Getting Rural Children through the Door: Perceived Barriers to Mental Health Care for School-Aged Children in Rural Areas

Abstract

With creativity and collaboration, children in rural communities who have the same mental health needs as children in urban areas can achieve access to mental health care. This review of the literature explores barriers to mental health services facing school-aged children residing in rural communities and focuses on how challenges unique to rural communities affect the type of care rural children ultimately receive. This review aligns with the NREA Research Agenda priority area “access to counseling/mental health services” (NREA, 2018). The discussion incorporates national trends in the treatment of children with mental health concerns and highlights some surprising facts about the state of mental health care in rural school and examines the following factors: (1) belief, (2) family poverty, (3) school support, (4) community resources, and (5) awareness. The review concludes by outlining opportunities for advocacy and proposed solutions for improving mental health care access for rural children and suggesting directions for future research.

Increasing rate of diagnosed childhood mental illness in the United States: Incidence, prevalence and costs

“…The Centers for Disease Control and Prevention estimate that between 13% and 20% of American children and adolescents aged 3 through 17 have a diagnosable mental, emotional, or behavioral disorder [ 8 ]. This has resulted in a considerable burden on a healthcare system that already presents significant access issues to mental health services for various segments of the population [ [9] , [10] , [11] ]. From 2012 to 2016, there was a 55% increase in mental health emergency room visits among pediatric patients [ 12 ], while hospitalizations for mood disorders among juveniles increased 80% from 1997 to 2010 [ 13 ].…”

Meeting the needs of children through telemental health: Application for rural mental health using child–parent relationship therapy.

“…In fact, up to 34% of children who receive health care only see a primary care physician for mental health concerns rather than a mental health specialist, such as counselors, psychologists, or psychiatrists (Anderson et al, 2015). Thus, many children in rural areas depend on doctors with little specialization in mental/ emotional concerns and psychopharmacology (Blackstock et al, 2018). Approximately 58% of rural areas have shortage of mental health providers, making access to specialized mental health services scarce for children living in these areas (HRSA, 2021).…”

“…However, per capita, there are fewer mental health professionals (i.e., counselors, social workers, psychologists, marriage, and family therapists) offering services in rural communities (HRSA, 2021). Additionally, 24% of the nation's school-aged children reside within rural communities and are impacted by the lack of access in mental health care services (Blackstock et al, 2018). Although researchers have studied health care accessibility among adults, little research explores the mental health utilization and needs of children living in rural areas (Blackstock et al, 2018).…”

“…Additionally, 24% of the nation's school-aged children reside within rural communities and are impacted by the lack of access in mental health care services (Blackstock et al, 2018). Although researchers have studied health care accessibility among adults, little research explores the mental health utilization and needs of children living in rural areas (Blackstock et al, 2018).…”

Enhancing child mental health in school and community settings: A pilot study of the kids’ empowerment program.

“…available services or long waitlists, treatment costs (Blackstock et al, 2018;Reardon et al, 2017;Stafford & Draucker, 2019), caregiver mental health (Acri et al, 2018), as well as the time burden for parents (Salloum et al, 2016). Symptom severity is also associated with those receiving treatment in the NSCH report (Ghandour et al, 2019).…”