Research Alert: May 14, 2026

Access to and Provision of Child and Youth Behavioral Health Services in the Rural and Urban U.S.

Between 2018 and 2023, suicide mortality rates among youth aged under 18 years in rural areas remained consistently higher than those in urban areas. Children in rural areas were more likely to have parent-reported mental, behavioral, and developmental disorders compared with their urban counterparts, and the prevalence of mental health conditions, such as depression and anxiety, was higher among children aged 3-17 living in rural areas than in urban areas, though estimates vary across studies. These elevated rates of need exist alongside workforce shortages: 70.2% of rural counties had no practicing youth behavioral health clinician, and 74.1% of rural counties were entirely or partially designated as mental health professional shortage areas. Prior research has documented that rurality is associated with reduced availability of youth mental health facilities offering suicide prevention services, and that geographic disparities in school-based mental health services leave rural elementary and secondary students with fewer in-school resources than their urban peers.

This report brings together findings from nine briefs and reports on youth behavioral health in the rural U.S., describing the prevalence of behavioral health conditions among youth, the youth behavioral health workforce, the behavioral health licensure and reimbursement policy landscape, and the provision of youth behavioral health services. Understanding the full picture of rural youth mental and behavioral health, from the health conditions they experience to the workforce available to treat them and the services youth actually receive, is important for informing policy and investment in this underserved population.

Additional Resources of Interest:

• More FORHP-funded research on Children and adolescents, Mental and behavioral health, Workforce
• More information about the WWAMI Rural Health Research Center
• More information from the Rural Health Information Hub's topic guide: Mental Health