Mental and behavioral health
Research Products & Journal Articles
Browse the full list of research publications on this topic completed by the Rural Health Research Centers.
Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.
Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.
2024
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Discussions of Cancer Survivorship Care Needs: Are There Rural Versus Urban Inequities?
Journal Article
Rural and Underserved Health Research Center
Date: 05/2024
This study used 2017 Medical Expenditure Panel Survey data to test for rural versus urban inequities and identify other correlates of discussions about cancer survivorship care with health care professionals. -
Housing for Rural Residents Recovering from Substance Use Disorders
University of Minnesota Rural Health Research Center
Date: 05/2024
The purpose of this case series is to highlight organizations providing housing for individuals in recovery from substance use disorders in rural communities. These may serve as examples to others considering this work. -
Suicide Rates and Risks Across U.S. Industries: A 29-Year Population-Based Survey
Journal Article
Rural and Underserved Health Research Center
Date: 01/2024
Combining 29 years of U.S. suicide data using the National Health Interview Survey (NHIS)-Mortality Linked data from 1986 through 2014, with mortality follow-up through 2015, this study estimates suicide risks across industries in the U.S. working population.
2023
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Geographic Variations in Driving Time to U.S. Mental Health Care, Digital Access to Technology, & Household Crowdedness
Journal Article
Rural and Minority Health Research Center
Date: 12/2023
This study compared travel time to mental health facilities in rural versus urban areas and potential barriers to digital devices for telemedicine access in those same rural/urban locations. In addition, the research examined private space within the home as it relates to household crowdedness. -
Eight Postpartum Support Programs in Rural Communities Across the United States
University of Minnesota Rural Health Research Center
Date: 08/2023
This case study series highlights locally focused organizations working to improve postpartum health for rural residents across the United States. Interviews were conducted with eight unique organizations working in their local rural communities to support postpartum health. -
The Relationship Between Experience With Mental Illness and Stigmatizing Attitudes and Beliefs
Policy Brief
Rural Health Equity Research Center
Date: 08/2023
This policy brief documents the relationship between self-reported experience with any mental illness (whether first-hand or second-hand) and public stigma associated with mental illness. Differences in the prevalence of experience with mental illness by geography are also explored. -
State Differences in Recommended Components of Care Received During Postpartum Visits for Rural and Urban Residents, 2016-2019
Policy Brief
University of Minnesota Rural Health Research Center
Date: 07/2023
The purpose of this policy brief is to measure state-level differences in the receipt of recommended postpartum care components among rural and urban residents in the United States who gave birth from 2016 to 2019. -
Two National-Level Organizations Supporting Rural Postpartum Health Across the United States
University of Minnesota Rural Health Research Center
Date: 07/2023
The purpose of this case study series is to highlight national-level organizations working in innovative ways to improve postpartum health for rural residents across the United States. These may serve as examples to others considering this work. -
Rural Healthy People 2030: Common Challenges, Rural Nuances
Policy Brief
Southwest Rural Health Research Center
Date: 05/2023
This study analyzes the most important Healthy People 2030 priorities for rural America. Data collected from a survey found mental health, substance use, health care access, and economic stability were among the most important priorities. This information could be used to accelerate health improvements in rural America. -
Indicators of Familial Social Support by Rurality and Gender Identity
Policy Brief
University of Minnesota Rural Health Research Center
Date: 03/2023
Social and emotional support from family significantly contributes to positive health outcomes. Understanding how familial social support differs for those with overlapping marginalized identities is critical to advance population health and health equity. This brief examines differences in familial social support by rurality and gender identity. -
Psychological Distress Is More Common in Some Occupations and Increases With Job Tenure: A Thirty-Seven Year Panel Study in the United States
Journal Article
Rural and Underserved Health Research Center
Date: 03/2023
This study used 1981–2017 data from the Panel Study of Income Dynamics and the Screening Scale for Psychological Distress (Kessler K6) to identify occupations with low and high risks of mental health problems in the United States. -
Rural Healthy People 2030: New Decade, New Challenges
Journal Article
Southwest Rural Health Research Center
Date: 03/2023
This study reports the findings of Rural Healthy People 2030, a companion piece to the Healthy People 2030 initiative with a focus on health priorities of rural populations. Data was collected from a survey given to rural stakeholders. Mental health, substance use, health care access, and economic stability were among the most important priorities. -
Rural School- and Community-Based Programs Supporting LGBTQ+ Youth
University of Minnesota Rural Health Research Center
Date: 02/2023
The purpose of this case series is to highlight youth-focused and school- and community-based organizations that affirm and support LGBTQ+ individuals in their rural communities. These may serve as examples to others considering this work.
