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 2024
- 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)

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.
Promising Examples
Schools That Care

Updated/reviewed August 2024
- 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

Updated/reviewed May 2024
- 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
Hope Squad
Updated/reviewed June 2025
- Need: To reduce youth suicide rates.
- Intervention: First begun in Utah, Hope Squad is a nationwide program that trains youth to identify peers' signs of distress and connect them to help. Hope Squads educate the entire student body to increase connectedness and reduce stigma.
- Results: Studies suggest that Hope Squad schools' students with suicidal thoughts are more likely than non-Hope Squad schools' students to solicit help. In addition, stigma surrounding mental illness is decreasing.
The Sapling Center
Updated/reviewed June 2025
- Need: To create a safe space for youth and young adults, ages 14 to 25, in rural eastern Kentucky.
- Intervention: The Sapling Center provides independent living skills education and offers a wide array of services as well as fun activities in a supportive environment.
- Results: The 5 Sapling Center locations serve 50-75 teens and young adults every day.
Together We Can Be Bully Free
Updated/reviewed June 2025
- Need: Union Parish, a rural county in Louisiana, continues to experience elevated rates of youth suicide, bullying, mental health challenges, and risk behaviors, as confirmed by a 2024 Community Health Needs Assessment (CHNA).
- Intervention: Union General Hospital, a Critical Access Hospital, started a program to educate students grade 4 through 12 on the negative effects of bullying, to foster positive social behavior, and to provide mental health support through school-based interventions.
- Results: Over 3,500 students have learned how to recognize, report, and respond to bullying. The program's integration with broader community health priorities has strengthened mental health, reduced suicide attempts, and improved awareness of youth risk behaviors.
Project ACTIVATE (Advancing Coordinated and Timely InterVentions, Awareness, Training, and Education)
Updated/reviewed May 2025
- Need: To improve students' access to behavioral health services in rural North Carolina.
- Intervention: North Carolina Project ACTIVATE provides three tiers of behavioral health supports in the school setting.
- Results: The six pilot sites (Cohorts 1 and 2) have created or revised 91 mental health policies, and 48,531 school-based and related employees have received training in different topics and protocols.
Regional Behavioral Health Network
Updated/reviewed April 2025
- Need: Multiple organizations in rural east central Illinois needed a more efficient, centralized system for referring patients experiencing a behavioral health crisis to appropriate treatment services.
- Intervention: The Regional Behavioral Health Network was established with a 24-hour toll-free crisis line, providing immediate access to trained crisis clinicians.
- Results: Improved access to high quality behavioral healthcare for patients in rural east central Illinois.
Last Reviewed: 6/7/2024