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Rural Mental Health Resources

Selected recent or important resources focusing on Rural Mental Health.

Rural and Urban Utilization of the Emergency Department for Mental Health and Substance Abuse
Details a report on the use of emergency services in treating mental health and substance abuse (MH/SA) in both rural and urban settings. Discusses healthcare needs of MH/SA patients, as well as the increasing demands on emergency departments. Breaks down data by urban, large rural, small rural, and isolated rural emergency departments, as well as by age and primary payer of patients.
Author(s): Shawnda Schroeder, Mandi Leigh-Peterson
Date: 06/2017
Type: Document
Sponsoring organization: Rural Health Reform Policy Research Center
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Access to Mental Health Services for Children in Rural Areas
Policy brief identifying strategies to help rural children with mental, behavioral, or development disorders (MBDDs) access behavioral health services. Discusses the potential of telehealth, integration of behavioral health and primary care, and school-based health centers to address this need.
Date: 05/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Trends in Suicide by Level of Urbanization — United States, 1999–2015
Reports on suicide rates from 1999–2015, with data for metropolitan, micropolitan, and non-core (rural) areas. Discusses possible causes for geographic disparities in suicide rates, including limited access to mental health care, social isolation, and the opioid overdose epidemic. Also discusses the widening gap beginning in 2007-2008, which may relate to the impact of the recession on rural areas.
Author(s): Scott R. Kegler, Deborah M. Stone, Kristin M. Holland
Location: MMWR (Morbidity and Mortality Weekly Report), 66(10), 270-273
Date: 03/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children Aged 2–8 Years in Rural and Urban Areas — United States, 2011–2012
Provides rural and urban data on a variety of health-related factors for children 2-8 years of age with and without mental, behavioral, and developmental disorders. Topics addressed include demographics, health insurance coverage, having a medical home, parental mental health, family financial difficulties, and community factors.
Author(s): Lara R. Robinson, Joseph R. Holbrook, Rebecca H. Bitsko, et al.
Location: MMWR (Morbidity and Mortality Weekly Report), 66(8), 1-11
Date: 03/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Vermont Care Network Advocates for Behavioral Health and Developmental Disability Agencies
Highlights the work of the Vermont Care Network, which supports 16 non-profit agencies that provide behavioral health and developmental disability services in the state. Discusses cross-sector collaboration and integration of mental health, substance use, and developmental disability services with primary care.
Author(s): Jenn Lukens
Location: Rural Monitor
Date: 03/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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Behavioral Health Barometer: United States, Volume 4
Provides a broad overview of behavior health in metropolitan and nonmetropolitan areas of the U.S. with an emphasis on illicit drug, alcohol, and tobacco use, as well as the estimated percentage of people living with serious mental illness. Includes special focus on the misuse of prescription pain relievers, heroin use, and medication-assisted therapy (MAT) for opioid addiction. Data is from the 2015 National Survey on Drug Use and Health and the National Survey of Substance Abuse Treatment Services.
Date: 2017
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Suicide Prevention in Indian Country
A fact sheet describing suicide prevention in Indian Country, and how the 2012 National Strategy for Suicide Prevention can align with tribal communities.
Date: 12/2016
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Health Professional Shortage Areas: Mental Health
Printable map that shows nonmetropolitan and micropolitan mental health HPSAs on one color scale and metropolitan mental health HPSAs on another. Data source: HRSA Data Warehouse.
Date: 11/2016
Type: Map/Mapping System
Sponsoring organization: Rural Health Information Hub
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Supply and Distribution of the Behavioral Health Workforce in Rural America
Discusses and compares the provider to population ratios of the behavioral health workforce in Metropolitan and Non-Metro (Micropolitan and Non-Core) U.S. counties.
Author(s): Eric H. Larson, Davis G. Patterson, Lisa A. Garberson, C. Holly A. Andrilla
Date: 09/2016
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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Suicide Rates by Occupational Group - 17 States, 2012
Provides a detailed report on the incidence of suicide in 2012 in the U.S. by occupation using the national Standard Occupational Classification (SOC) system. Identifies farming, fishing, and forestry as the occupation group having the highest rates of suicide (84.5 suicides per 100,000 persons), and among males farming, fishing, and forestry also accounted for the highest rates of suicide (90.5 per 100,000).
Author(s): Wendy LiKamWa McIntosh, Erica Spies, Deborah M. Stone, et al.
