Case Study: Avera Behavioral Health

Rural areas have the highest rates of suicide and drug overdoses in the nation, according to the Centers for Disease Control and Prevention. Avera Behavioral Health offers a full suite of behavioral health care services including a comprehensive eCARE telehealth solution delivering services in 32 states. Partnering with primary care providers, family members and providers throughout the country via its telepsychiatry network, it serves the behavioral health care needs of rural communities throughout the nation.

Executive Summary

People in rural areas face behavioral health conditions just as their urban counterparts do. Rural areas have the highest suicide rates in the nation, according to the Centers for Disease Control and Prevention (CDC), as well as a high concentration of veterans, who experience higher rates of suicide than nonveterans. In addition, the CDC reports that rates of drug overdoses in rural areas have surpassed those in metropolitan areas.

Yet, as the need for behavioral health care is increasing, there is a growing shortage of psychiatric professionals in the workforce. A 2018 study published in the American Journal of Preventive Medicine showed that 65% of nonmetropolitan counties do not have a psychiatrist, and 47% do not have a psychologist.

“This is a problem that’s hitting right in the heart of America,” says Matthew Stanley, D.O., vice president of the behavioral health service line for Avera, based in Sioux Falls, S.D. When people in rural areas experience mental health conditions, they often try to go at it alone. “There’s a ‘pull-yourself-up-by-the-bootstraps’ mentality that is so unfair to individuals who struggle,” Stanley adds. “Or their care is left to a general practitioner who doesn’t have the specialty expertise to treat complex conditions such as bipolar disorder or severe depression.”

For a strong, successful community network:

1. Embrace behavioral health care as a core part of the organizational mission, vision and values.
2. Establish a compelling value proposition with primary care providers.
3. Capitalize on increased social awareness and acceptance regarding addictions, suicide and behavioral health care.

Avera has long had a commitment to behavioral health care, with more than six decades of experience and leadership in the region. With nearly two decades of intensified investment in these services, Avera Behavioral Health has a full suite of behavioral health care services, a comprehensive eCARE telehealth solution delivering services in 32 states, and a full array of acute care services, including a 122-bed behavioral health care hospital, residency program, comprehensive community network and integration with Avera’s Health Plans. Avera Behavioral Health partners with primary care providers, family members and providers throughout the country via its telepsychiatry network to serve the behavioral health care needs of rural communities throughout the nation.

In 2019, Avera Behavioral Health opened the Avera Addiction Care Center, which offers acute, ambulatory and residential addiction-treatment services and, with the help of a $13 million grant from The Leona M. and Harry B. Helmsley Charitable Trust, is currently building a new four-story wing at the Avera Behavioral Health Center in Sioux Falls to add much-needed services — including more capacity for children and adolescents, residential addiction care for youth, 24/7 psychiatric urgent care and partial hospitalization space. Through its Zero Suicide initiative, Avera has instituted programs to identify and treat depression and suicidality earlier, through depression-screening tools used in primary care clinics and emergency departments (EDs).