American Psychological Foundation

In 1996, psychologist Joseph Evans, PhD, and members of his staff at the University of Nebraska Medical Center began accompanying medical geneticists on regular trips to rural Nebraska communities, providing behavioral health services to children and families. He quickly discovered the need was much greater than quarterly sessions with a psychologist could fill.

"Every three months going to see a family who had behavioral problems was not adequate, and there was no one in the rural areas to refer parents to," says Evans, director of psychology at the Munroe-Meyer Institute at the University of Nebraska Medical Center in Omaha.

Evans sought to fill that need. Armed with funding from a variety of sources including the Health Resources and Services Administration Graduate Psychology Education Program, Evans created a network of 14 integrated behavioral health clinics that serve 225 rural communities that previously had little access to child and adolescent mental health care. (The Graduate Psychology Program, which provides funding to accredited graduate programs of psychology, is an ongoing legislative initiative of APA's Education Directorate.) For these efforts, Evans won the $50,000 2008 APF Cummings PSYCHE prize, which recognizes people who have expanded the role of psychologists in primary-care settings. Nicholas Cummings, PhD, and his wife Dorothy established this prize through the Cummings Foundation; the Cummings will endow the prize with a $1 million bequest.

Each clinic in Evans's network is staffed by a pediatric psychologist, as well as interns and postdocs, who assist parents and children with a wide range of behavioral problems, including autism, depression, attention deficit hyperactivity disorder and truancy. The psychologists work alongside pediatricians and family medicine physicians, who benefit from having behavioral health experts in their practices, says Evans. Physicians spend about 20 extra minutes with patients who come in with a behavioral problem, so it's more efficient and effective to refer those patients to in-house behavioral health experts, he notes.

"They can turn some of those cases over to us, and it's economically better for them as well as for their patients and for their practices," says Evans.

Seeing a psychologist at the physician's office also allows parents to avoid any stigma that may come from having a child with a mental health problem, he adds.

When they're not consulting directly with families, the psychologists at Evans's centers provide community outreach, consulting with autism parent support groups and serving local teen-pregnancy prevention committees, for example.

"We try to train people to be generalists," he notes. "In these rural areas, you have to deal with every behavioral problem that comes in the door."