2022
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Rural-Urban Differences in Child and Adolescent Mental Health Prior to and During the COVID-19 Pandemic: Results From the National Survey of Children's Health
Policy Brief
Rural and Minority Health Research Center
Date: 11/2022
This policy brief analyzes data from a large national sample of children and adolescents to examine similarities and differences between rural and urban mental health outcomes prior to and during the COVID-19 pandemic and offers considerations for policy and program development. -
Rural-Urban Disparities in Quality of Inpatient Psychiatric Care
Journal Article
Rural and Minority Health Research Center
Date: 11/2022
Using data from the Inpatient Psychiatric Facility Quality Reporting program 2015-2019, this study examined differences and changes in the quality of inpatient psychiatric care in rural and urban hospitals. -
Changes in the Supply and Rural-Urban Distribution of Counselors in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of counselors by rural-urban status and Census Division. -
Changes in the Supply and Rural-Urban Distribution of Psychiatric Nurse Practitioners in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of psychiatric nurse practitioners by rural-urban status and Census Division. -
Changes in the Supply and Rural-Urban Distribution of Psychiatrists in the U.S., 1995-2019
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of psychiatrists by rural-urban status and Census Division. -
Changes in the Supply and Rural-Urban Distribution of Psychologists in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of psychologists by rural-urban status and Census Division. -
Changes in the Supply and Rural-Urban Distribution of Social Workers in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of social workers by rural-urban status and Census Division. -
Examining the Burden of Public Stigma Associated With Mental Illness in the Rural United States
Policy Brief
Rural Health Equity Research Center
Date: 09/2022
Stigma is a widely recognized barrier to receipt of health and mental health services. This policy brief documents the burden of public stigma associated with any mental illness in rural versus non-rural communities in the United States. Differences in stigmatizing attitudes and beliefs by rurality, gender, race and ethnicity, and age are examined. -
Rural-Urban Differences in Child and Adolescent Access to and Receipt of Mental Health Services Prior to and During the COVID-19 Pandemic: Results From the National Survey of Children's Health
Policy Brief
Rural and Minority Health Research Center
Date: 09/2022
This policy brief analyzes data from a large, national sample of children and adolescents to examine gross inter-group similarities and differences and offer timely recommendations for alleviating the youth mental health crisis. -
Self-Rated Health Among Gay, Lesbian, and Bisexual Adults: Rural/Urban Differences
Policy Brief
University of Minnesota Rural Health Research Center
Date: 07/2022
Research has documented worse health outcomes and constrained access to care for lesbian, gay, and bisexual adults. Rural residents also experience persistent disparities in health and access to care. This policy brief examines differences in self-rated health by sexual orientation and rural/urban location. -
Anxiety, Depression, and Access to Mental Health Care by Sexual Orientation and Rurality
Policy Brief
University of Minnesota Rural Health Research Center
Date: 06/2022
This policy brief addresses the research gap among rural sexual minorities by illuminating differences in mental health for two of the most common mental health disorders (depression and anxiety), as well as differences in access to health care. -
Improving Access to LGBTQIA+-Friendly Care in Rural Areas
University of Minnesota Rural Health Research Center
Date: 06/2022
The purpose of this case series is to highlight organizations doing exemplary work to improve access to and experiences of health care among lesbian, gay, bisexual, transgender, queer/questioning, and asexual/agender (LGBTQIA+) individuals in rural communities across the U.S. -
Non-Metropolitan and Metropolitan Trends in Mental Health Treatment Availability in Community Health and Community Mental Health Centers
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2022
This study shows how the supply of community mental health centers (CMHCs) and community health centers (CHCs) delivering mental health services changed from 2000 to 2019. While the supply of CHCs offering mental health services increased, the supply of CMHCs decreased. -
Prevalence of Chronic Conditions by Sexual Orientation and Rural-Urban Location
Policy Brief
University of Minnesota Rural Health Research Center
Date: 06/2022
This policy brief examines rates of individual chronic conditions, as well as differences in the number of chronic conditions by sexual orientation and rural-urban location. -
Rural Community Organizations Building Inclusive Environments for LGBTQ+ Residents
University of Minnesota Rural Health Research Center
Date: 06/2022
The purpose of this case series is to highlight rural organizations doing exemplary work to build community among lesbian, gay, bisexual, transgender, and queer/ questioning residents, and create a more inclusive environment in their communities. -
Small-Town Pride Celebrations Supporting Social Connectedness & Well-Being for LGBTQ+ Rural Residents
University of Minnesota Rural Health Research Center
Date: 06/2022
The purpose of this case series is to highlight organizations in two states doing exemplary work to celebrate and affirm lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) individuals in their rural communities through Pride events. These may serve as examples to others considering this work. -
Social and Emotional Support During the COVID-19 Pandemic by Sexual Orientation and Rurality
Policy Brief
University of Minnesota Rural Health Research Center
Date: 06/2022
This brief identifies differences in social and emotional support and changes to that support during the COVID-19 pandemic by rurality and sexual orientation. -
Racial/Ethnic Differences in Adverse and Positive Childhood Experiences Across Rural Communities: Results From the National Survey of Children's Health
Policy Brief
Rural and Minority Health Research Center
Date: 05/2022
This study examined whether ACE and PCE exposure varied by race/ethnicity, among rural children, finding that there were higher rates of four or more ACEs among racial/ethnic minority children. -
Social Isolation and Safety Issues Among Rural Older Adults Living Alone: Perspectives of Meals on Wheels Programs
Journal Article
University of Minnesota Rural Health Research Center
Date: 05/2022
In this article, we share results from a survey of 42 Meals on Wheels programs in rural areas across the US. Respondents highlighted challenges to meeting both social and safety needs of rural older adults living alone, as well as policy recommendations to improve the health and safety of older adults living alone in rural areas. -
Meeting the Behavioral Health Needs of Farm Families in Times of Economic Distress
Policy Brief
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 02/2022
Economic fluctuations and periods of distress in farming cannot be eliminated, however, their impact on communities and individuals can be mitigated. Strategies for meeting the behavioral health needs of farm families by supporting community-based services, and expanding behavioral health services in rural contexts are highlighted in this work. -
Serious Mental Illness and Mental Health Treatment Utilization Among Adults Residing in Non-Metropolitan and Metropolitan Counties
Policy Brief
Rural and Underserved Health Research Center
Date: 02/2022
This report estimates and compares the prevalence of mental health treatment utilization and reasons for not seeking mental health treatment among adults with serious mental illness residing in non-metropolitan and metropolitan counties nationally. -
Rural-Urban Differences in Adverse and Positive Childhood Experiences: Results From the National Survey of Children's Health
Policy Brief
Rural and Minority Health Research Center
Date: 01/2022
This brief examines the types and counts of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) for rural and urban children. The study reports on the differences between rural and urban ACEs and PCEs across all fifty states and the District of Columbia. -
Social Cohesion and Social Engagement Among Older Adults Aging in Place: Rural/Urban Differences
Policy Brief
University of Minnesota Rural Health Research Center
Date: 01/2022
This policy brief examines rural/urban differences in social cohesion and social engagement for older adults aging in place, as well as within-rural differences by race and ethnicity.
