New Approach to Preparing Tomorrow’s Rural Community Mental Health Leaders

Program Description

To help meet the unconscionable unmet mental health needs in rural communities, we have developed a pioneering program (“The Horseshoe Farm Fellowship”) focused on preparing promising future community health leaders to shape a better future in rural community mental health. Since its launch in 2009, the extremely competitive program has attracted nearly 50 top recent college graduates from around the nation to spend 13 months living in Greensboro, Alabama learning how to work successfully with our community to develop and lead innovative community mental health programs. Through managing, leading, and serving in supported housing programs and day programs for adults with mental illness, as well as in after school tutoring, mentoring, and enrichment programs for at risk children, Fellows gain a deep understanding of the biopsychosocial factors necessary to support and help our most vulnerable neighbors. The experience is intended to shape Fellow’s future understanding of their role as community health leaders and give them skills necessary to develop and lead similar approaches to support the mentally ill in their future work. Finally, Fellows come to appreciate the beauty and attractiveness of work in rural communities as they learn to work effectively with and support the values of rural communities.

Creativity

To our knowledge, the Horseshoe Farm Fellowship is the only program of its kind in the nation. No other program that we know of has brought together social entrepreneurial approaches to developing rural community mental health systems with leadership training programs designed to prepare individuals to build better community mental health and community health systems for tomorrow’s communities.

Leadership

Much recent literature has focused on the need to teach future healthcare providers and leaders about community based approaches to care, community partnerships in medicine, team approaches to care, care of populations, biopsychosocial models of care, mental health in rural communities, and new models for caring for an aging population. One of the challenges in fulfilling these goals is that the systems that serve as training sites for most medical, nursing, and allied health education were built during and therefore reflect the political, economic, and practice realities of the last 50 years. As a result, a large majority of training still occurs academic medical centers or other institutions that are largely detached from community based processes that affect mental and community health. By partnering with academic medical centers, we believe we can provide a model and path forward to help medical schools fulfill our shared aspirations in community health education.

Sustainability

Though we now have an 8 year track record of success in the Horseshoe Farm Fellowship program, we believe that we are still are at our early stages and believe that we are on a path towards significant expansion of our leadership development programs. Partnerships with our community and with organizations across our State are very important to Horseshoe Farm. We have established relationships with the University of Alabama School of Medicine, The University of Alabama at Birmingham (UAB) School of Medicine, The UAB School of Nursing, and the UAB Physician’s Assistants Program, and we are developing partnerships with the Auburn University School of Medicine and the Alabama College of Osteopathic Medicine. We are also in the process of renovating a 20,000 square foot Main Street historic building that will serve as a unique housing and training site for medical, nursing, and allied health students from across our State.

Replicability

We have already begun informal consultation to other programs seeking to replicate aspects of the Horseshoe Farm Fellowship. We have met with leaders from the University of Alabama College of Community Health Sciences who this year launched a “Fellowship” program in rural Pickens County, Alabama. We have also met with leaders from the University of Alabama Honors College who are also looking to launch a one year “Fellowship” program in Marion, Alabama. We believe that there is growing interest in this model and hope to continue to provide consultation to help other organizations seeking to develop similar programs in other rural communities.

Results/Outcomes

Including this year’s class of Fellows, 49 top recent college graduates have participated in the Horseshoe Farm Fellowship. Graduates of the Fellowship program have gone on to some of the top medical, nursing, public health, and graduate programs in the nation and have received some of the most prestigious honors and scholarships at their respective schools. Fellows complete an exit survey and more than 95% of responding Fellows “agreed” or “strongly agreed” with the following statements: I have greater understanding of how psychological and social factors impact health and quality of life and have greater confidence that I can use this understanding to benefit those I plan to serve. I feel more confident in my ability to develop, manage, and lead service related projects. My experience has increased the likelihood that my future work will have greater community involvement. I made a good decision to pursue the Horseshoe Farm Fellowship.