I tend to closely monitor the statistics on the number of mental health providers per capital in each state, particularly the Midwest states. According to Mental Health America (Reinert, Fritze, & Nguyen, 2021) most of the Midwestern states tend to fall in the bottom half of this state-by-state ranking. This means the need for mental health care is rapidly overtaking the workforce’s ability to provide it.  

          So how can Extension bridge this gap? To be honest there is little we can do to fully bridge this gap. The nation’s universities may not have the capacity to train enough mental health professionals to fully meet the need. But Extension does have the resources and educational opportunities to train lay people to respond to those who may be struggling or who need assistance with finding mental health care. The mission statement I use for my Extension program effort is “Helping Iowans Help Each Other.”

To help Iowans, Iowa State University Extension and Outreach has deployed evidence-based gatekeeper trainings, such as Mental Health First Aid and Question.Persuade.Refer. The term gatekeeper refers to individuals who have face-to-face contact with large numbers of community members as part of their usual routine. These individuals, who may have an unknown level of understanding, ability, and commitment, can be trained to “identify persons at risk of suicide and refer them to treatment or supporting services as appropriate” (U.S. Department of Health and Human Services Office of the Surgeon General and National Action Alliance for Suicide Prevention, 2012).  We have complemented these gatekeeper trainings with plentiful information about the 988 Suicide and Crisis Lifeline and our Iowa Concern Hotline that provides stress counselors, legal information and information and referral services for a wide variety of topics 24/7.

Iowa State University Extension and Outreach staff have trained over 4,200 gatekeepers using these programs. We know this does not replace the need for additional mental health providers, but it can provide a successful bridge for individuals who are struggling. It provides the opportunity for these individuals to be assisted by someone who is trained and can assist them to find the best resources available.  We hope by doing this we are also fulfilling the Extension Professional’s Creed, “that people when given facts they understand, will act not lonely in their self- interest, but in the interest of society” (or their neighbor in need).