Closing the Gap in East Texas: Improving Mental Health Care for Disadvantaged, Rural Populations

Recently, Burke therapist, Stephanie Knott was interviewed by Diolog: The Texas Episcopalian magazine. Read below to learn more about Burke’s partnership with the Episcopal Health Foundation and the Seminary of the Southwest to improve access to mental health services in East Texas counties.

Seven patients. Two clinics. One elementary school. That’s the typical day for therapist Stephanie Knott. She works for Burke, a mental health agency serving low-income adults and children across 12 East Texas counties surrounding Nacogdoches and Lufkin.
Every patient Knott visits was previously one of the hundreds of people in a mental health crisis waitlisted for care because this particular region has an average of one mental health provider for every 10,000 residents. Eighty-eight percent of Burke’s clients are from households that earn less than $20,000 a year.

But thanks to a one-of-a-kind partnership between Burke, Episcopal Health Foundation and Seminary of the Southwest, low-income families in East Texas now have easier access to desperately needed mental health services.
“It is such an awesome process to see clients come in at some very low and dark point in their life, and be able to teach them to help themselves throughout the therapy process,” Knott said.

“It’s truly a powerful transformation to see them come out on the other side as a much healthier and happier person.”
Knott was one of the first two Seminary of the Southwest counseling graduates accepted into the Bishop Dena A. Harrison Fellows Program in 2015. The program is named in honor of Harrison, a Bishop Suffragan in the Diocese of Texas, an alumna, and chair of the Seminary ‘s board.

Episcopal Health Foundation ‘s investment in the program allows Harrison fellows to earn a salary and benefits at Burke while they complete 3,000 hours of required on-the-job training to become fully licensed therapists. During the training, fellows work with disadvantaged rural families at no cost to Burke ‘s clinics.
The seminary discovered many counseling graduates wanted to serve disadvantaged families while they completed their required post-graduate training, but most nonprofit post-graduate programs were unpaid.

“We found very few graduates were working with the underserved because they couldn’t afford to,” said Dave Scheider, director of the Seminary’s Loise Henderson Wessendorff Center for Christian Ministry and Vocation. “We never had the funding before to be part of the solution. Now, in partnership with Episcopal Health Foundation, we believe we’re the first graduate school to offer this kind of program to hire our own graduates and send them to work in these rural counties.”
The majority of Knott’s clients don’t have health insurance. Their mental health needs vary from depression and anxiety to post-traumatic stress disorder and schizophrenia. She works with adults, families and young clients inside local schools. She says the Harrison fellows program allowed her to follow her faith, give back to others and focus on something bigger than herself.

In addition to the immediate impact, a key goal for the Harrison fellows program is for students to continue their work with underserved families following completion of their training. That’s exactly what Knott did. She became an “official” full-time Burke therapist in September.

“I feel a responsibility to stay and work here because this is an area that lacks resources:’ said Knott. “This works gives me a sense of purpose and fulfillment.”
Knott’s decision demonstrates the program’s potential for building an ongoing supply of mental health providers in an area with a severe shortage of mental health professionals. Seminary of the Southwest believes recruiting students from East Texas to participate as Harrison fellows may be the best way to get therapists to remain in these same communities when they finish their training.

“We believe this is a model that will thrive and it will become part of the solution,” Scheider said.