Area of Focus

Rural Mental Health

The Mountain Plains MHTTC’s rural mental health vision is to support increased access to providers of behavioral health services for the more than 60 million Americans living in rural communities. To achieve this vision, the Mountain Plains MHTTC develops and promotes training and technical assistance which supports the rural behavioral health workforce in HHS Region 8. This includes enhancing access to training and technical assistance that reduces barriers to behavioral health treatment for rural residents.


Rural Barriers to Mental Health Services

  1. Accessibility

    Rural residents may have limited access to mental healthcare due to cost of services, insurance coverage, lower behavioral health literacy which allows mental health concerns to go unrecognized and/or untreated, and the remote nature of living rural may require residents to travel long distances to receive services.
  2. Acceptability

    Rural residents are likely to experience self-stigma, fear or embarrassment related to seeking out mental healthcare due to internal beliefs. When implementing rural mental health programs, community members and mental health care providers should consider how stigma may impact access and use of mental health services among rural residents. Lower health literacy and not recognizing the signs of various mental health issues can also serve as barriers to behavioral healthcare access in rural areas.
  3. Availability

    Nearly every county in the Mountain Plains MHTTC Region 8 states are designated as whole county mental health professional shortage areas. Higher levels of unmet need for mental health professionals exist in counties that are more rural and have lower income levels according to the county-level estimates of mental health professional shortage areas in the United States.

    U.S. map showing HPSA mental health by counties

Addressing Rural Mental Health

The Mountain Plains MHTTC is addressing the barriers of rural mental healthcare accessibility, availability, and acceptability in Region 8 by developing and providing training and technical assistance that:

  • Reaches students, entry level professionals, and established providers in rural communities.
  • Highlights the appropriate use of technologies for the existing rural mental health workforce. Telehealth technology and the availability of video conferencing can ease the burden of long travel times and improve access to geographically limited specialty care.
  • Covers effective practice in rural communities. Many established models for delivery of behavioral healthcare do not account for the unique challenges presented by rural communities. Providing focused training on the realities of practice for rural behavioral health providers can help increase the satisfaction of the patients being served by these providers.


Farm Stress and Mental Health Resources

The Mountain Plains Mental Health Technology Transfer Center team is dedicated to addressing rural mental health. However, they also recognize that the agricultural community encounter unique challenges related to the accessibility, availability, and acceptability of mental health services.


Rural Mental Health Resources

There are several resources available that provide summaries of rural mental health concerns, up-to-date data visualization, and toolkits for addressing rural barriers to mental health services. Some of these resources include:

Addressing Rural Behavioral Health Workforce Shortages: Lessons Learned from a Rural Psychology Internship Initiative
This brief describes an initiative focused on developing rural psychology internship opportunities in an effort to grow the rural workforce. These internships have proven effective for behavioral health workforce development and may apply to other health disciplines as well.

Behavioral Health in Rural America: Challenges and Opportunities
This 2019 report describes the prevalence of behavioral health disorders among rural populations as well as the barriers associated with the provision of prevention, treatment, and recovery services. Following discussion of the need, the report presents rural models as well as policy options.

Behavioral Health Provider Geographic Distribution and Reimbursement Inequities
This cross-sectional study examines the relationship between reimbursement and behavioral health provider geographic distribution and seeks to understand how Medicare and Medicaid reimbursement for behavioral health providers may limit service delivery.

Behavioral Health Service Provision by Primary Care Physicians
This project seeks to understand which behavioral health services primary care physicians currently provide for their clients and how often they do so.

Critical Crossroads: Pediatric Mental Health Care in the Emergency Department
The number of children seeking care for a mental health crisis in an emergency department is on the rise. With often limited mental health services, hospitals in rural areas bear an excessive burden. This toolkit can better prepare hospital emergency departments to manage and coordinate care for children and adolescents in mental health crisis. You can tailor the resources to your specific needs, patient population, and community. This is a product of the Health Resources and Services Administration (HRSA).

National Association for Rural Mental Health
NARMH is a professional organization that serves the field of rural behavioral health. NARMH's membership includes the entire spectrum of the rural mental health community, including consumers, family members, practitioners, administrators, educators, researchers, and policy makers. A unifying force for NARMH has been a focus on rural concerns, which includes a commitment to rural people and those that serve them. This belief that rural comes first has allowed NARMH to concentrate its efforts to improve access, availability, acceptability of behavioral health and substance abuse services and research in rural and frontier areas.

Promoting Positive Mental Health in Rural Schools
This guide provides resources specific to addressing the unique mental health training and technical assistance needs of schools serving rural and remote communities. Underscoring the purpose of the document was a recognition that schools, communities, and families often lack comprehensive treatment and services for children and youth. That is particularly true in rural communities.

Rural Health Information Hub (RHIhub) Mental Health in Rural Communities Toolkit
This toolkit provides an overview of mental health as well as an introduction to some of the unique challenges facing isolated communities. Additionally, this module will provide insight into important background information needed to implement programming and improve mental health in rural communities.

Rural Health Information Hub (RHIhub) Rural Mental Health Topics Page
Here you can access resources, current data, news, events, models and innovations, and funding opportunities specific to rural mental health.

Rural Health Research Gateway Mental and Behavioral Health Topic Page
The Rural Health Research Gateway is funded by the Health Resources and Services Administration Federal Office of Rural Health Policy. Gateway provides access to all of the research products of the federally-funded Rural Health Research Centers. Access all of their recent research on rural mental and behavioral health.

Rural, Remote, and Resilient: How to Build Better Outcomes Outside of America’s Cities
Developed by the Master of Public Health (MPH) online program from Baylor University's Robbins College of Health and Human Sciences, this product discusses health disparities between metro and non-metro counties and offers strategies on how to collaborate to foster better health results in rural areas.

State Incentive Programs that Encourage Allied Health Professionals to Provide Care for Rural and Underserved Populations
This study describes allied health incentive programs at the state level as described during 30 semi-structured phone interviews with key informants from 27 states and information found online.

Substance Abuse and Mental Health Services Administration (SAMHSA)
Leads public health efforts to advance the behavioral health of the nation. Works to reduce the impact of substance abuse and mental illness on America's communities. Part of the U.S. Department of Health & Human Services.

The Hidden Crisis in Rural America
This short documentary discusses rural mental health access issues and how rural residents with a serious mental illness are both more likely to encounter police and to live without treatment.

Understanding Rural Communities: Perspectives on Rural Mental Health
In 2017, the Hogg Foundation for Mental Health began to take a hard look at ways to work and learn alongside rural communities to promote conditions that support mental health. In this 20 minute podcast, you will hear from Dennis Mohatt, a national expert in the field of rural mental health, as he discusses how the unique characteristics of rural communities affect mental health and the implementation of mental health programs.