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Rural Health
Research Gateway

Mental and behavioral health

Current Projects

  • Access to and Provision of Child and Youth Behavioral Health Services in the Rural and Urban U.S.
    The need for behavioral health treatment for youth has been exacerbated by the COVID-19 pandemic. Little is known about the availability of youth behavioral health providers in rural areas. This study will investigate who provides behavioral health services to youth, how the workforce is distributed, and gaps in service availability.
    Research center: WWAMI Rural Health Research Center
    Topics: Allied health professionals, Children and adolescents, Health services, Healthcare access, Mental and behavioral health, Nurses and nurse practitioners, Pharmacy and prescription drugs, Physician assistants, Physicians, Substance use and treatment, Workforce
  • Assessing Access to Medication Treatment for Opioid Use Disorder in Rural Communities Influenced by the Rural Communities Opioid Response Program (RCORP)
    This project will use national prescription claims data to compare access to buprenorphine treatment for opioid use disorder in rural counties with and without Rural Communities Opioid Response Program (RCORP) funding and urban counties. An accurate understanding of access to buprenorphine treatment is essential for determining the influence of RCORP funding on a critical strategy for curbing the opioid epidemic.
    Research center: WWAMI Rural Health Research Center
    Topics: Health services, Healthcare access, Mental and behavioral health, Pharmacy and prescription drugs, Substance use and treatment, Workforce
  • Availability and Characteristics of Outpatient and Residential Substance Use Treatment in Rural and Urban Areas
    This study will look at: 1) the availability of residential and outpatient treatment centers in rural and urban counties, including identifying counties with no facilities; and 2) characteristics of services offered (e.g., residential, outpatient), demographics of persons treated, and insurance plans accepted by rural vs urban centers.
    Research center: Rural and Underserved Health Research Center
    Topics: Health services, Healthcare access, Mental and behavioral health, Pharmacy and prescription drugs, Social determinants of health, Substance use and treatment
  • Changes in Buprenorphine Prescribing Following the Elimination of the Drug Enforcement Administration X Waiver Requirement
    The Drug Enforcement Administration requirement for an X waiver to prescribe buprenorphine for opioid use disorder was lifted in January 2023. This study aims to describe if and how this policy change has impacted the prescribing practices of clinicians and medication treatment access for patients with opioid use disorder.
    Research center: WWAMI Rural Health Research Center
    Topics: Health services, Healthcare access, Legislation and regulation, Mental and behavioral health, Nurses and nurse practitioners, Physician assistants, Physicians, Substance use and treatment, Workforce
  • Disparities in Family Physician Burnout Before and During the COVID-19 Pandemic
    High levels of burnout during the COVID-19 pandemic have been documented among health professionals, particularly women and persons from underrepresented groups. This study examines how burnout has changed from 2019 through 2021 among family physicians as well as variation by rural/urban geography, other sociodemographics, and practice characteristics to identify physicians most in need of interventions to foster resilience and alleviate burnout.
    Research center: WWAMI Rural Health Research Center
    Topics: Mental and behavioral health, Physicians, Workforce
  • Examining Rural Population Characteristics and Access to Care: A Study of Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs)
    This project examined Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs), analyzing geographic disparities in provider shortages across rural and urban settings. Findings highlight variations in access to primary care, mental health, and dental services, informing federal programs that allocate resources to improve health care access.
    Research center: ETSU/NORC Rural Health Research Center
    Topics: Healthcare access, Mental and behavioral health, Oral health, Workforce
  • Medical and Mental Health Service Provision Amongst Rural Health Clinics
    This study will provide a descriptive analysis of differences in Rural Health Clinic (RHC) type, clinic size, and geographic location of RHCs providing same day medical and mental health visits, compared to RHCs that are only providing one or the other type of visits on the same day.
    Research center: Maine Rural Health Research Center
    Topics: Health services, Mental and behavioral health, Rural Health Clinics (RHCs)
  • Mental Health Treatment Among Rural and Urban Adults at Risk for Suicide
    This study will look at rural/urban disparities in 1) the receipt and sources of mental health treatment among adults with suicidal thoughts and attempts using data from the National Survey on Drug Use and Health; and 2) mental health follow-up visits among adults with a hospital admission or emergency department visit for self-inflicted harm using data from a national insurance claims dataset.
    Research center: Rural and Underserved Health Research Center
    Topics: Health services, Healthcare access, Mental and behavioral health, Post-acute care
  • Methamphetamine Use, Mental Health Comorbidities, and Treatment in Rural and Urban Areas
    This study will investigate methamphetamine (meth) use in rural versus urban areas - including meth use in combination with opioids and alcohol, mental health comorbidities, and perceived need for and receipt of treatment by meth users and those with meth use disorder - to identify hotspots for targeting of prevention and treatment resources.
    Research center: WWAMI Rural Health Research Center
    Topics: Mental and behavioral health, Substance use and treatment
  • Postpartum Morbidity and Mortality and Health Care Utilization in Rural vs. Urban Communities
    Using 2006-2018 data from the National Health Interview Survey linked to the National Death Index through 2019, this project will examine postpartum mortality among rural and urban residents. We will also evaluate differences in health, health care utilization, and barriers to care across rural and urban communities.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Healthcare access, Maternal health, Medicaid and CHIP, Mental and behavioral health, Private health insurance, Social determinants of health, Uninsured and underinsured, Women
