A qualitative study of rural mental health practitioners regarding the potential professional consequences of social justice advocacy.

Abstract

Practitioners who wish to advocate for clients or respond to larger social justice issues have little practical guidance. Depending on contextual factors, there may be numerous issues to consider before deciding whether to become involved in social justice advocacy. The challenges associated with practicing in a small community amplify the need to carefully consider whether or how to act as an advocate. In this study, eight rural mental health professionals were interviewed about the benefits and challenges of rural practice, experience with social justice advocacy, and perspectives on participating in advocacy about contentious social justice issues. The results highlight how the context of rural community practice affects decisions regarding advocating for clients or responding to larger social justice issues.

Primary care integration in rural areas: A community-focused approach.

“…Factors contributing to lower acceptability of mental health services among rural populations include increased stigma and decreased anonymity in using mental health services (U.S. Department of Health & Human Services, 2005). These perceptions represent risk factors that may influence participation in health care and mental health services (Bradley, Werth, Hastings, & Pierce, 2012;Schank & Skovholt, 2006). Rural individuals may possess strong kinship ties with family residing in the same community, a tendency toward family based support, hesitancy to share personal information with strangers or professionals (Bradley et al, 2012), and a strong sense of self-reliance that can be a potential barrier preventing outsiders from gaining the trust of community members (Schank & Skovholt, 2006).…”

The successes of experienced rural counselor supervisors and their recommendations for rural mental health.

“…It may be that community involvement gave these rural practitioners a sense of place in the community, made them visible, and gave them an interest area outside of work. Although they were well known and trusted, as noted by earlier authors (Bradley et al, 2012), LPC-Ss did report the need to be mindful of their community image and behave accordingly. They also addressed this with supervisees in their roles as mentors.…”

“…Rural communities abound with rich possibilities for mental health providers (Breen & Drew, 2012). Opportunities include career flexibility, helping the underserved, and working with multiple generations of the same family (Bradley, Werth, Hastings, & Pierce, 2012; Cohn & Hastings, 2013; Hastings & Cohn, 2013; Oetinger, Flanagan, & Weaver, 2014). Participants in previous studies also cited a slower pace of life, natural surroundings, and lower living costs as benefits of rural practice (Cohn & Hastings, 2013; Hastings & Cohn, 2013; Oetinger et al, 2014; Witt & McNichols, 2014).…”

“…High visibility within the community and a lack of other mental health professionals contribute to feelings of personal and professional isolation. Although LPC-Ss feel connected to their communities (Witt & McNichols, 2014), they must thoughtfully consider the implications of personal choices and publicly stated opinions on contentious topics (Bradley et al, 2012). Rural LPC-Ss surveyed by Witt and McNichols (2014) infrequently interacted with professional organizations and felt disconnected from other counseling professionals and unsupported as supervisors.…”

Enhancing the perceived competence and training of rural mental health practitioners.

“…The challenges of rural practice are well documented and tend to cluster around ethical issues regarding professional competence, ensuring confidentiality, and avoiding/managing multiple relationships (DeLeon, 2000; Helbok, 2003; Jameson & Blank, 2007; Murray & Keller, 1991; Rollins, 2010; Schank, Helbok, Haldeman, & Gallardo, 2010; Weigel & Baker, 2002; Werth, Hastings, & Riding-Malon, 2010), as well as quality-of-life issues that are somewhat unique to living and working in a rural community (Hastings & Cohn, 2013; Morrissette, 2000; Schank et al, 2010). The benefits have not received as much attention in the literature, but researchers have identified advantages related to rural lifestyle (e.g., slower pace of life, lower crime rates, less traffic, less pollution, and ample recreational activities), as well as professional advantages such as relative autonomy, the challenge and variety associated with generalist work, less competition when establishing one’s practice, and the ability to see the outcomes of one’s work in the community (Bradley, Werth, Hastings, & Pierce, 2012; Hastings & Cohn, 2013; Jameson, Blank, & Chambless, 2009; Schank et al, 2010).…”