Location: MMWR (Morbidity and Mortality Weekly Report), 65(25), 641-645
Date: 07/2016
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Surveillance Success Stories: The Fort Peck Indian Reservation
Describes a partnership between the National Native Children’s Trauma Center (NNCTC) and the Fort Peck Indian Reservation to examine and compare data from healthcare providers and emergency services within the reservation and in surrounding Roosevelt County. The objective was to establish a baseline of understanding of suicidal behavior on the reservation in order to effectively apply their suicide prevention resources, and monitor individual cases to determine if their methods were successful.
Author(s): Richard A. van den Pol
Date: 06/2016
Type: Document
Sponsoring organization: Suicide Prevention Resource Center
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Assessing Fidelity of Cognitive Behavioral Therapy in Rural VA Clinics: Design of a Randomized Implementation Effectiveness (Hybrid Type III) Trial
Reports on a study to develop the CALM (coordinated anxiety learning and management) program to meet the needs of mental health clinicians working in Veteran Affairs (VA) community-based outpatient clinics (CBOC) and of rural veterans, and to assess the best method for future implementation of the CALM tool among mental health providers in rural VA CBOCs.
Author(s): Michael A. Cucciare, Geoffrey M. Curran, Michelle G. Craske, et al.
Date: 05/2016
Type: Document
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Adverse Childhood Experiences in Rural and Urban Contexts
Reports on a study analyzing the rural prevalence of individual adverse childhood experiences (ACEs), the level of exposure to ACEs in rural regions, and the rural-urban differences of exposure to ACEs by adults using data from the Behavioral Risk Factor Surveillance System (BRFSS).
Author(s): Jean A. Talbot, Donald Szlosek, Erika C. Ziller,
Date: 04/2016
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Health Professional Shortage Areas (HPSA) - Mental Health
A map of the U.S. displaying Health Professional Shortage Areas (HPSA) and HPSA scores for mental health by county.
Date: 2016
Type: Map/Mapping System
Sponsoring organization: Health Resources and Services Administration
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Recruitment and Retention of Mental Health Care Providers in Rural Nebraska: Perceptions of Providers and Administrators
Results from focus groups held in four rural mental health regions of Nebraska during 2012 and 2013 to identify possible solutions to the mental health provider shortage in rural and frontier areas.
Author(s): Shinobu Watanabe-Galloway, Lynda Madison, Katherine Watkins, Anh Nguyen, Li-Wu Chen
Location: Rural and Remote Health, 15, 3392
Date: 11/2015
Type: Document
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Statement of James Macrae, Health Resources and Services Administration, on Rural Health before the U.S. Senate Health, Education, Labor and Pensions Committee
Testimony of the HRSA Acting Administrator at an October 29th, 2015 U.S. Senate HELP Committee hearing, Mental Health and Substance Use Disorders in America: Priorities, Challenges, and Opportunities. Identifies HRSA activities that address mental health and substance abuse issues, highlighting efforts focused on rural areas. A full video of the hearing is available, with Macrae's testimony beginning at 38:30.
Author(s): James Macrae
Date: 10/2015
Type: Document
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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Results from the 2014 National Survey on Drug Use and Health: Mental Health Detailed Tables
Provides data on mental health conditions, co-occurring substance use disorders, use of mental health services, and unmet needs. Rural-specific information is available in the detailed tables that list "geographic characteristics."
Date: 09/2015
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Not Near Enough: Racial and Ethnic Disparities in Access to Nearby Behavioral Health Care and Primary Care
Analyzes the association of integrated behavioral health and primary care services with communities in rural areas and communities with higher percentages of African Americans and Hispanics for a better understanding of the disparities in access to integrated care.
Author(s): Lynn M. VanderWielen, Emma C. Gilchrist, Molly A. Nowels, et al.
Location: Journal of Health Care for the Poor and Underserved, 26(3) 1032–1047
Date: 08/2015
Type: Document
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Advancing Suicide Prevention Research with Rural American Indian and Alaska Native Populations
Summarizes the conclusions from a meeting of a multidisciplinary group of American Indian or Alaska Native (AI/AN) suicide research experts to discuss the persistent issues related to suicide disproportionately affecting Indigenous communities. Identifies challenges hindering improvement in Indigenous suicide research and provides recommendations to support and strengthen Indigenous suicide research.
Author(s): Lisa Wexler, Michael Chandler, Joseph P. Gone, et al.
Location: American Journal of Public Health, 105(5), 891-899
Date: 05/2015
Type: Document
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Widening Rural-Urban Disparities in Youth Suicides, United States, 1996-2010
Analyzes the trends in suicide rates from January 1, 1996 through December 31, 2010 in rural and urban areas for deceased individuals aged 10 to 24 years using county-level national mortality data for all counties in the United States.
