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Rural Health Information Hub

Rural Mental Health – Models and Innovations

These stories feature model programs and successful rural projects that can serve as a source of ideas and provide lessons others have learned. Some of the projects or programs may no longer be active. Read about the criteria and evidence-base for programs included.

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.

Effective Examples

I Got You: Healthy Life Choices for Teens (IGU)

funded by the Federal Office of Rural Health Policy

Updated/reviewed February 2024

  • Need: To improve awareness of behavioral and mental health issues by students in rural, east central Mississippi.
  • Intervention: An intensive community mental health outreach program was implemented for students in rural Mississippi.
  • Results: As of 2018 and on a yearly basis, 6,000 7th and 8th grade students receive mental health education on a variety of topics which improves their ability to recognize mental health issues, high risk behaviors, and manage their own choices.

University of Vermont Medical Center's Nursing Home Telepsychiatry Service

Updated/reviewed December 2023

  • Need: To improve the health status and access for rural nursing home patients in need of mental health services.
  • Intervention: The University of Vermont Medical Center provides telepsychiatry care and education to nursing homes in communities that face shortages of mental health professionals.
  • Results: These telepsychiatry consultations have eased the burden on nursing home residents by saving travel time, distance, and money it takes to travel to the nearest tertiary facility.

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.

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.

Promising Examples

Schools That Care

funded by the Federal Office of Rural Health Policy

Updated/reviewed August 2022

  • Need: To provide mental health services to rural Kansas students and their families.
  • Intervention: The Schools That Care project provides mental health treatment and case management as well as community education events.
  • Results: From 2018 to 2021, 3,456 individuals participated in health education and counseling activities offered to the public, and 964 individuals and 303 families received direct services through the Family Advocate.

Cross-Walk: Integrating Behavioral Health and Primary Care

funded by the Federal Office of Rural Health Policy

Updated/reviewed October 2021

  • Need: To address and treat substance use disorder (SUD) and depression in the Upper Great Lakes region.
  • Intervention: Cross-Walk, a program that integrates behavioral healthcare into primary care services, was developed in Michigan's Marquette County.
  • Results: The collaborative efforts strengthened care management services in local healthcare facilities as primary care patients were referred to a behavioral health specialist.

Other Project Examples

Coast to Forest: Mental Health Promotion in Rural Oregon and Beyond

Updated/reviewed January 2024

  • Need: To promote mental health and prevent substance use disorders in rural Oregon, Washington, Idaho, and Alaska.
  • Intervention: Coast to Forest strengthens local capacity through training, education, and community partnerships.
  • Results: In its three years of operation, the project has trained over 500 individuals across the Pacific Northwest in Mental Health First Aid, developed 36 county-level resource guides, organized a series of Community Conversations in three rural Oregon counties, and more.

Riverfront Talks: Substance Matters Podcast

Added December 2023

  • Need: To reduce stigma around mental illness and substance use in North Carolina.
  • Intervention: The Beaufort County Behavioral Health Task Force created the Riverfront Talks: Substance Matters podcast to interview people with lived experience.
  • Results: As of December 2023, the podcast has 10 episodes.

Schoharie County ACEs Team

Updated/reviewed December 2023

  • Need: Agencies in Schoharie County, New York were seeing a widespread trend of Adverse Childhood Experiences (ACEs) in the children and families they served.
  • Intervention: The Schoharie ACEs Team was formed as a way to educate rural communities about ACEs, the associated brain science, and ways to build resiliency.
  • Results: The ACEs Team has put on 5 half-day educational conferences, 2 virtual conferences, and 10 trainings for various groups across the region. The team has also trained 3 school districts on trauma-informed care and provided resources for families exposed to trauma.

Last Updated: 2/26/2024