Community perspectives on the use of extension offices for behavioral health

Abstract

Rural communities experience more systemic health disparities than urban communities, particularly around behavioral health. Disparities include a lack of providers, few hospitals, lack of health insurance, stigma, and limited public transportation. This study explored the potential use of Cooperative Extension offices to serve as “hubs” for behavioral health services. We conducted six focus groups (n = 52) in rural communities with high rates of opioid use and misuse. Community stakeholders were asked about the potential benefits and barriers to using Cooperative Extension as a behavioral health hub and what role Extension can play in behavioral health. We identified four major themes related to the extension being used to address behavioral health: the organization is trusted, the organization could provide many services, potential structural and social barriers need to be addressed, and resources are necessary for success. The study found that Extension is trusted, lacks the stigma of a traditional behavioral health setting, and could provide prevention and/or recovery education and a connector to support services. However, Extension is not currently seen as a resource for behavioral health and may have structural barriers and create stigma by providing services. To address these barriers, it was suggested Extension partner with other organizations to extend the reach of existing resources (telehealth and support groups) while focusing on both prevention education and relationship building. Moving forward, participating counties will leverage their partners into a community advisory group to define next steps, develop processes and protocols and begin advertising services/resources, and provide continual feedback on how needs are being met and recommended improvements.