During the years when copper was king in Butte, Montana, it was known as “The Richest Hill on Earth.” Editor’s Note: For more than a year, the Health AGEnda blog has been featuring occasional guest posts regarding the eight primary care community clinics receiving funding through the federal Social Innovation Fund (SIF) initiative to spread the IMPACT program, also known as Collaborative Care, in the rural Pacific Northwest. Today’s guest post by Shelley Stingley shares the story of why The Leona M. and Harry B. Helmsley Charitable Trust decided to partner with The John A. Hartford Foundation and SIF to bring the Collaborative Care model to Bighorn Valley Health Clinic in Hardin, Montana, and Southwest Montana Community Health Center in Butte, Montana. The John A. Hartford Foundation was one of just four new awardees chosen in 2012 to serve as an intermediary between SIF and subgrantees implementing innovative care models. As a result, a $3 million federal grant has been matched by $3 million from the John A. Hartford Foundation, with additional matching grants raised by the subgrantees, to spread the IMPACT/Collaborative Care model of depression treatment in Washington, Wyoming, Alaska, Montana, and Idaho. View or download a PDF of our 2015 Annual Report for an in-depth look at the SIF initiative.

Cross-sector partnerships can help provide mental health services to underserved communities. The Leona M. and Harry B. Helmsley Charitable Trust is honored to have the opportunity to partner with The John A. Hartford Foundation, the Social Innovation Fund (SIF), and two federally qualified health centers (FQHCs) to bring depression treatment to rural Montana. Rural areas are a natural target for better models of depression treatment for a variety of reasons, including high rates of depression, a lack of accessible care, and the tendency of many rural residents to eschew help because of the stigma associated with mental illness. The Trust, through our Rural Healthcare Program, is providing financial assistance to support The John A. Hartford Foundation in implementing the IMPACT (Improving Mood – Promoting Access to Collaborative Treatment) collaborative depression care model in hard-to-reach communities. This proven model is based on close coordination between a patient’s primary care provider, an on-site depression “care manager,” and a psychiatric consultant.

The Bighorn Valley Health Center is in Hardin, Montana, the county seat of Bighorn County.

The Bighorn Valley Health Center is in Hardin, Montana, the county seat of Bighorn County. Our specific role was helping two Montana subgrantees raise their required SIF match. We were happy to assist the FQHCs in Butte and Hardin, Montana to raise their match so as to reduce the fundraising burden on them and to help them improve and expand depression care for their patients. This partnership represented several “firsts” for the Rural Healthcare Program, including our first public-private partnership, our first behavioral healthcare grants, our first grants to FQHCs, and our first direct partnership with another foundation. It proved to be a relatively easy, inexpensive, and risk-tolerable experience that we learned much from. For example, through our work with rural emergency departments, critical access hospitals, and medical providers, we learned more about the great unmet needs for behavioral healthcare in rural areas. During the first few months of the SIF project, The Trust simultaneously completed a statewide survey of mental health needs in rural South Dakota. In addition to providing solid rural data, creating a baseline, and pinpointing geographic disparities, the survey also told us that many rural individuals were screening positive for depression but had never been diagnosed with depression and either didn’t, wouldn’t, or couldn’t seek care. The IMPACT model addresses many of the reasons given by survey participants for not accessing or receiving care. In addition to being a research-driven, clinically proven best-practice model, IMPACT integrates behavioral care into primary care to deliver effective collaborative care for patients. While our main goals for participating were gaining experience with the IMPACT model and improving depression care (and the number of people being screened and receiving care), we also learned how to work with FQHCs and special populations. We also gained access to new research on the benefits of the IMPACT model. Moreover, while our direct participation is with two IMPACT implementation sites, we are learning from all of the other sites within the two cohorts of SIF subgrantees, including sites in even more isolated rural and frontier geographies. Overall, this was an amazing opportunity for us to develop skills in funding behavioral healthcare nested within and collaborating with primary care. We thank the SIF and The John A. Hartford Foundation for the chance to join this unique collaboration.

This is the seventh in an occasional series of Health AGEnda posts on The John A. Hartford Foundation’s Social Innovation Fund projects. Read the previous posts: SIF Grant Helps Strengthen ‘Butte-tiful’ Community Bringing Proven Depression Treatment to a Greatly Underserved Population Fighting ‘Chronic Despair’ in Rural Communities in Washington State For Missoula Clinic, SIF Program Support Is a Dream Come True Innovative Depression Treatment Helps Sophie Enjoy Better Mental and Physical Health Partnership Advances a Revolution in Mental Health Care