David Hartley, PhD, MHA
Contact information for this researcher is no longer available, but you can still access their previous work.
- Completed Projects - (16)
- Publications - (30)
Completed Projects - (16)
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Adolescent Alcohol Use in Rural Areas: What Are the Issues?
This study will use the National Survey on Drug Use and Health (NSDUH) to examine the effect of developmental, individual, and environmental factors on adolescent alcohol use across the urban-rural continuum.
Research center: Maine Rural Health Research Center
Topic: Substance use and treatment
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Chronic Illness and the Rural Informal Safety Net: The Case of Diabetes
Research center: Maine Rural Health Research Center
Topics: Chronic diseases and conditions, Diabetes, Uninsured and underinsured
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Database for Rural Health Research in Progress
This searchable database of current rural health services research and policy analysis includes all ORHP-funded studies as well as research funded by other federal agencies, major private foundations and other sources.
Research center: Maine Rural Health Research Center
Topic: Health services
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Effects of Scope of Service and Reimbursement on Access to Mental Health Services in Rural Areas
Research center: Maine Rural Health Research Center
Topics: Health services, Mental and behavioral health
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Health Reform-Rapid Response
This project will include several projects as requested by ORHP and DHHS as those agencies prepare for national health reform. Responses are primarily in the areas of health insurance and behavioral health.
Research center: Maine Rural Health Research Center
Topics: Health services, Healthcare financing, Mental and behavioral health
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Implications of Mental Health Comorbidity and Rural Residence for Health Care Use Patterns of Individuals with Chronic Disease
This study will use the 2005-2010 panels of the Medical Expenditure Panel Survey to compare the prevalence of concurrent mental health and chronic illnesses across rural and urban populations and to describe relationships among comorbidity, residence, and healthcare use. Findings will inform public and private decisions on how best to allocate new resources available for mental health/primary care integration efforts.
Research center: Maine Rural Health Research Center
Topics: Chronic diseases and conditions, Mental and behavioral health
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Mental Health Encounters in Critical Access Hospital Emergency Rooms: A National Survey
This project will survey Emergency Room (ER) managers in a nationally representative sample of Critical Access Hospitals (CAHs) to determine the proportion of ER encounters involving mental health pathology, types of mental health problems most commonly seen in these encounters, and resources available to CAHs to address the problems encountered.
Research center: Maine Rural Health Research Center
Topics: Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Mental and behavioral health
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Mental Health Services in Rural Jails
This project will investigate how rural jails manage the mental health and substance abuse problems of their inmates. Through analysis of the National Survey of Jails and semi-structured interviews with state-level and county-level/local officials, barriers to providing such services will be assessed and promising practices will be documented.
Research center: Maine Rural Health Research Center
Topic: Mental and behavioral health
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National Study of Substance Abuse Prevalence and Treatment Services in Rural Areas
This project will research the prevalence of the abuse of legal and illegal substances across rural populations and geographic areas, including the extent to which rural individuals are receiving treatment for their substance abuse and barriers to the receipt of treatment.
Research center: Maine Rural Health Research Center
Topics: Health disparities and health equity, Health services, Rural statistics and demographics, Substance use and treatment
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Patterns of Care for Rural and Urban Children with Mental Health Problems
This study will assess whether use of office-based care and psychotropic medicine by children differs between rural and urban areas, as well as the role of insurance coverage and availability of mental health providers on use of these services.
Research center: Maine Rural Health Research Center
Topics: Children and adolescents, Health disparities and health equity, Mental and behavioral health
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Provision of Specialty Mental Health Services by Rural Health Clinics
This project will document the extent to which Rural Health Clinics (RHCs) are employing mental health staff nationally, understand why more RHCs are not employing specialty mental health staff, and analyze the barriers to and opportunities for the delivery of mental health services by RHCs. The results will identify opportunities and interventions to encourage RHCs to offer this important service.
Research center: Maine Rural Health Research Center
Topics: Health services, Mental and behavioral health, Rural Health Clinics (RHCs), Substance use and treatment
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Role of Advanced Practice Registered Nurses in Addressing Mental Health Workforce Shortages
Research center: Maine Rural Health Research Center
Topics: Mental and behavioral health, Nurses and nurse practitioners, Workforce
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Role of Community Mental Health Centers as Rural Safety Net Providers
Research center: Maine Rural Health Research Center
Topics: Federally Qualified Health Centers (FQHCs), Mental and behavioral health
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Role of Inpatient Psychiatric Units in Small Rural Hospitals and Rural Mental Health Systems
This is a descriptive, exploratory study which will investigate the role of the small rural hospital Inpatient Psychiatric Units from the perspectives of both the rural hospital, in terms of scope of services and revenue enhancement, and the regional mental health system, meeting the needs of outpatient mental health and primary care providers, law enforcement, and human services.
Research center: Maine Rural Health Research Center
Topics: Health services, Hospitals and clinics, Mental and behavioral health
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Rural Maternal Smoking Behaviors
In this project, we will develop a chart book documenting the prevalence of mental health/substance abuse conditions and describing the utilization of mental health services in rural and urban settings.
