In response to the need for expanded psychiatry services, particularly in rural areas, MaineHealth has launched a Rural Residency Program (RRP) in Rockland, Maine. Residents participate in the four-year program that includes two years on a rotation at MaineHealth Maine Medical Center Portland followed by two years at a rural location focused on outpatient psychiatry at MaineHealth Behavioral Health (MHBH).

Recognizing Unique Needs

Annya Tisher, MD

Treating patients in an urban setting is different than the experience in a rural area, said Dr. Annya Tisher, associate training director at MaineHealth. “The patients they treat may not see their primary care physician as often as is ideal. The cases they see can be more complex, so they need a slightly broader comfort level with the medical consequences of the treatments they give and a more in depth understanding of medical conditions that have mental health implications.”

As the onsite director of the residents, Dr. Harold Van Lonkhuyzen is excited to have students interested in rural psychiatry.

“These residents get the genuine experience of living, working and being part of a rural community. Hopefully, they will decide to pursue careers here or in other underserved communities. This program will help improve the quality of care by enhancing our educational mission and increasing access as the residents are seeing additional patients.”

Mental Health Professional Shortage

• 66% of Maine residents live in a rural area
• There are mental health professional shortages in most Maine counties, specifically in rural areas
• Suicide death rates are highest in some of the more rural counties

Source: Rural Health Information Hub, 2019; CDC WONDER, 2015-2020)

Care Coordination Makes Treatment Possible

Care Coordinator Manivone Sundara (left) consults with Richard Sterrs, employment specialist at the Rockland outpatient clinic.

Manivone Sundara, MHRT/C, is a care coordinator at MaineHealth Behavioral Health’s Certified Community Behavioral Health Clinic (CCBHC) in Knox and Waldo Counties. Care coordinators like Sundara are the heart of the CCBHC program.

“A big part of my job is building an overall connection with our patients to support their treatment,” said Sundara. “We routinely ask patients if they are facing any barriers to care.”

Barriers may include food insecurity, unemployment or transportation issues, a particular concern in rural areas with little public transit. Even the cost of gas is a consideration, so Sundara can arrange for gas cards, funded through the CCBHC grant, for those eligible to make it possible for patients to get to appointments.

“It may seem like a small thing, but it warms my heart to help people get the care they need.”

Meet the Residents

Kristen Clark, MD, and Carlos Rodas, DO, are the first to participate in MaineHealth’s RRP.

Dr. Rodas has a longstanding love of working in the mental health field and plans to work in Maine. “I really like working here because of how small it is, and I get to know everyone’s name. I’m learning about the resources in this region, and I enjoy how close-knit the outpatient offices are at MHBH (MaineHealth Behavioral Health).”

Dr. Clark is enjoying her residency as well. “It’s been great working in the clinic and working with the entire multidisciplinary team to learn about the resources available in this area. Someday I envision myself working in a smaller hospital where I can see patients on an inpatient unit while expanding my capabilities, consulting, and wearing many hats in the community.”

Next year the program will usher in two more students to the area with hopes to continue growing to meet the increasing demand across the MaineHealth footprint.

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