  • Psychiatric Bed Closures in Rural Hospitals: An Assessment of Trends, Impact, and Policy Strategies
    This study will examine trends in the closure of psychiatric beds by rural hospitals using the Substance Abuse and Mental Health Services Administration Treatment Services Locator; the American Hospital Association Annual Survey of Hospitals (2010-2017); and the Area Health Resources File.
    Research center: Maine Rural Health Research Center
    Topics: Healthcare access, Hospitals and clinics, Mental and behavioral health
  • Risky Substance Use Among Rural and Urban Adults: An Update
    Very little research has examined rural vs. urban differences in substance misuse and treatment access nationally. Using public and nationally representative data from the National Survey on Drug Use and Health, this project will: 1) Estimate and compare alcohol use and binge drinking, and 2) Estimate and compare drug use (marijuana, other illicit drugs, and non-medical use of other drugs) between non-metropolitan and metropolitan adults.
    Research center: Rural and Underserved Health Research Center
    Topics: Mental and behavioral health, Substance use and treatment
  • Rural/Urban Differences in Forgoing Health Care during the COVID-19 Pandemic
    Several surveys conducted during the COVID-19 pandemic showed that adults delayed or skipped healthcare services during the initial months of the COVID-19 pandemic. This study examines changes in healthcare utilization for primary and preventative care among rural and urban Medicare fee-for-service enrollees since the COVID-19 pandemic.
    Research center: ETSU/NORC Rural Health Research Center
    Topics: Aging, Care management, Chronic diseases and conditions, Coronavirus Disease 2019 (COVID-19), Diabetes, Health promotion and disease prevention, Health services, Medicare, Mental and behavioral health, Telehealth
  • Rural/Urban Variations in Drug and Alcohol Use Treatment
    Using the National Survey on Drug Use and Health, this study will investigate rural vs. urban variations in treatment utilization for alcohol use disorder (AUD) and, separately, drug use disorder (DUD). It will yield prevalence estimates of any treatment receipt and sources of treatment among persons with past year AUD and DUD as well as the receipt of medication therapy among those treatable with medications.
    Research center: Rural and Underserved Health Research Center
    Topics: Health services, Healthcare access, Mental and behavioral health, Substance use and treatment
  • Screening, Brief Intervention and Referral to Treatment (SBIRT) Penetration in Rural vs. Urban Healthcare Settings in the U.S.
    This study will include an analysis of 2018/2019 Medicare, Medicaid and Commercial claims to compare the penetration of Screening, Brief Intervention and Referral to Treatment (SBIRT) and its different components in rural compared to urban healthcare settings. Within the overarching analysis, the study team will examine the type of interventions conducted within the SBIRT framework stratified by provider type, healthcare setting, and rural and urban provider ZIP codes. Findings will be analyzed within the context of county-level substance use rates, historical enactment of state SBIRT billing codes, overdoses, and alcohol poisoning-based hospital admissions contrasting trends in SBIRT administration with a proxy for community need.
    Research center: ETSU/NORC Rural Health Research Center
    Topics: Chronic diseases and conditions, Health promotion and disease prevention, Medicaid and CHIP, Medicare, Mental and behavioral health, Private health insurance, Public health, Substance use and treatment
  • Suicide Mortality: A Comparison of Urban and Rural Rates
    Suicide contributes to significant mortality in the United States. This project will examine the differences in suicide rates by geography and explore its driving factors among urban and rural areas in the United States from 2018 to 2021. The research design of this study will adopt a cross-sectional, retrospective approach, using secondary data.
    Research center: ETSU/NORC Rural Health Research Center
    Topics: Healthcare access, Mental and behavioral health, Public health, Rural statistics and demographics, Uninsured and underinsured
  • Treatment, Provider, and Cost Differences for Rural and Urban Patients with Opioid Use Disorder Across the U.S.
    This study describes and compares the treatment that rural and urban patients with opioid use disorder (OUD) receive, documenting the workforce providing care, distance that patients travel to receive care, and cost of care. Findings will inform policies to ensure that rural patients with OUD have access to care from local healthcare providers.
    Research center: WWAMI Rural Health Research Center
    Topics: Health services, Healthcare access, Healthcare financing, Mental and behavioral health, Nurses and nurse practitioners, Pharmacy and prescription drugs, Physician assistants, Physicians, Substance use and treatment, Telehealth
  • Treatment, Provider, and Cost Differences for Rural and Urban Patients with Opioid Use Disorder and Medicaid Insurance Across the U.S.
    This project will analyze Medicaid claims data to compare the treatment that rural and urban patients with opioid use disorder receive, documenting the workforce providing care, the distance that patients travel to receive care, and the cost of care. Findings from this study can be used to improve policies regarding opioid use disorder treatment.
    Research center: WWAMI Rural Health Research Center
    Topics: Health services, Healthcare access, Healthcare financing, Legislation and regulation, Medicaid and CHIP, Mental and behavioral health, Nurses and nurse practitioners, Pharmacy and prescription drugs, Physician assistants, Physicians, Substance use and treatment, Telehealth, Workforce
  • Understanding Changes in the Rural Marriage and Family Therapist and Mental Health Counselor Workforces Under New Medicare Reimbursement Policy
    Marriage and family therapists and mental health counselors are newly eligible as of January 1, 2024, for reimbursement to provide care for Medicare enrollees. This study will describe the change in these clinicians in rural vs. urban communities and seek to understand barriers and solutions to fully realize the benefits of this new reimbursed policy for rural populations.
    Research center: WWAMI Rural Health Research Center
    Topics: Allied health professionals, Medicare, Mental and behavioral health, Workforce