Research center: Maine Rural Health Research Center
Topics: Health disparities and health equity, Mental and behavioral health, Substance use and treatment
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Year 2 of the Sentinel Cohort of Rural Health Clinics: Testing, Evaluating and Refining a Set of Rural Health Clinic Quality Measures
This project implements the set of core consensus quality measures identified during Year One of the Rural Health Clinic (RHC) Sentinel Cohort project among a group of approximately 130 RHCs in 13 states.
Research center: Maine Rural Health Research Center
Topics: Quality, Rural Health Clinics (RHCs)
Publications - (30)
2016
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Understanding the Business Case for Telemental Health in Rural Communities
Journal Article
Maine Rural Health Research Center
Date: 07/2016
This article describes the current landscape and characteristics of rural telemental health programs and then examines their business case. -
Pilot Testing a Rural Health Clinic Quality Measurement Reporting System
Policy Brief
Maine Rural Health Research Center
Date: 02/2016
More than 4,000 Rural Health Clinics (RHCs) serve the primary care needs of rural communities. Unfortunately, the Rural Health Clinic Program is plagued by a lack of data participating clinics. This reports on the results with a focus on assessing the feasibility and utility of the reporting system and quality measures for the participating RHCs.
2015
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Adoption and Use of Electronic Health Records by Rural Health Clinics: Results of a National Survey
Policy Brief
Maine Rural Health Research Center
Date: 09/2015
This study reports the extent of electronic health record implementation and use in a randomly selected sample of 1,497 rural health clinics surveyed in 2013. -
Rural Health Clinic Readiness for Patient-Centered Medical Home Recognition: Preparing for the Evolving Healthcare Marketplace
Policy Brief
Maine Rural Health Research Center
Date: 02/2015
This policy brief reports findings from a survey of rural health clinics (RHC) that examined their capacity to meet the National Council for Quality Assurance patient-centered medical home requirements and discusses the implications of the findings for efforts to support RHC capacity development.
2014
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Implications of Rurality and Psychiatric Status for Diabetic Preventive Care Use Among Adults With Diabetes
Policy Brief
Maine Rural Health Research Center
Date: 05/2014
This brief examines patterns of diabetic preventive care use among adults with diabetes to determine whether these patterns vary according to respondents' rural/urban residence or the presence/absence of a mental health diagnosis. -
Meaningful Use of the Electronic Health Records by Rural Health Clinics
Maine Rural Health Research Center
Date: 02/2014
This paper identifies the rates of electronic health record adoption among a random national sample of rural health clinics (RHCs) and the extent to which RHCs that have adopted an EHR are likely to achieve Stage 1 meaningful use.
2013
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Telemental Health in Today's Rural Health System
Maine Rural Health Research Center
Date: 12/2013
This policy brief describes the organizational setting, services provided, and staff used in 53 telemental rural health programs. It also outlines the opportunities and challenges for telemental health in the rural health system. -
Patterns of Care for Rural and Urban Children With Mental Health Problems
Maine Rural Health Research Center
Date: 06/2013
This study reports that rural children are significantly less likely to be diagnosed and treated for non-ADHD mental health problems than urban children and are less likely to receive mental health counseling.
2012
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Adolescent Alcohol Use: Do Risk and Protective Factors Explain Rural-Urban Differences? (Policy Brief)
Maine Rural Health Research Center
Date: 03/2012
This policy brief finds that after controlling for a broad range of key risk and protective factors, it is clear that an unexplained rural effect persists with rural adolescents still exhibiting higher alcohol use than their urban counterparts. -
Adolescent Alcohol Use: Do Risk and Protective Factors Explain Rural-Urban Differences? (Working Paper)
Maine Rural Health Research Center
Date: 03/2012
This study examines alcohol use among rural and urban adolescents between the ages of 12 and 17.
2010
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Are Rural Health Clinics Part of the Rural Safety Net?
Policy Brief
Maine Rural Health Research Center
Date: 09/2010
This policy brief examines whether rural health clinics are part of the rural safety net. -
Safety Net Activities of Independent Rural Health Clinics
Maine Rural Health Research Center
Date: 09/2010
Rural Health Clinics (RHCs) provide primary care services to rural residents of 45 states. Since RHCs are in underserved rural areas and serve vulnerable populations, many consider them safety net providers. In this paper, we explore whether, and to what extent, independent RHCs are serving a safety net role or have the capacity to do so. -
Mental Health Services in Rural Jails (Working Paper)
Maine Rural Health Research Center
Date: 08/2010
This study explored the role of rural jails in the mental health systems in rural communities, investigating how rural jails manage mental health and substance abuse problems among inmates, determining barriers to providing mental health services faced by rural jails, and identifying promising practices for service delivery. -
Encouraging Rural Health Clinics to Provide Mental Health Services: What Are the Options?
Maine Rural Health Research Center
Date: 05/2010
This study examined changes in the delivery of mental health services by rural health clinics (RHCs), their operational characteristics, barriers to the development of services, and policy options to encourage more RHCs to deliver mental health services. -
The Provision of Mental Health Services by Rural Health Clinics
Maine Rural Health Research Center
Date: 05/2010
This study examined changes in the delivery of mental health services by rural health clinics (RHCs), their operational characteristics, barriers to the development of services, and policy options to encourage more RHCs to deliver mental health services.
