Challenges and opportunities associated with rural mental health practice.

Abstract

This manuscript outlines the challenges and opportunities associated with rural mental health practice, and provides descriptive data on the scope of care, area of competence, and clinical training of a group of practitioners providing services in rural central Appalachia. Thematic content analysis reveals ethical challenges encountered, job satisfaction, and the pinnacles and pitfalls of mental health care practice in the region. Implications for training, recruiting, and retaining practitioners to work in underserved rural settings are described. The authors highlight a number of areas that need additional research attention in order to address remaining questions relevant to clinical practice in rural settings.

The Complex Decision-Making Processes of Rural Emerging Adults: Counseling Beyond Dualism

“…Rural school counselors may be the only mental health professional troubled students see; however, these counselors are often constrained in their response to mental health concerns because of stigma, inadequate referral options, and the limited way their roles are construed, and these limitations can impact social-emotional well-being, education, and career development (Hastings & Cohn, 2013;Saba, 1991). In addition, there is a structural reality that affects all students: school counselors' formal role with emerging adults ends just as that life stage begins.…”

“…In addition, there is a structural reality that affects all students: school counselors' formal role with emerging adults ends just as that life stage begins. School counselors are vested with building an on-ramp to a bridge, but their work stops at the edge of the water (Hastings & Cohn, 2013;Saba 1991).…”

In My Own Words: Exploring Definitions of Mental Health in the Rural Southeastern United States

“…Rural residents face challenges in finding transportation to facilities for professional care. Consequently, rural residents often forgo attaining adequate and timely mental health treatment (Alang, 2015;Hastings & Cohn, 2013). Rural residents often depend on alternative sources such as faith-based organizations to address mental health concerns (Bryant, Moore, Willis, & Hadden, 2015) or ignore the prevalence of mental health symptomology altogether (Snell-Rood et al, 2017).…”

“…Rural residents often depend on alternative sources such as faith-based organizations to address mental health concerns (Bryant, Moore, Willis, & Hadden, 2015) or ignore the prevalence of mental health symptomology altogether (Snell-Rood et al, 2017). Unfortunately, researchers indicated that rural residents seek treatment for mental health disorders after they have become progressively worse, resulting in more extensive treatment, which is often unavailable or costly for rural clients (Gore, Sheppard, Waters, Jackson, & Brubaker, 2016;Hastings & Cohn, 2013;Snell-Rood et al, 2017). Deen and Bridges (2011) suggested these delays in seeking mental health treatment are associated with low MHL.…”

“…Treatment availability for mental health care in rural areas is fragmented because of critical shortages in mental health care providers in these communities (El-Amin, Anderson, Leider, Satorius, & Knudson, 2018;Snell-Rood et al, 2017). Practitioner shortage is attributed to difficulty in recruiting and retaining professionals for rural practice as well as practitioners' limited understanding of cultural norms and effective interventions to address mental health needs in rural communities (Fifield & Oliver, 2016;Hastings & Cohn, 2013). Among practitioners who provide clinical services in rural areas, many report feeling incompetent to work with the population because of receiving fewer training opportunities to learn how to work with rural populations, less access to consultation resources, and professional isolation (Hastings & Cohn, 2013;Jameson & Blank, 2007).…”