South Texas Psychiatric Capacity Expansion Project (STEPP)

Two Universities partnered to address the severe shortage of psychiatric providers in the highly impoverished four-county area which makes up the Lower Rio Grande Valley. STEPP was funded through the US Bureau of Nursing Advanced Education Nursing Program. This region, one-third larger than the state of Rhode Island with a population of 1,170,776, is 88.7% Hispanic with 82.1% speaking a language other than English at home.

Texas is ranked 46th in per capita spending for mental health ($38 versus national average of $85). Only three designated mental health facilities exist in the target region. Two full-time practicing psychiatrists and one PMH CNS are available to meet the psychiatric needs of the four-county region. Two counties have no community-based mental health services.

Hispanics are more likely to be depressed and have lower scores on the SF- 12 Mental Composite Score than other ethnic groups, but make far fewer visits to mental health professionals. Hispanics also report greater use of alcohol, heroin, and cocaine that non-Hispanics. Issues are magnified for rural people with language barriers.

Post masters certificate students are recruited /enrolled in one University's FPMHNP program via distance learning methodologies. APRNs, faculty, and psychiatrists collaborate to provide precepted clinical experiences. A key project outcome is to build capacity needed for the second University to launch a FPMHNP program of its own in the academic year following expiration of the grant. We anticipate 12 post masters certificate completers to become locally-based FPMHNPs who will then serve as preceptors and faculty in subsequent years.

The program advances the Bureau of Health Professions’ mission of increasing access to health care by providing national leadership in development, distribution, and retention of a diverse, culturally competent health workforce that can adapt to the population’s changing health care needs and provide the highest quality of care for all. Lessons learned from year two of project implementation will be shared.