Bridging the Gap: The Dire Need for Mental Health Professionals in Rural Communities

A study conducted by the Centers for Disease Control (CDC) recently found that in the past two decades, suicide rates in rural areas have been consistently higher compared to those in urban areas of America. Between 2000 and 2020, suicide rates increased 46% in non-metro areas compared to 27.3% in metro areas. In order to explain this discrepancy, we first have to examine the stark differences between rural and urban life, how these differences impact mental health as well as overall access to care.

It is important to define what we mean by “rural” and “urban.” Urban areas are regions with high population density, extensive infrastructure, and significant economic and industrial development. They are typically characterized by high-rise buildings, complex public transportation networks, and concentrated commercial activity. In contrast, rural areas have lower population density, more open spaces, and economies often centered around agriculture, natural resource management, and smaller-scale industries.

A major issue when looking at this scenario as a whole is a lack of cultural competency in mental health care when it comes to treating rural versus urban patients. Specifically, there tends to be more stigma towards receiving help for mental health concerns in rural areas which is largely in part due to more limited educational opportunities and more limited access to services. When there is less access to care, mental health becomes less of a priority, making it that much harder to destigmatize. Rural hospital closures have significantly impacted the already-limited access to care in rural areas as well. Prior to the Covid-19 pandemic, these hospital closures would have completely removed access to care altogether. However, due to the rising popularity in telehealth as a result of the Covid-19 pandemic, more patients have been able to gain access to the care they need without necessarily having a physical location nearby. This, however, has not been without its faults. Children tend to have a more difficult experience with telehealth care since it isn’t always developmentally or clinically appropriate for them. In these instances, parents are either forced to take time away from work and commute to the nearest larger city with a clinic, or forgo care altogether. Additionally, in some cases it can be difficult to utilize telehealth for prescribing medication because some medications require the patient to be frequently monitored.

One way Centerstone is working to bridge this gap is by adding school-based services in rural areas as well as providing in-home services for those who can’t come to us. And while these services help bring services to many, it doesn’t work to bring services to all who need them. With the continued expansion of telehealth, school-based, and in-home services, we can better serve rural communities. The largest issue in bridging this gap and expanding access to care is limited funding. Additionally, it can be difficult to find clinicians willing to commute or relocate to rural areas.

Ultimately, it’s important that we are able to bridge this gap so we can improve, and save, more lives. For more than a decade, there has been a steady rise in people experiencing mental health issues in the United States with numbers in rural areas consistently outweighing those in urban areas. Being from a small, rural area shouldn’t automatically disqualify you from having access to quality healthcare. Mental health care should be a guarantee for all, no matter where you come from.

I encourage those reading this article to educate yourself on the resources available to you in your community so you know where to turn when you or someone you know needs care. And remember that in times of crisis, the National Suicide and Crisis Lifeline is available to text or call 24/7/365 by dialing 988.

Marion Smyser is a Program Coordinator at Centerstone, a nonprofit health system specializing in mental health and substance use disorder services. Learn more at Centerstone.org.