APA highlights report on improving rural mental health care

One in 25 American adults will experience a serious mental illness each year, with residents of rural areas more likely to experience it, according to a press release from the American Psychiatric Association.

Residents of rural areas are also more likely to face barriers to receiving treatment.

A report from SMI Adviser outlined three obstacles to connecting these populations with mental health care — availability, accessibility and acceptability — and presented solutions developed by medical professionals who work in these underserved areas.

Saul Levin

“On National Rural Health Day, it’s critical to make sure mental health is part of the equation,” Saul Levin, MD, MPA, APA CEO and medical director, said in the release. “Even before the pandemic, rates of serious mental illness [SMI] were higher in rural areas.

“To ensure continued improvement in care, we need to remember that tailored solutions for the resources, workforce and community in rural areas are critical,” Levin added.

Solutions proposed in the report included:

• expanding rural primary care providers’ knowledge of SMI;

• implementing the Collaborative Care model;

• expanding peer support networks to support care in rural communities; and

• training emergency medical technicians and community members on assessing suicide risk and performing crisis intervention.

SMI care in rural and remote locations includes several obstacles to accessibility, such as challenges obtaining readily available or affordable transport, lack of childcare options and various economic issues like low wages, homelessness and broadband availability. Solutions proposed in the report focused on such factors as mobile health service and telehealth access once broadband issues are addressed.

“Some rural communities are utilizing innovative strategies to increase the availability, accessibility and acceptability of workforce and services to bridge behavioral health gaps,” Brian Hepburn, MD, executive director of National Association of State Mental Health Program Directors, noted when discussing the importance of the report. “In doing so, individuals living in rural and remote communities are able to have equitable access to high-quality care.”

Another obstacle to addressing mental health in rural areas listed in the report is the stigma attached to admitting these issues and seeking out treatment, particularly among those communities with a strong sense of self-sufficiency. In attempting to minimize stigma, the report suggested starting early with youth-targeted mental health literacy, working with civic and spiritual leaders to help the community understand those dealing with mental health issues and launching suicide awareness campaigns.

“The powerful part about this report is that its recommendations come from the clinicians, administrators and staff who work directly with people with SMI in rural communities,” Amy Cohen, PhD, director of SMI Adviser, said in the release. “What they told us was not exactly what you’d learn in your training, but rather, smart, creative and practical ways to connect individuals with SMI with the care they need. Anyone who is involved in the provision of mental health care in rural areas should examine its recommendations.”