The (2022-2023) Community Health Assessment (CHA) conducted among community members in a rural Western Kentucky county identified mental health as one of the top health issues in the county. The purpose of CHA is to identify key health needs and issues through data and develop strategies for action.

Methods:

Secondary data analyses were performed from survey results conducted by the local health department, local public schools, and the County Health Rankings 2022. The quantitative data was analyzed using SPSS software. Qualitative data were analyzed through qualitative methodologies using a two-cycle coding process.

Results:

Mental health was identified on the community survey portion of the CHA as a top health issue in the rural Western Kentucky county, with stress listed by 57.2% (n=281) participants ranked as the number one issue and mental health/suicide/anxiety listed by 33.6% (n=165) participants ranked as the number four issue. Among town hall meetings with vulnerable groups in Marshall County, lack of mental health services was identified as a barrier. Additionally, per the County Health Rankings 2022, the data showed that there is a major deficit in mental health providers in Marshall County with 3120 patients per mental health provider.

The local health department Access to Care Survey conducted February 2023 among community members and health providers also revealed that one of the top barriers to access was lack of providers, including specialists (8.6%, n=24). This barrier was reiterated by the health providers' responses. Health providers indicated that mental health conditions were the number one challenge when referring patients to specialists and that a psychiatrist, especially a pediatric psychiatrist, was a needed specialist in the Western Kentucky region. Health providers also mentioned the need for specialists to accept Medicaid as that is a barrier to healthcare access.

Conclusions:

Access to mental healthcare is an area of great need in this rural Western Kentucky county. Researcher recommendations include having the regional hospital systems work together to recruit a psychiatrist and work with healthcare providers, especially specialists, to accept Medicaid. It is recommended to cross-train other professionals to address mental health needs in this region.