2021
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Suicide Mortality Rates in Farm-Related Occupations and the Agriculture Industry in the United States
Journal Article
Rural and Underserved Health Research Center
Date: 09/2021
This article examines suicide mortality among agricultural workers comparing rural and urban residents using pooled data from the Mortality‐Linked National Health Interview Survey, 1986–2014.
2020
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Acuity Differences Among Newly Admitted Older Residents in Rural and Urban Nursing Homes
Journal Article
Maine Rural Health Research Center
Date: 11/2020
This study found newly admitted residents of rural nursing homes were more likely to have cognitive issues/problem behaviors than those in urban facilities. Yet rural facilities admitted less complex older (age 75+) residents than urban, raising questions about the rural long-term services and supports system and capacity of rural nursing homes. -
Risky Substance Use Behaviors Among Adolescents Residing in Nonmetropolitan and Metropolitan Counties in the United States, 2017-2018
Policy Brief
Rural and Underserved Health Research Center
Date: 11/2020
This brief uses nationally representative survey data to compare past-30 day and past-year risky substance use among adolescents 12 to 17 years of age residing in metropolitan and nonmetropolitan counties. Specifically, we compared consumption of alcohol, tobacco, and other illicit substances. -
Risky Substance Use Behaviors Among Adults Residing in Nonmetropolitan and Metropolitan Counties in the United States, 2017-2018
Policy Brief
Rural and Underserved Health Research Center
Date: 11/2020
This brief uses nationally representative survey data to identify differences in past-30 day and past-year risky substance use among adults, including alcohol, tobacco, and illicit drugs. This data indicates some significant differences in substance use consumption. -
A Comparison of Rural and Urban Specialty Hospitals
Policy Brief
Rapid Response to Requests for Rural Data Analysis
Date: 09/2020
This brief describes key differences between specialty hospitals located in rural versus urban areas. -
Telebehavioral Health Use Among Rural Medicaid Beneficiaries: Relationships With Telehealth Policies
Journal Article
Rural Telehealth Research Center
Date: 09/2020
This study assesses policy levers potentially supporting sustained use of telehealth services. Among rural Medicaid fee-for-service beneficiaries with behavioral health needs, engaging patients through informed consent within provider settings that receive facility fees may facilitate improved access to telebehavioral health services. -
Comparing the Health Workforce Provider Mix and the Distance Travelled for Mental Health Services by Rural and Urban Medicare Beneficiaries
Journal Article
WWAMI Rural Health Research Center
Date: 08/2020
This study used 2014 administrative Medicare claims data to describe the mix of health professionals who care for rural and urban patients with mood and/or anxiety disorders. It further describes where these beneficiaries received care and the one-way distance (miles) and time (minutes) they travelled to receive it. -
Major Depression, Treatment Receipt, and Treatment Sources Among Non-Metropolitan and Metropolitan Adults
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2020
This study estimates and compares the prevalence of past year depression, receipt of treatment for depression, and sources of treatment for depression between non-metropolitan and metropolitan adults. -
Rural/Urban Disparities in the Utilization of Health and Behavioral Assessments/Interventions in the Fee-for-Service Medicare Population
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2020
Identifying behaviors that contribute to disease and modifying them can be an important step in treatment. This study investigated geographic disparities and the availability of Health and Behavioral Assessments and Interventions services in rural and urban areas by examining fee-for-service Medicare beneficiaries in 2012-2016. -
Measure and Data Element Identification for the HRSA Evidence-Based Tele-Behavioral Health Network Program and the HRSA Substance Abuse Treatment Telehealth Network Grant Program
Policy Brief
Rural Telehealth Research Center
Date: 04/2020
This brief details work to identify measures and develop data elements appropriate to tele-behavioral health, create an Excel-based tool, and collect data from grantees in the Health Resources and Services Administration's Evidence-Based Tele-Behavioral Health Network Grant Program and Substance Abuse Treatment Telehealth Network Grant Program. -
Early-Career and Graduating Physicians More Likely to Prescribe Buprenorphine
Journal Article
Rural and Underserved Health Research Center
Date: 01/2020
Only a small percentage of people who need treatment for opioid use disorder receive it, including buprenorphine. This paper shows differences in rates of prescribing buprenorphine and intentions to prescribe buprenorphine between early- and mid-to-late career family physicians, based on a survey of physicians taking a certification examination. -
Practice Predictors of Buprenorphine Prescribing by Family Physicians
Journal Article
Rural and Underserved Health Research Center
Date: 01/2020
Physicians may prescribe buprenorphine if they obtain a waiver, but relatively few family physicians do so. This paper examines the association between practice characteristics and the likelihood that a family physician will prescribe buprenorphine, based on a survey of physicians seeking board certification in family medicine.
