Mental Health Services in Rural Areas

August 2020

Among the many significant gaps between availability of mental health care and need for these services in the United States, access to timely diagnosis and treatment is particularly limited in rural areas. Growing problems of isolation, depression, and substance use in rural communities have magnified the impact of the country’s shortage of mental health professionals on rural populations. Despite the need to recruit mental health professionals to rural areas, the teaching, research, and employment opportunities tend to be more concentrated in urban areas. Challenges in rural mental health care include inadequate workforce, varying levels and quality of training of new and existing personnel, and inequitable access to care. This collection highlights ongoing efforts to develop an adequate and sustainable workforce to provide rural behavioral health care.

The first set of articles describes the importance of culturally appropriate, patient-centered services and community stakeholder engagement to meet the mental health needs of rural communities. The next section highlights the importance of addressing the shortages of psychiatrists and behavioral health professionals in rural America, including implementing support programs aimed at increasing engagement of health professionals. The final group of articles examines how technology and telepsychiatry have expanded mental health access in rural communities both before and during the COVID-19 pandemic. Examples include the complexities of designing, implementing, and sustaining telepsychiatry to maximize benefits for rural populations.

Hector Colon-Rivera, M.D., C.M.R.O.
Lisa B. Dixon, M.D., M.P.H.

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Community Integration and Recovery-Oriented Care in Rural Areas

Peer Support Program for Veterans in Rural Areas
Shaili Jain, M.D., Julia M. Hernandez, M.S., Steven E. Lindley, M.D., Ph.D.
2014, Volume 65, Issue 9, p. 1177


The Changing Context of Rural America: A Call to Examine the Impact of Social Change on Mental Health and Mental Health Care
Elizabeth Carpenter-Song, Ph.D., and Claire Snell-Rood, Ph.D.
2017, Volume 68, Issue 5, pp. 503–506


Addressing Mental Health Needs: Perspectives of African Americans Living in the Rural South
Tiffany F. Haynes, Ph.D., Ann M. Cheney, Ph.D., J. Greer Sullivan, M.D., M.S.P.H., Keneshia Bryant, Ph.D., R.N., Geoffrey M. Curran, Ph.D., Mary Olson, D.Min., Naomi Cottoms, M.S., Christina Reaves, M.P.H.
2017, Volume 68, Issue 6, pp. 573–578


Flexible Assertive Community Treatment
Dieneke A. A. Hubbeling, M.Res., M.R.C.Psych., Maria Alonso-Vicente, M.D., Ph.D., Mike Firn, R.N.
2017, Volume 68, Issue 9, p. 983

Addressing Shortages of Mental Health Professionals in Rural Areas

Addressing the Shortage of Psychiatrists in Rural Areas
Mantosh Dewan, M.D., Zsuzsa Szombathyne Meszaros, M.D., Ph.D., John Manring, M.D.
2014, Volume 65, Issue 12, p. 1508


Consultant Psychiatrists’ Role in Ensuring High-Quality Care From Nonspecialists
Bibhav Acharya, M.D., Sikhar B. Swar, M.D.
2016, Volume 67, Issue 7, p. 816


Addressing the Opioid Epidemic in Rural America
Michael T. Flaherty, Ph.D., Precia Stuby, L.I.S.W.-S., William Kose, M.D.
2018, Volume 69, Issue 10, p. 1114


Engagement With Project ECHO to Increase Medication-Assisted Treatment in Rural Primary Care
Julie Salvador, Ph.D., Snehal Bhatt, M.D., Rebecca Fowler, M.S., M.P.H., Jerrilyn Ritz, M.P.H., Regina James, Vanessa Jacobsohn, M.D., Heidi Rishel Brakey, M.A., Andrew L. Sussman, Ph.D., M.C.R.P.
2019, Volume 70, Issue 12, pp. 1157–1160

Improving Access and Continuity of Rural Mental Health Care With Telepsychiatry

Assessing Telemedicine Utilization by Using Medicaid Claims Data
Megan Daugherty Douglas, J.D., Junjun Xu, M.P.H., Akilah Heggs, M.A., Glenda Wrenn, M.D., M.S.H.P., Dominic H. Mack, M.D., M.B.A., George Rust, M.D., M.P.H.
2017, Volume 68, Issue 2, pp. 173–178

Also featured in the Telepsychiatry collection.

Telemedicine for Mental Health in the United States: Making Progress, Still a Long Way to Go
Michael L. Barnett, M.D., M.S., and Haiden A. Huskamp, Ph.D.
2020, Volume 71, Issue 2, pp. 197–198

Also featured in the Telepsychiatry collection.

Using Continuous Quality Improvement to Design and Implement a Telepsychiatry Program in Rural Illinois
Hossam Mahmoud, M.D., M.P.H., Emily L. Vogt, B.A., Rabih Dahdouh, M.S., Michael Luke Raymond, L.C.P.C.
2020, Volume 71, Issue 8, pp. 860–863

Also featured in the Telepsychiatry and The Psychiatric Workforce Shortage collections.

Rural-Nonrural Differences in Telemedicine Use for Mental and Substance Use Disorders Among Medicaid Beneficiaries
Timothy B. Creedon, Ph.D., Kristin E. Schrader, M.A., Peggy L. O'Brien, Ph.D., Janice R. Lin, B.S., Christopher D. Carroll, M.Sc., Norah Mulvaney-Day, Ph.D.
2020, Volume 71, Issue 8, pp. 756–764

Also featured in the Telepsychiatry collection.

An Innovative Approach to Care: Integrating Mental Health Services Through Telemedicine in Rural School-Based Health Centers
Taniya Pradhan, M.B.B.S., M.D., E. Ashley Six-Workman, B.S.N., R.N.-B.C., Kari-Beth Law, M.D.
2019, Volume 70, Issue 3, pp. 239–242

Also featured in the Telepsychiatry collection.

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