The Southwest Rural Health Research Center has done just that identified mental health and addiction concerns as the first and second top priorities for rural health care stakeholders, according to a May 2023 policy brief.
With a chronic shortage of mental health providers in rural areas, there is a significant lack of access to this much-needed care for those who live there. A an estimated 122 million Americansor 37% of the population, lived in 5,833 shortages of mental health professionals as of March 31, 2021.
The country needs an additional 6,398 mental health providers to fill these shortages, noted Dr. Bob Booth, head of care at TimelyCare, a telehealth provider for students. Two-thirds of the shortage areas are in rural or partially rural parts of the country.
Additionally, research shows that rural Americans are less likely to receive mental health care due to stigma, Booth added.
Healthcare IT news interviewed Booth to discuss the problem with rural and partially rural areas and so few mental health providers, rural patients’ concerns about mental health care and addiction and the role of telemedicine, and the stigma with mental health care and how telehealth can help address this challenge vanquish.
Q. What’s the problem with rural and partially rural areas and so few mental health providers? How has this problem developed?
A. Living in rural America presents unique challenges, not the least of which is access to healthcare. These challenges can be attributed to a number of factors, including but not limited to: geographic isolation, limited infrastructure, labor shortages, stigmatization, lack of incentives, regulatory barriers, educational limitations, and unequal allocation of resources.
Over the past two decades, America’s rural communities have seen a 50% increase suicide rates. Even as this percentage grows exponentially, the number of supporting healthcare providers and practitioners has not kept pace. According to Mental Health Americarural areas have 20% fewer primary care providers than urban areas and 65% of rural counties have no psychiatrist.
Colleges and universities are not immune to health care access issues, especially those in rural areas. According to the Regional College Research AllianceThere are 1,087 institutions serving rural areas in the United States.
Due to the nationwide provider shortage and long wait times that put both students and schools at risk, colleges and universities can no longer meet all of the health and wellness needs of students on campus. Despite the perception of increased access to resources, many schools are forced to rely on the already overburdened local community with mental health and crisis resources to support their students.
Q. Two of the biggest problems for rural patients are mental health care and addiction. How exactly does telemedicine step in here and help solve the problem?
A. Unlike traditional one-on-one therapy with a personal care provider, telemedicine can significantly expand the reach of patients that healthcare providers can help. Rural patients suffering from mental illness and addictions often face limited access to specialized healthcare services due to geographic remoteness and inadequate healthcare infrastructure.
Telemedicine removes these barriers to care and ensures patients can receive timely and effective support regardless of their location.
By utilizing telemedicine, patients who require specialized care for the challenges they face can access much-needed therapy, counseling, support groups, medication-assisted treatments, etc., reducing the need for in-person visits that would otherwise require people seeking help would discourage searching.
The level of privacy that telemedicine provides is another crucial benefit for those struggling with the stigma often associated with mental health and/or addiction. Allowing patients to seek support from the comfort of their home in a virtually confidential environment creates a more comfortable environment for discussing sensitive, personal matters.
This privacy could also lead more people to seek help early, potentially preventing the escalation of mental health and addiction crises.
Like rural communities, college and university campuses face many similar challenges when it comes to providing better access to care. This may be especially the case for schools that are also rurally located. More than half (53%) of students who sought help through our higher education-specific virtual care said they would not have done anything if the service was not available to them.
Q: One interesting aspect of all this is that research shows that rural Americans attach more stigma to mental health care than other groups. How can telehealth help overcome this challenge?
A. Stigma is a major barrier to care across diverse cultural, socio-economic and demographic backgrounds, further exacerbating the challenges people face in recognizing their need for additional support. The fear of being labeled, judged, or treated differently can prevent people from openly discussing their mental health issues or seeking help.
Rural communities tend to be close-knit, increasing concerns about privacy and confidentiality. Virtual care gives patients the anonymity they desire, minimizing the fear of judgment and disclosure that keeps people from seeking care.
College campuses are in many ways very similar to rural communities when it comes to stigma and the desire for anonymity. By eliminating the need for physical travel, telehealth reduces the visibility of seeking mental health support. This can help break down barriers related to shame and social judgment, ultimately encouraging more people to take proactive steps to manage their mental health.
Furthermore, comprehensive efforts to reform societal attitudes, raise awareness, and promote a culture of caring will empower individuals to prioritize their mental well-being without fear of judgment.
Q. You have hands-on experience with rural mental health patients and telemedicine. Please share the stories of two patients that show how technology stepped in and filled some of these gaps.
A. Whether rural or remote on a college or university campus, virtual healthcare has saved and changed lives.
Our 24/7 on-demand emotional support service line helped an astute community college student who was experiencing suicidal thoughts after hours. The student was a commuter and lived a province far from the university, in a very rural area with a lack of access to finance, transport, healthcare, support and internet.
This student lived in a negative and destructive home environment and experienced verbal and physical abuse from a family member. Unfortunately, it was not useful to contact the local emergency service due to the student’s place of residence, as the agency could not respond in a timely manner.
This student was able to stay connected to one of our providers via phone instead of having to rely on an internet connection that was unavailable. In addition to helping the student process his own emotions, the provider helped coordinate another family member to get the student to safety and connected the student with the community college counseling center to ensure that this student also in the future. Continuous support.
The student has since transitioned to our planned maintenance care consulting services.
Our platform solved a number of problems in this situation, including a lack of access to basic needs and resources, all available to this student at no cost and without the hassle of traditional insurance.
Another rural student enrolled in an online university called after hours looking for support to deal with their depression. This student had suffered from suicidal thoughts in the past. Often, although caregivers are licensed in the state where they provide care, they do not necessarily live there.
In this case, our provider made a big difference because they lived near the student’s rural hometown and were familiar with local resources to help coordinate care, including connecting the student to a mobile crisis unit located approximately 40 minutes away. The first responder was able to stay on the phone with the student throughout the journey to ensure they reached the physical aid safely.
From an institutional perspective, telehealth has been a game changer for college campuses looking for additional robust resources for students. The vice president of student affairs at a public university said off-campus referral sources were limited because they were located in a rural community.
Their school also had difficulty filling traditional mental health vacancies and the counseling operation was usually a traditional 8am to 4:30pm operation, Monday through Friday. By having access to a virtual care partner, this university was able to provide students with on-demand support anytime, anywhere.
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