2019
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Partial Psychiatric Hospitalization Program Availability in Nonmetropolitan and Metropolitan Hospitals Nationally
Policy Brief
Rural and Underserved Health Research Center
Date: 12/2019
Partial psychiatric hospitalization programs (PPHPs) are intended to reduce or avoid inpatient stays by providing intensive psychiatric services in outpatient settings. We provide national estimates of PPHP availability among nonmetropolitan and metropolitan hospitals and describe the hospital characteristics associated with the provision of PPHPs. -
Tele-Emergency Behavioral Health in Rural and Underserved Areas
Journal Article
Rural Telehealth Research Center
Date: 11/2019
This paper describes how two distinct tele-emergency department (ED) behavioral health models address challenges in access and placement for patients in rural and underserved areas presenting to EDs. The notable difference in disposition rates between cases and controls shows the impact each model is having on care practices and processes. -
Prescribing Practices of Nurse Practitioners and Physician Assistants Waivered to Prescribe Buprenorphine and the Barriers They Experience Prescribing Buprenorphine
Journal Article
WWAMI Rural Health Research Center
Date: 10/2019
This study surveyed rural and urban nurse practitioners (NPs) and physician assistants (PAs) with Drug Enforcement Agency waivers to provide medication treatment for opioid use disorder by prescribing buprenorphine. Rural NPs and PAs reported facing many of the same barriers to providing buprenorphine as rural physicians have reported. -
Suicidal Thoughts, Plans, and Attempts by Non-Metropolitan and Metropolitan Residence
Policy Brief
Rural and Underserved Health Research Center
Date: 05/2019
Suicide is among the leading causes of death in the US, and rates in non-metropolitan (rural) counties have historically exceeded those in metropolitan (urban) counties. This study examined the prevalence of suicidal thoughts, plans, and attempts by year (2010-2016) and county type (non-metropolitan, small metropolitan, and large metropolitan).
2018
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Patterns of Telehealth Use Among Rural Medicaid Beneficiaries
Journal Article
Rural Telehealth Research Center
Date: 10/2018
This study uses data from the 2011 Medicaid Analytic eXtract (MAX) to examine the prevalence of telehealth use among rural and urban Medicaid beneficiaries, characteristics of telehealth users, types of telehealth services provided, and diagnoses associated with telehealth use. -
Geographic Variation in the Supply of Selected Behavioral Health Providers
Journal Article
WWAMI Rural Health Research Center
Date: 06/2018
This study examined the supply of select behavioral health providers by metropolitan, micropolitan, and non-core county and Census Division. Psychiatrists, psychologists, and psychiatric nurse practitioners are unequally distributed throughout the U.S., with disparities between Census Divisions and rural vs. urban areas. -
Illicit Drug and Opioid Use Disorders Among Non-Metropolitan Residents
Policy Brief
Rural and Underserved Health Research Center
Date: 01/2018
We provide estimates of the prevalence of illicit drug and opioid use disorders among non-metropolitan adults ages 18-64. Prevalence rates did not decline from 2011-2013 to 2014-2015 despite the implementation of major substance use treatment policies. Of particular concern, heroin use disorder prevalence increased in recent years. -
Perceived Treatment Need and Utilization for Illicit Drug and Opioid Use Disorders in Non-Metropolitan Areas
Policy Brief
Rural and Underserved Health Research Center
Date: 01/2018
The vast majority of non-metropolitan adults 18-64 who satisfy criteria for an illicit drug use or opioid use disorder do not perceive a need for treatment or receive formal substance use treatment. Despite policies to increase treatment access during the 2008-2015 study period, we found few changes in perceived treatment need and utilization.
2017
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Barriers to Nursing Home Care for Nonelderly Rural Residents
Journal Article
University of Minnesota Rural Health Research Center
Date: 12/2017
This study uses data from 23 semi-structured interviews with rural hospital discharge planners in five states to identify specific barriers to finding nursing home care for nonelderly rural residents. We found three primary themes—payment status, fit, and medical complexity—as well as two minor themes—caregivers and bureaucratic processes. -
Identifying Variability in Patient Characteristics and Prevalence of Emergency Department Utilization for Mental Health Diagnoses in Rural and Urban Communities
Journal Article
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 10/2017
Patients needing behavioral healthcare can get more appropriate, cost-effective treatment if they are redirected from emergency departments (EDs). This study examined whether a larger proportion of rural versus urban patients went to went to EDs. -
Barriers Rural Physicians Face Prescribing Buprenorphine for Opioid Use Disorder
Journal Article
WWAMI Rural Health Research Center
Date: 07/2017
Opioid use disorder is a serious public health problem. Management with buprenorphine is an effective medication-assisted treatment, but 60.1% of rural counties lack a physician with a Drug Enforcement Agency waiver to prescribe buprenorphine. This national study surveyed all rural physicians who have received a waiver in the United States. -
Use of the Emergency Department for Mental Health and Substance Abuse Among Women
Fact Sheet
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 07/2017
This study identifies trends among women in rural and urban communities who utilize the emergency department for mental health and substance abuse. The information can be used to help communities provide more relevant, appropriate, and less costly care. -
Rural and Urban Utilization of the Emergency Department for Mental Health and Substance Abuse
Policy Brief
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 06/2017
Utilizes data from the Healthcare Cost and Utilization Project's (HCUP's) State Emergency Department Databases (SEDD) for seven states. Researchers explore, and describe in this brief, the use of the Emergency Department for mental health and substance abuse among Urban, Large Rural, Small Rural, and Isolated Small Rural residents. -
Changes in the Supply of Physicians With a DEA DATA Waiver to Prescribe Buprenorphine for Opioid Use Disorder
Policy Brief
WWAMI Rural Health Research Center
Date: 05/2017
This project mapped the location of physicians with a DEA DATA 2000 waiver to prescribe buprenorphine for opioid use disorder in July 2012 and April 2016. The number of counties without a waivered physician and the ratio of waivered physicians per 100,000 population is reported by the rural/urban status of the county.
