Great Commitments: A public health crisis

Orion Mowbray talking to two students

Orion Mowbray trains the next generation of substance use and mental health experts.

You can’t solve a public health crisis if you don’t have the workforce to tackle it.

And the U.S.—Georgia, in particular—has a massive shortage of health care professionals trained to address substance use disorders.

The University of Georgia’s School of Social Work is aiming to close that gap, by partnering with local behavioral health agencies and a federal grant designed to help students get the hands-on training they need to hit the ground running after they graduate.

More than 1,000 Georgians died from opioid overdoses in 2017, a 245% increase from 2010, according to the Georgia Department of Public Health. Orion Mowbray, an associate professor of social work, partnered with Advantage Behavioral Health Systems, a local mental and behavioral health center, to gauge the extent of the provider shortage in Georgia’s Public Health District 10, which includes Clarke, Oglethorpe and Elbert counties, among others. The findings were bleak.

Some counties had one or two treatment centers; many had none.

That means many rural Georgians have to secure transportation and time off work, not to mention childcare, to access treatment centers a county or more away.

“That takes time, money and effort. Some people don’t have that,” Mowbray said. “One thing that we know from research is that if treatment services are far away, there’s a higher likelihood that people aren’t going to access them.”

Facilities that offer medication-assisted treatment (MAT) are also hard to come by. These facilities substitute a safer substance, like methadone or buprenorphine, for opioids, which helps ease the pains of withdrawal from hard-core narcotics or offers a long-term, safer substitute from opioids. The ultimate goal is to safely wean patients off the opioid-substitute as well.

The Substance Abuse and Mental Health Services Administration supports MAT, along with counseling and behavioral therapies, but many insurers, including Medicaid, aren’t keen to cover it. Plus, providers subject themselves to intense scrutiny by the Drug Enforcement Agency.

“It’s a highly regulated process to distribute medication,” Mowbray said. “And that creates a disincentive to provide it.”

Along with College of Education professor Bernadette Heckman, Mowbray secured a $1.4 million grant from the U.S. Health Resources and Services Administration to train about 100 graduate students to help address the mental and behavioral health services shortage.

The graduate students will serve in treatment facilities across District 10. The grant will also enable the students to receive advanced training in everything from screening for substance use problems to medication-assisted treatment for opioid addiction.

“We can teach students all they want in the classroom,” Mowbray said, “But that direct experience, that experiential learning, is critical.”


This story was first published online at UGA Today.

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