Organizers may face several barriers when implementing a
community-based program focused on behavioral health.
However, these barriers can be minimized through
awareness, active listening, effective communication and
problem solving. The following were the most common
barriers encountered by the IBH Program's community
Many rural communities have cultural, systemic, and
personal stigmas associated with mental illness and
behavioral health. There tends to be a lack of
understanding and compassion towards mental illness and
behavioral health crises that should be addressed.
Lack of trust
There can be a lack of community trust and effective
partnerships due to history, territorial thinking, or
ineffective communication. Working around busy schedules
and getting the initial buy-in of community partners was
a struggle, especially when the specific benefit for the
partner is not clearly identified at the beginning.
Coordination of Care
Obtaining a signed patient release of information for
multiple partners can also be a challenge. One community
team created a universal release of information form,
which has streamlined the delivery of care and
communication between partners.
Incorporating and leveraging technology for community
partners who use different interfaces can be very
challenging and can hinder effective communication.
Social Determinants of Health
When social determinants of health are compromised,
finding stable housing or reliable transportation, for
instance, can become the top priority for many
individuals. Healthcare providers who actively listen to
the patient's needs and connect them to resources can
help to mitigate future mental and behavioral health
Other challenges cited by participants include community
and service provider education, availability of funding,
policy and government limitations, lack of transportation
for transfers, and workforce shortages.
In 2018-2019, six Critical Access Hospitals participated
in the IBH Stigma Project to address more directly the
issue of stigma as one of the major barriers to
behavioral health integration. Stigma Project
participants engaged in community-wide planning to
develop local strategies that would increase awareness of
the challenges of stigma in a rural health setting and
work to eliminate stigma related to mental health in