2016
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Health-Related Quality of Life Among Adults 65 Years and Older in the United States, 2011-2012: A Multilevel Small Area Estimation Approach
Journal Article
Rural and Minority Health Research Center
Date: 10/2016
This study compiled estimates, at the county level, of poor health-related quality of life among those ages 65 and older. The study examined physical and mental health and found significant differences in health across the United States. -
Supply and Distribution of the Behavioral Health Workforce in Rural America
Policy Brief
WWAMI Rural Health Research Center
Date: 09/2016
This brief uses National Provider Identifier (NPI) data to report on the variability of the supply and provider to population ratios of five types of behavioral health workforce providers (psychiatrists, psychologists, social workers, psychiatric nurse practitioners, counselors) in Metropolitan, Micropolitan and Non-core rural areas across the U.S. -
Understanding the Business Case for Telemental Health in Rural Communities
Journal Article
Maine Rural Health Research Center
Date: 07/2016
This article describes the current landscape and characteristics of rural telemental health programs and then examines their business case. -
Adverse Childhood Experiences in Rural and Urban Contexts
Policy Brief
Maine Rural Health Research Center
Date: 04/2016
This study was designed to address the gap in the literature examining rural-urban differences in adults' exposure to adverse childhood experiences (ACEs) and to inform health system initiatives geared toward mitigating the impacts of ACEs on rural populations. -
Mental Health First Aid in Rural Communities: Appropriateness and Outcomes
Journal Article
Maine Rural Health Research Center
Date: 01/2016
Mental Health First Aid (MHFA), an early intervention training program for general audiences, has been promoted as a means for improving population-level behavioral health in rural communities by encouraging treatment-seeking. This study examined MHFA's appropriateness and impacts in rural contexts.
2014
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The 2014 Update of the Rural-Urban Chartbook
Chartbook
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 10/2014
This chartbook includes trends and disparities in urban/rural health. Reports on population characteristics include age, race and ethnicity, and poverty; risk factors such as smoking, alcohol use, and obesity; mortality data; health status measures such as adolescent births and total tooth loss; healthcare access/use; and mental health measures. -
Implications of Rurality and Psychiatric Status for Diabetic Preventive Care Use Among Adults With Diabetes
Policy Brief
Maine Rural Health Research Center
Date: 05/2014
This brief examines patterns of diabetic preventive care use among adults with diabetes to determine whether these patterns vary according to respondents' rural/urban residence or the presence/absence of a mental health diagnosis.
2013
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Telemental Health in Today's Rural Health System
Maine Rural Health Research Center
Date: 12/2013
This policy brief describes the organizational setting, services provided, and staff used in 53 telemental rural health programs. It also outlines the opportunities and challenges for telemental health in the rural health system. -
Challenges and Opportunities for Improving Mental Health Services in Rural Long-Term Care
Maine Rural Health Research Center
Date: 06/2013
This study explores practices for increasing the quality, quantity, and accessibility of mental health services in rural long-term care. -
Patterns of Care for Rural and Urban Children With Mental Health Problems
Maine Rural Health Research Center
Date: 06/2013
This study reports that rural children are significantly less likely to be diagnosed and treated for non-ADHD mental health problems than urban children and are less likely to receive mental health counseling. -
Rural Border Health Chartbook
Rural and Minority Health Research Center
Date: 01/2013
The chartbook examines potential geographic and ethnic disparities among U.S. border residents and describes select indicators related to access to care, women's preventive services, oral health, infectious and communicable diseases, and mental health that have been identified as disparities. -
Rural Border Health Chartbook (Key Facts)
Rural and Minority Health Research Center
Date: 01/2013
This report examines potential geographic and ethnic disparities among U.S. border residents and describes select indicators related to access to care, women's preventive services, oral health, infectious and communicable diseases, and mental health that have been identified as disparities.
2010
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Access to Mental Health Services and Family Impact of Rural Children With Mental Health Problems
Maine Rural Health Research Center
Date: 10/2010
Rural children are more likely to have mental health problems, to have behavioral difficulties, and to be usually or always affected by their conditions than urban children. Rural children also are more likely to go without access to all parent-reported needed mental health services, and their families spend more time coordinating their care. -
Mental Health Problems Have Considerable Impact on Rural Children and Their Families
Policy Brief
Maine Rural Health Research Center
Date: 10/2010
This policy brief provides information on the prevalence of children's mental health needs and associated access to care and family impact across rural and urban areas. Analyses are based on the 2005-06 National Survey of Children with Special Health Care Needs. -
Mental Health Services in Rural Jails (Working Paper)
Maine Rural Health Research Center
Date: 08/2010
This study explored the role of rural jails in the mental health systems in rural communities, investigating how rural jails manage mental health and substance abuse problems among inmates, determining barriers to providing mental health services faced by rural jails, and identifying promising practices for service delivery. -
Encouraging Rural Health Clinics to Provide Mental Health Services: What Are the Options?
