Rural social service systems as behavioral health delivery systems.

Abstract

Rural areas are often characterized by population scarcity, but this does not necessarily imply a scarcity of social service systems. In fact, social service systems may be of greater importance in rural areas because they serve as a congregation point for individuals and families. The social service systems of education, health, and religion serve the needs of rural residents but often work independently of one another. Nonetheless, established social service systems in rural communities are potential partners for the ambitious, committed rural behavioral health provider.The collaboration between a behavioral health provider and a social service system requires a framework for the partnership. Franklin and Streeter (1995) developed a taxonomy in which they distinguished levels of school-based health and social service collaboration as follows: informal, coordinated, partnerships, collaborative, and integrated. Although developed for school-based collaborative health services, the definitions are useful guides for all social service systems. We have adapted these definitions for the purposes of this chapter but have retained the labels for illustration. In Table 8.1, we define each of the degrees of social service system collaboration.The purpose of this chapter is to review four systems spanning education, health, and religious systems that could accommodate the provision of behavioral services and to examine the assets and barriers to such collaboration. In the final section of the chapter, we provide recommendations for collaborations.The four delivery systems presented here have been explored as conduits for rural behavioral health to some degree, but no universally accepted model has yet been derived. Thus, they are presented as possibilities that possess inherent strengths and weaknesses.

Rural mental health and psychological treatment: a review for practitioners

“…An estimated 34-41% of patients in primary care in rural areas have a diagnosable mental health disorder (Sears, Evans, & Kuper, 2003), and more than 40% of individuals with mental health needs originally seek treatment in a primary care setting (Chapa, 2004). This high overlap led the President's New Freedom Commission on Mental Health (2003) to highlight the need of increasing access to and quality of mental health care in rural areas through integrated care, specifically stating there is a need to ''screen for mental disorders in primary health care, across the life span, and connect to treatment and supports'' (p. 11).…”

Telehealth videoconferencing psychotherapy in rural primary care.

“…Together, barriers to availability, accessibility, and acceptability of mental health treatment contribute to a state of poor mental health for many rural residents (Gamm et al, 2010). In one study, approximately 34% to 41% of rural patients seen in primary care had a mental health disorder (Sears, Evans, & Kuper, 2003). Several studies have reported that the prevalence of mental health problems such as depression, sub-stance abuse, domestic violence, incest, child abuse, and suicide are serious risks to individuals in rural areas that often occur at equal or higher rates than in urban residents (Eberhardt & Pamuk, 2004).…”

Manitoba's Rural and Northern Community-Based Training Program for Psychology Interns and Residents.

“…The department and the internship emphasize the role of psychologists as health care providers addressing a variety of behavioral health issues, not only mental health (Belar, 1995). The program's philosophy was a particularly good fit for training rural and northern psychologists because they, more than anyone, truly have to be generalists (Kersting, 2003; Sears, Evans, & Kuper, 2003). The internship currently accepts seven predoctoral interns and one postdoctoral resident per year (two of the interns and the one resident are part of the Rural and Northern Program.…”