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Rural Health Information Hub

Rural Project Examples: Behavioral health

Evidence-Based Examples

Mental Health First Aid
Updated/reviewed July 2023
  • Need: Rural areas face challenges in access to mental health services, including shortages of mental health providers.
  • Intervention: This 8-hour course trains rural community members to recognize mental health and substance use issues and learn how to help someone who is developing a mental health concern or experiencing a mental health crisis.
  • Results: Numerous studies of this method have found that course participants are better able and more likely to help others regarding mental health issues.
Helping Kids PROSPER
Updated/reviewed January 2023
  • Need: An approach to support sustained, quality delivery of evidence-based programs for youth and families in rural communities.
  • Intervention: PROSPER, a program delivery system, guides communities in implementing evidence-based programs that build youth competencies, improve family functioning, and prevent risky behaviors, particularly substance use.
  • Results: Youth in PROSPER communities reported delayed initiation of a variety of substances, lower levels of other behavioral problems, and improvements in family functioning and other life skills.
Project ECHO® – Extension for Community Healthcare Outcomes
Updated/reviewed October 2022
  • Need: Increase medical management knowledge for New Mexico primary care providers in order to provide care for the thousands of rural and underserved patients with hepatitis C, a chronic, complex condition that has high personal and public health costs when left untreated.
  • Intervention: Project leveraging an audiovisual platform to accomplish "moving knowledge, not patients" that used a "knowledge network learning loop" of disease-specific consultants and rural healthcare teams learning from each other and learning by providing direct patient care.
  • Results: In 18 months, the urban specialist appointment wait list decreased from 8 months to 2 weeks due to Hepatitis C patients receiving care from the project's participating primary care providers. Improved disease outcomes were demonstrated along with cost savings, including those associated with travel. The project model, now known as Project ECHO® – Extension for Community Healthcare Outcomes — has evolved into a telementoring model used world-wide.
keepin' it REAL Rural
Updated/reviewed March 2022
  • Need: A drug and alcohol prevention program for middle school students that is specific to rural culture.
  • Intervention: An adaptation of the evidence-based keepin' it REAL curriculum was customized for rural middle school students.
  • Results: Students showed a reduction in all substance use and less personal acceptability of substance use.

Effective Examples

Strong African American Families-Teen Program
Updated/reviewed May 2023
  • Need: There is a lack of interventions that addresses teenager behavioral problems, particularly for rural African American adolescents.
  • Intervention: Rural, locally trained leaders administered five 2-hour meetings for teenagers and their primary caregivers. Trainings focused on reducing risks that prevent positive development, specifically sexual risk-taking that can lead to HIV and other STIs.
  • Results: Teens reported reduced conduct problems, depressive symptoms, and substance abuse. Families were strengthened, and SAAF-T reduced unprotected intercourse and increased condom efficacy.
Parent Partners
Updated/reviewed March 2023
  • Need: To support parents whose children have been removed from the home so that the parents can make the changes needed for the children to return safely home.
  • Intervention: A statewide program in Iowa pairs these parents with mentors who have successfully navigated their own child welfare cases.
  • Results: Participants' children were more likely to return home than non-participants' children and participants were less likely to have another child removal within a year of the child coming home.
Franklin Cardiovascular Health Program (FCHP)
Updated/reviewed February 2023
  • Need: To develop sustainable, community-wide prevention methods for cardiovascular diseases in order to change behaviors and healthcare outcomes in rural Maine.
  • Intervention: Local community groups and Franklin Memorial Hospital staff studied mortality and hospitalization rates for 40 years in this rural, low-income area of Farmington to seek intervention methods that could address cardiovascular diseases.
  • Results: A decline in cardiovascular-related mortality rates and improved prevention methods for hypertension, high cholesterol, and smoking.
Wyoming Trauma Telehealth Treatment Clinic
Updated/reviewed February 2023
  • Need: To provide psychotherapy to survivors of domestic violence and sexual assault.
  • Intervention: University of Wyoming psychology doctoral students provide psychotherapy via videoconferencing to crisis center clients in two rural locations.
  • Results: Clients, student therapists, and crisis center staff were satisfied with the quality of services, and clients reported reduced symptoms of depression and PTSD.
STAIR (Skills Training in Affective and Interpersonal Regulation)
Updated/reviewed January 2023
  • Need: To increase access to telemental health services for rural veterans, especially women, with a history of trauma.
  • Intervention: STAIR (Skills Training in Affective and Interpersonal Regulation) is a 10-week program designed to reduce PTSD and depression symptoms and increase emotional regulation and social functioning in clients.
  • Results: Therapists reported that clients attended more sessions when offered via teleconferencing, and clients reported satisfaction with the program.
Kitsap Mental Health Services: Race to Health!
Updated/reviewed November 2022
  • Need: To improve the physical health of individuals seeking mental healthcare.
  • Intervention: Race to Health! in Washington integrated mental health, substance use disorder treatment, and primary care for individuals with severe mental illness.
  • Results: Race to Health! helped reduce emergency department visits, hospitalizations, and costs (a total savings of $5,144,000 for Medicare patients).