Maine Rural Health Research Center
Date: 05/2010
This study examined changes in the delivery of mental health services by rural health clinics (RHCs), their operational characteristics, barriers to the development of services, and policy options to encourage more RHCs to deliver mental health services. -
The Provision of Mental Health Services by Rural Health Clinics
Maine Rural Health Research Center
Date: 05/2010
This study examined changes in the delivery of mental health services by rural health clinics (RHCs), their operational characteristics, barriers to the development of services, and policy options to encourage more RHCs to deliver mental health services. -
Assessment of the Mental Health Funding Marketplace in Urban vs. Rural Settings for Individuals With Serious Mental Illness (Findings Brief)
WICHE Center for Rural Mental Health Research
Date: 03/2010
This study was designed to assess the impact of rurality on the source of payment for mental health treatments and determine whether urban-rural differences in payment sources vary for the seriously mentally ill relative to all other mental health conditions. -
Assessment of the Mental Health Funding Marketplace in Rural vs. Urban Settings (Working Paper)
WICHE Center for Rural Mental Health Research
Date: 02/2010
Rural residents are less likely to have mental health services funded through private insurance and more likely through public sources than urban residents, suggesting that targeting policies through public funding sources could be the most effective method to reduce urban-rural disparities in mental healthcare.
2009
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Differences in Prescribing Patterns of Psychotropic Medication for Children and Adolescents Between Rural and Urban Prescribers
WICHE Center for Rural Mental Health Research
Date: 10/2009
This study reports that prescriptions of all psychotropic drug categories increased for urban and rural populations during the 10-year study period. Urban youth were more likely to be prescribed psychotropic medications by psychiatrists. In contrast, rural youth were more likely to have psychotropics prescribed by generalists or other prescribers. -
Rural-Urban Differences in Depression Care (Working Paper)
WICHE Center for Rural Mental Health Research
Date: 10/2009
This paper assesses the association between rurality and depression care. It reports that rural individuals are more reliant on pharmacotherapy than psychotherapy. -
Mental Health Services in Rural Jails (Policy Brief)
Policy Brief
Maine Rural Health Research Center
Date: 09/2009
The prevalence of mental illness among prison and jail inmates has attracted increasing attention in both mental health and criminal justice circles. -
Addressing Suicide Potential and Prevention in Rural and Frontier Areas: Suicide Prevention Toolkit for Rural Primary Care Providers
WICHE Center for Rural Mental Health Research
Date: 08/2009
Suicide rates in rural areas are significantly higher than they are in urban areas for men of all ages and for young women. Research shows that many people visit their primary care physician instead of a mental health provider for mental health problems. A Suicide Prevention Toolkit for rural primary care providers is provided. -
Distance Education Training in Behavioral Health: A Rural Primary Care Needs Assessment and Pilot Webcast
WICHE Center for Rural Mental Health Research
Date: 08/2009
Primary care providers (PCPs) are often the only resource for rural/frontier residents needing mental healthcare. Mental health training is not easily accessible for PCPs working in rural settings. Distance education offers a low-cost, convenient way for PCPs to obtain the information necessary to treat the mental health needs of their patients. -
The Association Between Rural Residence and the Use, Type, and Quality of Depression Care
Policy Brief
WICHE Center for Rural Mental Health Research
Date: 05/2009
The purpose of the project was to assess the association between rurality and the use, type (pharmacotherapy versus psychotherapy), and quality of care among individuals in the Medical Expenditure Panel Survey with self-reported depression. -
Rural Children Don't Receive the Mental Health Care They Need
Policy Brief
Maine Rural Health Research Center
Date: 01/2009
Controlling for other characteristics that affect access to care, rural children are 20% less likely to have a mental health visit than urban children. Having Medicaid or SCHIP increases the likelihood that a child will receive services, and this is pronounced in rural areas.
2008
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Rural Adults Face Parity Problems and Other Barriers to Appropriate Mental Health Care
Maine Rural Health Research Center
Date: 11/2008
The findings of this policy brief suggest that a multi-level approach is essential for meeting the mental health service needs of rural residents. -
Rural-Urban Differences in Work Patterns Among Adults With Depressive Symptoms
Maine Rural Health Research Center
Date: 03/2008
This study addresses poor mental health among young to middle-career rural residents and how their employment may be affected. Using the National Longitudinal Survey of Youth, the authors investigate how depressive symptoms affect employment patterns and the extent to which such effects differ by rural and urban residence.
2007
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Rural Inpatient Psychiatric Units Improve Access to Community-Based Mental Health Services, but Medicare Payment Policy a Barrier
Maine Rural Health Research Center
Date: 08/2007
This study investigates the characteristics/admission processes of inpatient psychiatric units (IPUs) in rural hospitals with less than 50 beds and the community-based services available to them when discharging patients. Reasons for developing IPUs, barriers to opening and operating a rural IPU, and factors leading some to close are also explored. -
Preventing Hospitalizations in Depressed Rural Primary Care Patients
WICHE Center for Rural Mental Health Research
Date: 05/2007
This study investigated the substitution of higher cost hospitalization for lower cost outpatient specialty care for depression and the extent to which insurance barriers impact service substitution patterns of outpatient specialty care for depression in rural and urban areas. -
Use of Critical Access Hospital Emergency Rooms by Patients With Mental Health Symptoms
Journal Article
Maine Rural Health Research Center
Date: 2007
Describes the results of a study investigating the use of critical access hospital (CAH) emergency rooms by patients with mental health problems to understand the role these facilities play in rural mental health needs and the challenges they face.
