Access and Quality of Mental Health Services in Rural and Urban America

View Policy Brief

07/2025

Mental health conditions require timely and appropriate treatment. Untreated conditions can result in substance use disorders, unemployment, homelessness, suicide, incarceration, deterioration of physical health, shorter lifespan, and increased co-occurrence of chronic diseases such as diabetes, obesity, epilepsy, cancer, and cardiovascular disease. This brief documents recent trends of mental health care access and quality in urban and rural communities.

Key Findings:

• Access to Mental Health Facilities: Nearly 18 percent of large rural and over 40 percent of small/isolated rural ZIP Code Tabulation Areas (ZCTAs) were located at least 30 minutes from any type of mental health care facility compared to less than 10 percent of urban ZCTAs.
• Digital Divide Exacerbating Access: Both rural and urban ZCTAs located more than 30 minutes away from the nearest mental health facility have a higher proportion of households without access to essential telecommunication devices.
• Quality of Rural Mental Health Facilities: Rural facilities generally demonstrate better performance compared to urban facilities in terms of continuity of care measures and lower rates of physical restraint and seclusion usage.

University of South Carolina Rural Health Research Center

Peiyin Hung, Sophia Negaro, Rachel Hantman, Emma Boswell, Christina Andrews, Cassie Odahowski, Elizabeth Crouch

Critical Access Hospitals (CAHs), Health information technology, Healthcare access, Hospitals and clinics, Mental and behavioral health, Public health, Quality, Rural statistics and demographics