply to expand credentialing but to create a pathway into a sustainable Tribal behavioral health workforce that communities can shape and maintain.

School head Dr. DJ McMaughan emphasized that Knutson’s curriculum is grounded in community need for behavioral health training in rural and Indigenous populations, directly supporting the mission of the school and greater university.

“The incredible resources, support and value OSU has for this sort of work is something to be celebrated,” Knutson said.

“I could not do this work without passionate, dedicated partners.”

Photo By:  Kelly Kerr |  Research Matters Magazine

Story By: Kirsi McDowell | kirsi@okstate.edu