2006
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Rural-Urban Differences in Depression Prevalence: Implications for Family Medicine
Journal Article
Rural and Minority Health Research Center
Date: 10/2006
Examined the prevalence of depression in rural vs. urban areas. An estimated 2.6 million rural adults suffer from depression. The unadjusted prevalence of depression was significantly higher among rural than urban populations. After adjusting for rural/urban population characteristics, the odds of depression did not differ by residence. -
Differential Effectiveness of Depression Disease Management for Rural and Urban Primary Care Patients
Journal Article
WICHE Center for Rural Mental Health Research
Date: 09/2006
Is there a differential impact of enhanced depression care on patient outcomes in rural vs. urban primary care settings? Differences may be mediated by receiving evidence-based care (pharmacotherapy and specialty care counseling). Findings indicate that care for depression improved mental health for urban populations, but not rural patients. -
Mental Health and Rural America: 1994-2005
WICHE Center for Rural Mental Health Research
Date: 2006
This report provides a summary of the current knowledge base surrounding mental health issues in America's rural and frontier areas and an overview of the environment of mental health in rural areas over three decades. -
Mental Healthcare in Rural Communities: The Once and Future Role of Primary Care
Journal Article
Maine Rural Health Research Center
Date: 2006
Discusses issues related to the delivery of mental health services in the United States. Addresses how these issues complicate the delivery of services in rural areas. Offers an argument for integrating primary care and mental health in rural areas. -
Modeling the Mental Health Workforce in Washington State: Using State Licensing Data to Examine Provider Supply in Rural and Urban Areas
Journal Article
WWAMI Rural Health Research Center
Date: 2006
Identifies mental health shortage areas using existing licensing and survey data. Shortages of mental health providers exist throughout the state, especially in rural areas. Urban areas had 3x the psychiatrist full-time equivalents (FTEs) per 100,000 and more than 1.5x the nonpsychiatrist mental health provider FTEs per 100,000 as rural areas. -
Posttraumatic Stress Disorder in Rural Primary Care: Improving Care for Mental Health Following Bioterrorism
Journal Article
FORHP-funded Individual Grantees
Date: 2006
Describes the need to educate rural primary care providers who will be the frontline providers of mental health services following bioterrorism, given the limited availability of tertiary mental healthcare in rural communities. -
PTSD and Substance Use: Unrecognized Sequelae of Bioterrorism in Primary Care Providers
Journal Article
FORHP-funded Individual Grantees
Date: 2006
Study looks at rural primary care providers' knowledge of likely mental disorders, their risk factors, and preferred treatment options following a public health emergency. -
Rural and Frontier Mental and Behavioral Health Care: Barriers, Effective Policy Strategies, Best Practices
Maine Rural Health Research Center
Date: 2006
This report discusses barriers to mental and behavioral health service delivery in rural America. It includes model programs and model policy strategies for rural mental and behavioral healthcare delivery and discusses the roles that telehealth and that the State Offices of Rural Health should play in service delivery. -
Smallest Rural Hospitals Treat Mental Health Emergencies
Maine Rural Health Research Center
Date: 2006
This research and policy brief discusses the extent to which rural emergency rooms encounter and treat mental health patients. -
Stakeholder Benefit From Depression Disease Management: Differences by Rurality?
WICHE Center for Rural Mental Health Research
Date: 2006
Despite increasing consensus about the value of depression disease management programs, the field has not identified which stakeholders should absorb the relatively small additional costs associated with these programs. This paper investigates whether two stakeholder groups economically benefit from improved depression.
2005
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Suicide in North Dakota: A Dialogue Across State and Tribal Boundaries
Policy Brief
Upper Midwest Rural Health Research Center
Date: 10/2005
This brief looks at three broad areas in addressing suicide: 1) an understanding of factors associated with suicide; 2) information about specific trends, such as race, gender, location, and costs; and 3) an awareness of suicide prevention strategies that address these factors through public policy and community action. -
Community-Level Risk Factors for Depression Hospitalizations
Policy Brief
WICHE Center for Rural Mental Health Research
Date: 09/2005
This policy brief examines the association between depression hospitalization rates and community-level socio-demographic, economic, and healthcare system characteristics. -
Differential Effectiveness of Enhanced Depression Treatment for Rural and Urban Primary Care Patients
WICHE Center for Rural Mental Health Research
Date: 09/2005
This paper explored whether a depression disease management program has a comparable impact on clinical outcomes over two years in patients treated in rural and urban primary care practices. -
Mental Health Encounters in Critical Access Hospital Emergency Rooms: A National Survey
Maine Rural Health Research Center
Date: 09/2005
This survey investigates the extent and types of cases that present with mental health problems in critical access hospital emergency rooms (ERs), as well as the resources available to ER staff for addressing such problems and what actually happens to these patients. -
Mental Health Risk Factors, Unmet Needs, and Provider Availability for Rural Children
Rural and Minority Health Research Center
Date: 09/2005
This study used the 2001 National Health Interview Survey to assess the prevalence of sub-clinical mental health problems among children, the degree to which children with potential problems use mental health and general providers for these problems, and the degree of unmet need. -
Depression in Rural Populations: Prevalence, Effects on Life Quality, and Treatment-Seeking Behavior
Rural and Minority Health Research Center
Date: 05/2005
The authors found the prevalence of major depression was higher among rural than among urban populations. Nearly all individuals scoring positive for depression reported their symptoms interfered with their life/activities. Persons without health insurance were less likely to have talked with a physician than were the privately/publicly insured. -
Depression in Rural Populations: Prevalence, Effects on Life Quality, and Treatment-Seeking Behavior (Fact Sheet)
Fact Sheet
Rural and Minority Health Research Center
Date: 2005
To explore the prevalence of selected mental health diagnoses across rural populations, including rural minority residents, they studied information obtained by the 1999 National Health Interview Survey, a nationally representative survey of more than 30,000 adults. -
Mental Health Risk Factors, Unmet Needs, and Provider Availability for Rural Children (Fact Sheet)
Fact Sheet
Rural and Minority Health Research Center
Date: 2005
Children in rural areas have fewer mental health resources available. To assess the need for services among rural children, they studied information from the 2001 National Health Interview Survey. Possible mental health problems were identified based on the Strengths and Difficulties Questionnaire. -
One Size Fits Some: The Impact of Patient Treatment Attitudes on the Cost-Effectiveness of a Depression Primary Care Intervention
Journal Article
WICHE Center for Rural Mental Health Research
Date: 2005
This study reports the estimated impact of patient receptivity to antidepressant medication on the cost-effectiveness of an evidence-based primary-care depression intervention.
