Mental Health Care In Rural Populations

Healthcare in the rural population faces challenges not as present in the urban population. Physicians and specialties are not as widespread as in urban settings. Public transportation is not as available and travel distance is greater. These barriers also affect mental health care. 30% of the US population live in a county designated as a Mental Health Professional Shortage Area (County Health Rankings & Road Maps, 2017). Only 63% of US counties have at least one facility that provides mental health treatment for children and adolescents with less than 50% of rural counties having this service (Cummings, Wen, & Druss, 2013). The purpose of this paper is to define the issues associated with mental health care in rural America, discuss

Lack of access to mental health care goes beyond a shortage of providers. Geographic, economic, and social characteristics all play a part. Rural populations often have a higher poverty rate than urban areas. Rural residents are more likely to be uninsured than urban residents, have poorer access to care, delay care, and obtain care at higher levels of acuity than those with health insurance (Ziller, Lenardson, & Coburn, 2012). Distance to outpatient mental health providers and inpatient settings can be far, which can be intensified by lack of public transportation and poor road conditions. The stigma attached to mental illness is often great in rural areas. Because of this, those needing mental health care may be reluctant to receive it due to their beliefs surrounding mental health or fear of family and friends opinion of them seeking

Telepsychiatry includes the delivery of psychotherapy and pharmacotherapy services as well as consultations to establish diagnoses and provide treatment recommendations (Fortney et. al, 2015). Telepsychiatry includes interactive video, telephones, smart phones, secured messaging portals, and shared electronic records (Fortney et. al, 2015). Telepsychiatry can be utilized by the patient in their own home, in a clinic, or in a school setting. It has been shown that diagnostic assessments conducted by interactive video is comparable to face-to-face assessments (Fortney et. al, 2015). One way to offer telepsychiatry is the referral model. In this model, the primary care provider refers the patient to the mental health provider who assumes primary responsibility for the patient’s mental health care (Fortney et. al, 2015). Mental health providers and primary care providers do not typically communicate in team meetings and there is minimal collaboration of care with this model. One barrier with this model is a high no-show and drop-out rate similar to face-to-face mental health clinics (Fortney et.al,