2009
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Mental Health Services in Rural Jails (Policy Brief)
Policy Brief
Maine Rural Health Research Center
Date: 09/2009
The prevalence of mental illness among prison and jail inmates has attracted increasing attention in both mental health and criminal justice circles.
2008
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Rural-Urban Differences in Work Patterns Among Adults With Depressive Symptoms
Maine Rural Health Research Center
Date: 03/2008
This study addresses poor mental health among young to middle-career rural residents and how their employment may be affected. Using the National Longitudinal Survey of Youth, the authors investigate how depressive symptoms affect employment patterns and the extent to which such effects differ by rural and urban residence.
2007
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Rural Inpatient Psychiatric Units Improve Access to Community-Based Mental Health Services, but Medicare Payment Policy a Barrier
Maine Rural Health Research Center
Date: 08/2007
This study investigates the characteristics/admission processes of inpatient psychiatric units (IPUs) in rural hospitals with less than 50 beds and the community-based services available to them when discharging patients. Reasons for developing IPUs, barriers to opening and operating a rural IPU, and factors leading some to close are also explored. -
Use of Critical Access Hospital Emergency Rooms by Patients With Mental Health Symptoms
Journal Article
Maine Rural Health Research Center
Date: 2007
Describes the results of a study investigating the use of critical access hospital (CAH) emergency rooms by patients with mental health problems to understand the role these facilities play in rural mental health needs and the challenges they face.
2006
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Smallest Rural Hospitals Treat Mental Health Emergencies
Maine Rural Health Research Center
Date: 2006
This research and policy brief discusses the extent to which rural emergency rooms encounter and treat mental health patients.
2005
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Mental Health Encounters in Critical Access Hospital Emergency Rooms: A National Survey
Maine Rural Health Research Center
Date: 09/2005
This survey investigates the extent and types of cases that present with mental health problems in critical access hospital emergency rooms (ERs), as well as the resources available to ER staff for addressing such problems and what actually happens to these patients. -
Scope of Services Offered by Critical Access Hospitals: Results of the 2004 National CAH Survey
Maine Rural Health Research Center
Date: 03/2005
Three years of data were used to examine services offered by critical access hospitals (CAHs). The authors investigated how the services offered by CAHs have changed, the role of network affiliations in the changes, and the reasons administrators gave for reported service expansions. They also looked at how services in CAHs have changed over time.
2004
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Are Advanced Practice Nurses a Solution to Rural Mental Health Workforce Shortages?
Maine Rural Health Research Center
Date: 04/2004
This paper summarizes the clinical skills and prescriptive authority of advanced practice psychiatric nurses and investigates current trends in their geographic distribution to determine what their future role may be in addressing rural mental health needs.
2002
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The Role of Community Mental Health Centers as Rural Safety Net Providers
Maine Rural Health Research Center
Date: 05/2002
This paper investigates the extent to which those organizations formerly designated as community mental health centers currently act as a rural mental health safety net, e.g., provide mental health services for free or at reduced charges to rural populations not covered by public or private insurance or grants. -
State Licensure Laws and the Mental Health Professions: Implications for the Rural Mental Health Workforce
Maine Rural Health Research Center
Date: 05/2002
This paper investigates whether and the extent to which licensure laws that determine the permissible scope of practice for each of these professions may affect the availability of mental health services, particularly in rural communities. -
Diabetes and the Rural Safety Net
Maine Rural Health Research Center
Date: 01/2002
This paper investigates the extent to which the rural safety net is able to meet the needs of people with diabetes.
2001
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Addressing Mental Health Workforce Needs in Underserved Rural Areas: Accomplishments and Challenges
Maine Rural Health Research Center
Date: 10/2001
This study reviews efforts to address mental health workforce needs in rural areas and addresses the questions: How is workforce adequacy measured? How do characteristics of communities and the mental health service delivery system challenge methods for determining workforce adequacy? What role has government played in addressing workforce needs? -
Medicaid Managed Behavioral Health Programs in Rural Areas
Policy Brief
Maine Rural Health Research Center
Date: 08/2001
This research and policy brief studies which states have implemented Medicaid-managed behavioral health programs in rural areas. It describes the programs in terms of Medicaid populations served, program design, and implementation model and the experience of programs regarding access to/coordination of services. -
Medicaid Managed Behavioral Health in Rural Areas
Maine Rural Health Research Center
Date: 01/2001
This study of which states have implemented Medicaid managed behavioral health (MMBH) programs in rural areas describes these programs in terms of Medicaid populations served, program design, and implementation model. It also describes the experience of programs regarding access to and coordination of services.
1996
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Integrating Primary Care and Mental Health Services: Current Practices in Rural Areas
Maine Rural Health Research Center
Date: 1996
This publication provides information on models for integrating mental health services in rural community health centers, viability of linkages between primary care and mental health providers, resources available, reimbursement, treatment philosophy, diversification, referral, and enhancement.