Primary and Psychiatric Care in Wisconsin’s Underserved Areas

Mental illness affects people of all ages, spans all socio-economic classes, and includes all races and nationalities.  It occurs in both men and women and doesn’t discriminate between urban and rural areas.  Families, schools, employers, and communities are all impacted by a person with mental illness. 

It is estimated that about one in four adult Americans suffer from a diagnosable mental disorder in any given year.  In economic terms, mental illness accounts for approximately $105 billion in lost productivity annually throughout the United States.

I was honored to be selected as one of 11 bi-partisan members for the Speaker’s Task Force on Mental Health.  The task force was challenged with objectives which included eliminating barriers to treatment, as well as promoting early and voluntary intervention for juveniles and adults in need of mental health services.  Individuals suffering with mental health issues in additional to over 70 experts testified during nine months of hearings held throughout the state.

A major barrier to treatment is limited access to services in medically underserved areas.  According to national studies cited in the testimony, primary care physicians are the sole providers treating 40% - 60% of patients with mental health needs.  

To help alleviate mental health care shortages in Wisconsin’s medically underserved areas, I authored Assembly Bill 454 - the Primary Care and Psychiatry Shortage Grant Program.  Senator Luther Olsen (R-Ripon) co-authored and took the Senate lead on the bill.

The Primary Care and Psychiatry Grant Program provides service-based financial awards to certain medical students.  To qualify, candidates would have to complete their residency training program in Wisconsin, apply for the grant prior to accepting an employment offer, and practice primary care medicine or psychiatry in a medically underserved area in the state.  However, if the participating doctor leaves the shortage area, the grant would be eliminated.

Qualifying programs include family medicine, internal medicine, pediatrics, psychiatry, and general surgery.  Underserved areas are defined as Health Professional Shortage Areas; Medically Underserved Areas; and Governor's Designation of Shortage Areas for Rural Health Clinics. 

On October 22nd, AB 454 had a hearing in the Assembly Committee on Health.  Groups registered in favor of the bill included Mental Health America of Wisconsin, Rural Wisconsin Health Cooperative, Wisconsin Academy of Family Physicians, as well as other groups involved in medical and mental well-being.

On November 5th, AB 454 was voted out of the Assembly Committee on Health’s Executive Session with a bipartisan vote. On November 12th, the bill was debated in the Assembly and passed with unanimous support.

In rural areas, a majority of front-line mental health services are provided by primary care physicians.  As a coordinated approach to mental health treatment, the Primary Care and Psychiatry Grant Program encourages new physicians and psychiatrists to select underserved areas when establishing their practices.