New York – While urban centers generally have a variety of care options, some with renowned academic hospitals, when it comes to mental health, care has still been a challenge. While new laws require insurance companies to consider mental health care needs equal to physical health care needs, opportunities to receive that care are significantly lacking due to a variety of reimbursement issues and in-network coverage options. I mention this point to highlight the fact that in areas that we might expect top level care options, we still face challenges. Enter rural regions, if we have challenges with care here, rural areas often face even more limited mental health care options, especially when mental health professionals tend to be more centralized within urban areas.
In rural communities, 18.7% (approximately 6.5 million people) of the population has a mental health condition. We also area seeing that residents of these rural communities are more likely to have a serious mental illness versus those in more urban areas and to face stigmas for seeking mental health care. This becomes an important fact when we also consider that privacy and anonymity can also be challenging within these small communities. Currently, in many of these rural regions, 60% of mental health care is provided by primary care providers. Factor in that most primary care physicians are not trained to provide effective mental health care—41% of countries have no mental health training for primary care providers.
These facts not only provide insight into the challenges facing these communities, but also incredible opportunity. With the lack of mental health care options, along with the prevalence of and need for it, telehealth is becoming an important consideration and there is potential for organizations that exist on a national level or in regional urban areas to extend their services. We’ve already seen the rise of mental health apps, but as I’ve stated in a previous post, those apps can be a mixed bag with patients being unsure of what effective outcomes may be.
When it comes to young adults in these communities, on a national level, we must pay attention. It was reported that 32% of high school students feel so sad or hopeless that they stop doing usual activities. Approximately 60% of teenagers between the ages of 12 and 17, did not receive treatment after being diagnosed with a major depressive episode. The National Alliance on Mental Illness (NAMI) also states that “50% of all lifetime mental illnesses develop by age 14 and 75% develop by age 24.” To say that mental health care for high school students is important is an understatement and it should be considered a critical factor in understanding the foundations for success through adulthood.
There are several schools that have made mental health a priority. In Summit County, Utah, every public school in the county will have access to an on-site clinical mental health counselor. In Middlesex County, New Jersey, residents of two local school districts voted to raise their taxes to help relieve the mental health care burden. They will use $700,000 to fund on-site clinicians and programs. But what about those smaller rural towns?
Here’s one initiative that might inspire models of other mental health care: in Orleans, Indiana, one school is finding ways to get their students the care they need. The town is small, a farming and manufacturing town of 2,000 residents. Orleans Junior and Senior High School have implemented a pilot program within their school to provide necessary care to their students. The principal, Chris Stevens, noted that many of the students are being “raised by their grandparents or in non-traditional homes” and have dealt with “past trauma.” And with Indiana having one of the highest rates of suicides in young adults in the nation, Orleans knew that something had to be done. Within the school, using an iPad and speaker, students are able to talk to therapists at Indiana University Health. Insurance provider, CareSource, partnered with the school, providing the equipment and helping to set up the services. The intention is to track the results of the pilot. Depending on the results, this pilot could pave the way for more rural communities to get a higher standard of mental health care, which some might say is desperately needed.