Handbook of Rural Mental Health

Download or read book Handbook of Rural Mental Health written by James Werth and published by Springer. This book was released on 2011-10-15 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Rural communities are often portrayed or perceived in one of two ways. One is the image of idyllic, bucolic villages located in the midst of beautiful, unspoiled natural environments where everyone knows each other and enjoys slow-paced, carefree living. An alternative perspective is of rural towns as blighted and economically depressed, filled with residents who are hopeless, physically disabled, and trapped while the land, water, and air around them are spoiled and turning toxic. The truth, of course, lies somewhere in the middle. Specifically regarding mental health issues, research has indicated that people living in rural areas have significant mental health problems (e.g., major depression, substance abuse) to the same or a greater extent than people living in urban areas (Gale & Lambert, 2006; Office of Rural Health Policy, n.d.; Sawyer, Gale, & Lambert, 2006). Of note, the suicide rate has been consistently higher in rural areas than in urban settings for decades (Office of Rural Health Policy, n.d.). At the same time, rural residents often have limited availability of mental health service providers and, even if they are available, limited access to these professionals. In general, rural areas do not have specialized mental health service providers available, as evidenced by the fact that the majority of rural residents live in mental health professional shortage areas (Gale & Lambert, 2006). As a result, people living in rural areas tend to rely on informal support networks or their primary care physician rather than mental health specialists to a far greater extent than urban dwellers (Gale & Lambert, 2006; see also Harowski et al., 2006, p. 160). Unfortunately, the research indicates that non-psychiatric physicians are not effective at detecting and treating conditions such as depression (Harowski et al., p. 160), which is not an indictment of the medical doctors but rather a reflection of the reality that they have neither the time nor the training to do a thorough psychological evaluation and intervention for their patients. Rural residents also tend to be poor at identifying mental health problems and knowing what treatment options are available (Gale & Lambert, 2006; Office of Rural Health Policy, n.d.), which leads to them often entering care later and with more severe conditions (Gale & Lambert). Other factors that impede accessibility of mental health specialist providers are the distances rural residents may need to travel to see a mental health service provider (coupled with unreliable transportation and no access to mass transit) and the inability to pay for services even if they can get to the offices (Gale & Lambert, 2006; Office of Rural Health Policy, n.d.). The growing area of telehealth is often mentioned as a possibility to help with accessibility and availability (e.g., Sawyer et al., 2006; ORHP, n.d.) The table of contents was developed based on the issues discussed above and others identified in the literature (e.g., stigma associated with seeking mental health services), consultation with experts (e.g., faculty training students to work in rural areas, members of the American Psychological Association’s Committee on Rural Health), and discussions with rural providers. This book will provide a solid foundation for those new to practice in rural areas as well as offer new information to even seasoned mental and physical health professionals. Table of Contents follows.