174395 Rural Mental Health Access: A Crisis in Public Mental Health?

Monday, October 27, 2008: 5:06 PM

Theodore W. McDonald, PhD , Department of Community and Environmental Health, Boise State University, Boise, ID
Linda S. Osgood , Department of Community and Environmental Health, Boise State University, Boise, ID
Michael Crabtree, PhD , Department of Psychology, Washington and Jefferson College, Washington, PA
Although rural environments are often stereotyped as being stress-free, protective, and generally idyllic, many researchers have reported the reality to be quite different. Although rural areas do indeed have positive qualities, they often tend to be characterized by geographical and social isolation, depressed local economies, and inadequacy of key health services. It has been reported that rural residents seem to be particularly underserved in terms of mental health care. The vast majority of U.S. counties classified by the federal government as “Mental Health Professional Shortage Areas” are rural and frontier (i.e., extremely rural) counties, and although nearly 25% of Americans live in rural counties, only 10% of the nation's mental health care providers work in these areas.

The purpose of this presentation is to call attention to some of the key barriers to mental health care in rural America and to question whether the prevalence and magnitude of access barriers constitute a public health crisis. Drawing from surveys of rural mental health professionals conducted in two states (one in the Intermountain West and the other in the Mid-Atlantic region), the presentation will show that these key barriers include cost/lack of insurance, lack of trained staff (particularly psychiatrists and other specialists), travel distance and time, and stigma associated with seeking mental health services. Strategies for addressing these barriers will be discussed in the context of workforce and training issues, national mental health policy, and public health outreach to rural residents with mental health problems.

Learning Objectives:
1. Recognize that the vast majority of U.S. counties designated as “Mental Health Professional Shortage Areas” are also counties designated as “rural” or “frontier.” 2. Evaluate myths about rural environments as being idyllic and generally protective of their residents’ mental health. 3. Identify mental health problems that seem particularly prevalent in rural areas. 4. Identify key access barriers to mental health care for rural residents, gleaned from two studies of rural and frontier mental health providers. 5. Prioritize strategies to reduce rural access barriers.

Keywords: Rural Mental Health Services, Access to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted a great deal of research on mental health issues as a university professor and because I have no financial ties to any commercial interests.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.