Care where patients need it most

Want to help underserved Americans and repay your educational loans? If you meet certain requirements, you can do both, thanks to a National Health Service Corps program that pays psychologists and other health professionals up to $50,000 toward their school loans, plus a competitive salary in exchange for working in underserved areas for two years.

"The National Health Service Corps has indicated that any eligible application will be funded," said Gary Hawley, PsyD, a psychologist at McConnell Air Force Base in Wichita, Kan., and chair of APA's Early Career Psychology Committee.

The NHSC program is designed to bring care to the nation's 3,059 health-profession shortage areas, which comprise 77 million people, mostly in rural areas.

"It will take 5,100 mental health professionals to fill that need," said Hawley, one of several psychologists who discussed psychology's role in community health settings at the 2009 APA Education Directorate's Annual advocacy breakfast, co-sponsored this year with APA's Public Interest Directorate.

In particular, community health centers need psychologists' advanced training, said Darryl Salvador, PsyD, who through the Corps program secured a position in a rural federally qualified health center on Molokai, Hawaii, that provides one-stop shopping for medical, dental and psychological care. Increasing access to care is particularly important in remote areas like Molokai, where the lack of services leads to increased stress, depression and suicides and puts children and older people at greater risk for mental and behavioral problems, he said.

Every day, Salvador works side-by-side with physicians and other primary-care providers who are eager for his help in managing patients' complex physical and psychological conditions. Patients often have depression, anxiety and substance abuse issues intertwined with poorly managed medical disorders, such as diabetes, hypertension and asthma.

"At these clinics, there's no separation of mind and body," said Salvador. "The work is fast-moving, exciting, maybe stressful at times, but always fun."

By applying to the National Health Service Corps, Salvador received $50,000 to repay his student loan debt on top of his salary for his two-year commitment to work in Molokai. He had left graduate school with $109,000 in debt. "This allows me to pay for that, plus be passionate about the work I'm doing in serving the underserved," he said.

Hawley explained the finer points of the loan-repayment program. Applicants must graduate from APA-accredited programs and must have completed a one-year postdoc. "That causes problems for people in the nine states that have eliminated the postdoc requirement," he pointed out, adding that this barrier needs to be addressed.

He also noted that while in the program, a psychologist must spend 32 hours of the 40-hour work week providing direct clinical services; 21 of the 32 hours must be spent doing face-to-face therapy.

Hawley said the stimulus package has added another $300 million to the program, creating 4,000 new positions. According to its Web site, the NHSC will accept applications until all the money is spent, or until Sept. 30, 2010, whichever comes first.

Another speaker, Bradley K. Powers, PsyD, of the Forest Institute, discussed his work to recruit students into the NHSC program early in their graduate studies and getting them involved in practicum experiences in Missouri. "It's working out well," said Powers. "They work in these rural areas and they really want to go back to them"—which helps address the long-term health-care needs of these rural areas.

The breakfast's moderator, former APA President Patrick H. DeLeon, JD, PhD, lauded APA's Education Directorate for its work to ensure psychologists were eligible for the corps program.

"Integrated community health centers are a wonderful place for the next generation of psychologists," he said. "The physicians, nurses and other health professionals want your services and the students who join the program love it."

As a psychologist who has worked for more than 30 years with Sen. Daniel K. Inouye (D-Hawaii), DeLeon emphasized that more federal education and training dollars are there for psychologists to tap into.

"There is absolutely no shortage of money, and there never has been. There's just a huge shortage of vision among the educators," he said. "Now it's up to the training system to go out and get involved in it."