Mental health worker makes house calls in rural Idaho

Briley meets with a client behind a convenience store.
(Idaho Statesman photo by Darin Oswald)

Rural residents often have a harder time getting mental-health care because they lack the time, money, and/or transport to make the long trip to the nearest provider. That's why one mental-health worker comes to her clients instead, Audrey Dutton reports for the Idaho Statesman in Boise.

Shawn Briley is a licensed clinical social worker in Idaho, where 28 percent of the state's population lives in rural areas and, like Arizona and Wyoming, every county has been federally designated as a mental-health provider shortage area. Briley's office is in McCall, a town of 2,991 in western Idaho, but she makes house calls to all but a few of her 20 or so clients.

"Access to mental health treatment is critically important to rural Idaho," Dutton reports. "Not only are Idaho’s mountain and frontier communities short of psychiatrists, therapists and other mental health specialists, they tend to be poorer, uninsured or underinsured, and more isolated. Between 20 and 30 percent of people have no health insurance in the region where Briley works. Suicide rates are higher in rural areas than in urban cities."

The Idaho Behavioral Health Planning Council wrote in its fiscal year 2017 report to state lawmakers that increased telehealth services would help rural residents get better access to health care, Dutton reports. But telehealth isn't the right fit for everyone, especially those who are homeless or transient and need mental health services. That's why Briley's services are so helpful to her clients. 

Ed Robinson, a client of Briley's with a host of mental illnesses, once told Briley it "'just always seemed ridiculous'" that people without reliable transportation, who might be afraid to leave home — those needing the most help to navigate life — should be expected to independently handle their mental health care," Dutton reports.