2004
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Are Advanced Practice Nurses a Solution to Rural Mental Health Workforce Shortages?
Maine Rural Health Research Center
Date: 04/2004
This paper summarizes the clinical skills and prescriptive authority of advanced practice psychiatric nurses and investigates current trends in their geographic distribution to determine what their future role may be in addressing rural mental health needs.
2003
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Rural Health Research in Progress in the Rural Health Research Centers Program, 7th edition
Maine Rural Health Research Center
Date: 03/2003
This book provides policy makers with a concise source of rural health services research underway in the Rural Health Research Centers funded by the Office of Rural Health Policy. It provides a context for legislation current and proposed that affects rural health services and populations.
2002
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The Role of Community Mental Health Centers as Rural Safety Net Providers
Maine Rural Health Research Center
Date: 05/2002
This paper investigates the extent to which those organizations formerly designated as community mental health centers currently act as a rural mental health safety net, e.g., provide mental health services for free or at reduced charges to rural populations not covered by public or private insurance or grants. -
State Licensure Laws and the Mental Health Professions: Implications for the Rural Mental Health Workforce
Maine Rural Health Research Center
Date: 05/2002
This paper investigates whether and the extent to which licensure laws that determine the permissible scope of practice for each of these professions may affect the availability of mental health services, particularly in rural communities. -
Essential Research Issues in Rural Health: The State Rural Health Directors' Perspective
NORC Walsh Center for Rural Health Analysis
Date: 03/2002
This policy brief describes the key issues confronting state rural health directors. Issues repeatedly raised by directors from a wide variety of states included workforce, telemedicine, emergency medical services, mental health, and lack of local data.
2001
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Addressing Mental Health Workforce Needs in Underserved Rural Areas: Accomplishments and Challenges
Maine Rural Health Research Center
Date: 10/2001
This study reviews efforts to address mental health workforce needs in rural areas and addresses the questions: How is workforce adequacy measured? How do characteristics of communities and the mental health service delivery system challenge methods for determining workforce adequacy? What role has government played in addressing workforce needs? -
Admission Severity and Mortality Rates Among Rural and Urban Nursing Facility Residents With Dementia (Research & Policy Brief)
Maine Rural Health Research Center
Date: 09/2001
This brief assesses whether the potentially higher use of nursing facility services in rural communities can be tied to differences in use patterns by older adults with dementia. Specifically, it addresses whether residents with dementia are less impaired at the time of their admission to a nursing facility than urban residents with dementia. -
Medicaid Managed Behavioral Health Programs in Rural Areas
Policy Brief
Maine Rural Health Research Center
Date: 08/2001
This research and policy brief studies which states have implemented Medicaid-managed behavioral health programs in rural areas. It describes the programs in terms of Medicaid populations served, program design, and implementation model and the experience of programs regarding access to/coordination of services. -
Medicaid Managed Behavioral Health in Rural Areas
Maine Rural Health Research Center
Date: 01/2001
This study of which states have implemented Medicaid managed behavioral health (MMBH) programs in rural areas describes these programs in terms of Medicaid populations served, program design, and implementation model. It also describes the experience of programs regarding access to and coordination of services.
1996
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Integrating Primary Care and Mental Health Services: Current Practices in Rural Areas
Maine Rural Health Research Center
Date: 1996
This publication provides information on models for integrating mental health services in rural community health centers, viability of linkages between primary care and mental health providers, resources available, reimbursement, treatment philosophy, diversification, referral, and enhancement.
Unknown year
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Assessment of the Mental Health Funding Marketplace in Urban vs. Rural Settings (Summary Brief)
WICHE Center for Rural Mental Health Research
Data from the National Comorbidity Survey Replication show that rural individuals with mental health problems are significantly less likely to receive mental health services than individuals in urban and suburban areas. -
The Association Between Rural Residence and the Use, Type, and Quality of Depression Care (Final Paper)
WICHE Center for Rural Mental Health Research
Rural individuals are more reliant on pharmacotherapy than psychotherapy, which may be a concern if this is due to poor access to psychotherapy rather than a preference for antidepressants.