The shortage of mental health care providers isn’t new to Arkansas, and it existed before the pandemic, but the situation has now become even more critical with 97% of counties in Arkansas classified as Behavioral Health Professional shortage areas. 


“This includes psychiatrists, psychologists, licensed mental health counselors, social workers and nurse practitioners with special training in mental health,” said Laura Dunn, M.D., chair of the University of Arkansas for Medical Services (UAMS) Department of Psychiatry and director of the Psychiatric Research Institute. “While the shortage of behavioral health professionals is most severe in rural areas, there can still be challenges in accessing mental health care in urban areas due to long wait times because the practices are already very busy. I would also note that this is also a problem that is being seen nationally.”


It has been widely reported, by organizations such as the Kaiser Family Foundation, that the pandemic has had a major negative impact on mental health, particularly for anxiety, depression and substance abuse. Dunn said even with many services going virtual during the pandemic, demand for mental health services accelerated.  State data from the Kaiser Family Foundation also revealed the significance of the need for mental health care in Arkansas. 


UAMS is working with members of the legislature, other providers and leaders of state agencies to leverage all currently available resources to better meet the needs of those seeking care. 


It is a problem that not only affects patients, but providers who may feel under pressure to work longer hours with less time off.


UAMS programs to increase the availability of mental health professionals include more residencies for training psychiatrists such as a new psychiatry residency program in collaboration with Baptist Health in North Little Rock. UAMS also has very active psychologist training programs, which includes interns, fellows, and other students training in a variety of specialty areas. 


“We would very much like to add residency slots in other areas of the state as well – stay tuned,” Dunn said. “Psychologists and other providers also work toward increasing mental health services through community engagement and by working in programs that train other professionals to recognize and treat mental health disorders, including trauma and addiction. UAMS continues to work with our congressional delegation, state legislators and other providers to increase the number of residencies available to train physicians, not only in psychiatry, but in all aspects of medicine. In addition, a cross section of providers, state agency leadership and members of the legislature have been meeting since February to discuss various approaches to increase the number of providers.” 


The pandemic highlighted the opportunities that telemedicine can provide. Some patients may have to travel hours from home to see a provider. Telemedicine is a tool that helps remove some of the barriers for access to care.


The UAMS AR ConnectNow virtual mental health program started with a federal grant in May 2020. 


“People couldn’t get out,” said AR ConnectNow Program Manager Tony Boaz. “They couldn’t visit their therapist in person, so we started a virtual clinic. The overall goal of our therapists is to get people established in their community. We usually see them for four to six sessions. If that is not enough, we will set them up with longer-term care in their community.”


It can take two months or longer to get an appointment with a psychiatrist. According to the National Alliance on Mental Illness (NAMI), 1,426,349 people in Arkansas live in a community that does not have enough mental health professionals. 


AR ConnectNow, is a free resource that fills the need for immediate care and is available to anyone. If a patient has insurance, the visit will be billed to the insurance company. 


In addition to psychiatrists and therapists, AR ConnectNow has four care coordinators who help get patients approved for insurance, and meet other critical needs such as for housing, food, education and treatment in other aspects of health care.


“It is awesome that we can provide this service,” Boaz said. “If you are feeling stressed, give us a call. We can help you. Since we started this, we have taken 3,500 calls and treated more than 2,000 people who might not have gotten help otherwise. The grant will sunset in the spring of 2023. We’re hoping that continues. I think it is too valuable to let it end. There is too much need in the state, so I’m fairly confident we are going to find a way to continue it.”


There are important implications for the economy.


“Obviously, when people are feeling better about their mental situation, they are able to perform better at work,” Boaz said. “With clinical depression, you don’t feel like getting up or doing anything, let alone keeping a job and paying the bills. If you can get medication, therapy or both, sooner rather than later, you can get on with the good parts of your life.”


The AR ConnectNow toll-free number, 1-800-482-9921, is answered 24/7 by a nurse triage group at UAMS. In an emergency, callers are advised to call 911 or visit the closest emergency department. If it is not an emergency, Boaz said UAMS usually schedules patients within a day or two.


Boaz said UAMS has seen very little difference between virtual and in-person appointments.


“Obviously, you have to get used to interacting virtually,” he said. “We have seen a lot of success with adolescents all the way up to 90-year-olds we have had in the clinic. People love the convenience of it. Our therapists love it. They have a lot of success stories. We’ve even done it at high schools. We see a lot of adolescents and referrals from the Arkansas Children’s Hospital. Those kids are used to being on their phones, so doing a video session is nothing new for them.”


This has also been helpful in fighting the stigma surrounding mental health treatment, as patients can attend visits virtually, without anyone knowing. The lack of stigma increases the likelihood of people being able to get help. 


Boaz is also the director of STRIVE, a school-based mental health program serving the Greater Little Rock area. STRIVE has offices in the schools. Instead of having to check out children and take them to an appointment, they can be seen at the school. The kids don’t miss half a day of school, but just an hour. And if children ares having a crisis, they can get immediate help. 


Depression and anxiety in youth during the pandemic have shot up; the suicide rate for the teenage population has gone up significantly. 


“The fact we are onsite helps out a lot,” Boaz said. “If the school has an issue, they know exactly who to call to get services.”