FY 2011 Congressional Appropriations Request: Strengthen the Graduate Psychology Education Program
Request: Provide $7 million in the FY 2011 Labor, HHS, and Education Appropriations Bill for the Graduate Psychology Education (GPE) Program within the “Allied Health and Other Disciplines” budget activity of the Health Resources and Services Administration.
Background: The Graduate Psychology Education (GPE) Program is the nation’s only federal program dedicated solely to the education and training of psychologists.
The activity is authorized by the Public Health Service Act [P.L. 105-392 Section 755 (b)(1)(J)] and appropriated under the “Allied Health and Other Disciplines” account in the Labor-HHS Appropriations Bill. Without GPE, the nation would lose its critical mechanism to ensure that psychologists who specialize in underserved populations receive interdisciplinary training and placement in communities with shortages of mental and behavioral health providers.
The GPE program is a competitive grant activity operated by the Health Resources and Services Administration’s Bureau of Health Professions. Currently, it supports training grants at 18 academic institutions and training sites (i.e., children’s and VA hospitals) throughout the nation.
Purpose: Established in 2002, the GPE Program provides grants to accredited psychology doctoral, internship, and postdoctoral training programs. An exemplary “two-for-one” federal program, the GPE Program supports the training of psychology graduate students with other health professions while they provide supervised mental and behavioral health services to underserved populations—such as older adults, children, the chronically ill, victims of abuse and trauma including veterans—in rural and urban underserved communities. Special attention is given to:
Older Adults: Approximately 20% of older adults have a mental health condition, such as depression, anxiety, alcohol, or substance abuse. In addition, studies show that substance abuse combined with depression makes older adults especially vulnerable to suicide (Retooling for an Aging America, IOM, 2008). Mental health disorders can adversely affect physical health and the ability to function. In fact, depression can lower immunity to disease and may compromise one’s ability to fight infection, which is especially true for older adults (APA, 2005). Moreover, older adults with chronic illnesses such as heart disease have higher rates of depression than those who are physically healthy (APA, 2008). Rural areas have a greater percentage of older adults than urban areas, and older adults in rural communities have a higher incidence of chronic illnesses such as heart disease, diabetes, high blood pressure, and obesity than those in urban communities (Alliance for Health Reform, RWJ Foundation, January 2010). Undeserved communities need psychologists to treat older adults with depression, anxiety, suicidal ideation, and chronic illnesses.
Veterans: Rand Corporation reported that one in five veterans (approximately 300,000) suffer from depression or stress disorders, and only half of veterans with a probable diagnosis of PTSD or major depression seek help (April 2008). Nearly 15% of soldiers reported suffering mild traumatic brain injury, which is significantly associated with a diagnosis of PTSD and physical health problems three to four months after returning home (New England Journal of Medicine, Jan. 31, 2008). The Veterans Administration (VA) recently reported that the suicide rate among 18- to 29-year-old men who left the military rose 26% from 2005 to 2007 (2009). One of the reasons for the increase was that the veterans did not want to be treated at the VA with older patients, stated Ralph Ibson, Senior Fellow for Health Policy, Wounded Warrior Project. Ibson further testified that veterans with untreated mental health problems may face long-term consequences with general health, energy, emotional well-being, physical functioning, and ability to work (House Committee on Veterans Affairs, April 30, 2009). At a briefing hosted by the Journal on Health Affairs, Audrey Burnam, PhD, Rand Corporation, declared that veterans need care in their home communities and that the mental health workforce is not adequately trained to meet their needs (Washington D.C., May 5, 2009). Further, in a recent study from the University of New Hampshire, researchers found that most veterans with service-related disabilities live in rural and Southern communities (November 2009). Underserved areas need psychologists to treat veterans with depression, PTSD, traumatic brain injury, and adjustment problems.
Federally Qualified Health Centers (FQHCs): More than 7,000 FQHCs nation-wide provide health care to uninsured and underinsured persons (2009). FQHCs are in designated Health Professional Shortage Areas in rural or urban communities, and there are over 3,000 mental health professional shortage areas. Psychologists are needed to ensure an integrated health care approach that addresses the FQHCs’ most common health problems, including depression and chronic illnesses (e.g., heart disease, cancer and diabetes) and behavioral problems (e.g., diet, exercise, smoking, and alcohol) as well as other at-risk behaviors, such as violence and accidents that lead to health problems.
Funding History: The program has been included in the President’s Budget Request for the past two years, and the FY 2011 OMB request is $2,945,000. In FY 2010, the GPE Program received $2,945,000 in appropriations. Previous funding: $1.8 million per year from FY 2006 to FY 2009; $4.5 million per year from FY 2003 to 2005; and $2 million in FY 2002. In FY 2006, the funding reduction of more than 50% forced the elimination of all geropsychology training grants and cut funding for each of the remaining 20 grants by 44%.
Funding Request Summary: Providing $7 million in FY 2011 would allow for approximately 35 to 45 GPE grants across the nation, including grants that focus solely on the needs of older adults and others that focus on returning military personnel. At the same time, providing $7 million in FY 2011 would create training opportunities at our nation’s FQHCs that provide health care for those in need who live in rural and urban communities.
