Health News
Addressing America’s mental health crisis – especially in rural areas – starts by making care more accessible – MedCity News

Addressing America’s mental health crisis – especially in rural areas – starts by making care more accessible – MedCity News

After more than two years of lockdowns and social restrictions due to the Covid-19 pandemic and the recent escalation of gun violence, there’s a significant spotlight on mental health in the United States. The state of mental health has been labeled a crisis by the mainstream media and top political figures, and the data backs up this assessment. According to a study by the Kaiser Family Foundation (KFF), roughly four in 10 adults reported symptoms of depression or anxiety during the pandemic. Additionally, new data from the Centers for Disease Control and Prevention (CDC) shows that more than one-third (37%) of high school students reported experiencing poor mental health during Covid-19, and 44% reported they persistently felt sad or hopeless in 2021.

Addressing these mental health issues will be a long, challenging journey, but it’s essential to the wellbeing of our nation. Creating the path for healing starts by addressing the shortage of mental health resources and improving access to high-quality care and counseling.

Mental health care deserts limit patient options

According to KFF, only about one-quarter of the nation’s need for mental health providers is currently being met, a figure the organization calculated by dividing the number of psychiatrists available to serve a population by the number of psychiatrists necessary to address the need adequately. America’s rural communities tend to be hit hardest by these provider shortages.

For example, according to the Centers for Medicare & Medicaid Services (CMS), 75% of rural counties have no mental health providers or fewer than 50 per 100,000. Most of these counties are in the Midwest and Southeast.

These mental healthcare deserts create a multitude of access issues that make it harder for patients to get the care they need in a timely manner. When resources are limited, wait times can increase and keep patients waiting an average of five to six weeks to get the care they need.

Travel and transportation issues can serve as additional barriers. Rural residents must often travel long distances to receive mental healthcare, a huge deterrent for those without reliable transportation, paid time off, or childcare. According to an American Hospital Association (AHA) report, 3.6 million people in the U.S. cannot access medical care due to lack of transportation.

Social stigmas in rural America decrease mental health action 

Beyond limited resources, rural areas also encounter added social stigmas related to mental healthcare. For example, rural communities do not offer the same level of privacy cities provide. As the saying goes, “everyone knows everyone” in small-town America, and this fear of being recognized at the local mental health facility can discourage people from seeking the care they need. The lack of anonymity can compromise patient safety and comfort, evoking feelings of embarrassment and shame.

Additionally, people in rural communities often don’t want to risk having their family’s “dirty laundry” disclosed to others in the community for fear of being labeled or ostracized by their friends and neighbors. This mentality can prevent people from fully opening up to a local mental health professional and receiving the care they need.

Strong religious convictions are generally a protective factor against suicide and mental illness, but they can also serve as a barrier to care in certain communities. Some religions view seeking mental healthcare as a spiritual weakness, a moral failure, or a lack of faith. Additionally, some individuals may view taking psychiatric medications as contrary to their religious beliefs. In fact, a study by Mental Health & Prevention uncovered several common themes related to stigma among rural, low-income healthcare consumers. Some of the top themes were “faking and pretending,” “get over it,” and the religious-based “God is all you need.”

Telepsychiatry provides a more accessible and inviting mental health option 

Telepsychiatry addresses provider shortages and social stigmas head-on by building a bridge between people and the care gaps they encounter when seeking mental healthcare. For example, many telepsychiatry organizations recruit and employ mental health providers from a large, culturally diverse, and geographically distributed pool, including a wealth of specialty providers. Telepsychiatry can provide a multitude of provider and scheduling options for people living in mental healthcare shortage areas, resulting in timelier access to high-quality care. Furthermore, since sessions are conducted remotely via virtual visits, travel and transportation-related barriers are eliminated.

Telepsychiatry can also help overcome the social stigma concerns that often discourage people from seeking mental health support by allowing individuals to receive care in the privacy of their own homes. Residents of rural communities can receive the care they need without fear of being seen at a behavioral care center by friends, neighbors, and acquaintances. Moreover, patients are more willing to discuss sensitive issues with mental health professionals via telepsychiatry, knowing their anonymity is more firmly protected.

Some skeptics question the impact telepsychiatry can have on rural mental health, citing technology, broadband, and cellular limitations individuals in these areas often face. Indeed, many of the most vulnerable, high-risk patients in these communities may not have the resources or coverage necessary to initiate telepsychiatry engagements independently. However, local providers can bridge this gap by partnering with telepsychiatry organizations to extend their care networks. Several telepsychiatry vendors offer solutions and services that integrate seamlessly with existing on-premises technology systems at local care facilities. With options available at home or at the clinic, telepsychiatry can truly meet people where they are — regardless of their technological resources.

With increased anxiety, fear, trauma, depression, and substance use disorders across the U.S., improving access to timely, high-quality mental healthcare has never been more critical. In our efforts to address this crisis, more attention must be focused on the needs of rural communities. These areas are historically underserved and disproportionately impacted by the ongoing provider shortage. Telepsychiatry services can extend provider networks and remove barriers to care, giving all patients better access to the care they deserve.