Author(s): Cynthia A. Fontanella, Danielle L. Hiance-Steelesmith, Gary S. Phillips, et al.
Location: JAMA Pediatrics, 169(5), 466–473
Date: 05/2015
Type: Document
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QuickStats: Age-Adjusted Rates for Suicide, by Urbanization of County of Residence - United States, 2004 and 2013
Chart comparing suicide rates in non-metropolitan and metropolitan counties, with data for 2004 and 2013. Shows higher suicide rates for less urbanized counties.
Location: MMWR (Morbidity and Mortality Weekly Report), 64(14), 401
Date: 04/2015
Type: Chart/Graph
Sponsoring organization: Centers for Disease Control and Prevention
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An Exploratory Study of Mental Health and HIV Risk Behavior Among Drug-Using Rural Women in Jail
Examines the HIV risk behavior and the mental health problems of depression, anxiety and PTSD through face-to-face interviews of 136 women incarcerated in three rural Kentucky county jails within Appalachia.
Author(s): Michele Staton-Tindall, Kathi L.H. Harp, Alexandra Minieri, et al.
Location: Psychiatric Rehabilitation Journal, 38(1), 45-54
Date: 03/2015
Type: Document
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A Guidebook of Professional Practices for Behavioral Health and Primary Care Integration: Observations from Exemplary Sites
Assists primary care and behavioral health practices in identifying professional practices that have developed a successful workforce model of integrated care. Several primary care organizations with effective integrated behavioral health and primary care participated in the study including 3 in rural areas.
Author(s): Deborah J. Cohen, Melinda M. Davis, Jennifer D. Hall, Emma C. Gilchrist, Benjamin F. Miller
Date: 03/2015
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Human Services Program Evaluation: How to Improve Your Accountability and Program Effectiveness
Manual describing how to develop an evaluation program focused on process and outcome measures for human service programs. Includes a section on rural mental health and rural homelessness.
Author(s): Thomas Barrett, James Sorensen
Date: 03/2015
Type: Document
Sponsoring organization: WICHE Mental Health Program
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Evaluation and Disposition of Medicaid-Insured Children and Adolescents with Suicide Attempts
Evaluates the sociodemographic characteristics linked with differences in the evaluation of youth ages 7–18 enrolled in Medicaid with suicidal behavior in rural, urban and suburban areas of Tennessee.
Author(s): Candice L. Williams, William O. Cooper, Leanne S. Balmer, et al.
Location: Academic Pediatrics, 15(1), 38-40
Date: 02/2015
Type: Document
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The Future of Rural Behavioral Health
Policy paper discussing the unique challenges of providing behavioral healthcare services in rural areas. Includes policy recommendations and interventions related to workforce development, reimbursement and financing, integration of care, and the use of technology in delivering behavioral healthcare.
Author(s): Will Wilson, Angela Bangs, Tammy Hatting
Date: 02/2015
Type: Document
Sponsoring organization: National Rural Health Association
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Special Considerations for Mental Health Services in Rural Schools
Discusses the challenges experienced by rural and frontier schools regarding the development, implementation, and the expansion of behavioral health services for students and their families.
Author(s): Susan Wilger
Date: 2015
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Behavioral Health and Service Use Among Civilian Wives of Service Members and Veterans
Analyzes rural-urban differences in behavioral health and service use among civilian wives of military veterans and service members.
Author(s): Joshua Breslau, Ryan Andrew Brown
Date: 2015
Type: Document
Sponsoring organization: RAND Corporation
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Behavioral Health Equity Barometer: United States, 2014
Reports on differences in prevalence of behavioral health disorders, perceptions of risk, and access to treatment for different populations. Includes information for metropolitan and non-metropolitan residents, as well as by race/ethnicity, income level, and health insurance status.
Date: 2015
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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The Prevalence and Correlates of Lifetime Psychiatric Disorders and Trauma Exposures in Urban and Rural Settings: Results from the National Comorbidity Survey Replication (NCS-R)
Results of a study of national statistics to compare the correspondence of exposure to trauma and psychiatric disorders, with a particular focus on rural communities. Includes statistics and data broken down by race, age, diagnosis, types of trauma, and rural or urban location.
Author(s): Jennifer S. McCall-Hosenfeld, Sucharita Mukherjee, Erik B. Lehman
Location: PLoS One, 9(11)
Date: 11/2014
Type: Document
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Rural Parents' Perceived Stigma of Seeking Mental Health Services for Their Children: Development and Evaluation of a New Instrument
Discusses the effectiveness of a research tool to measure perceptions of stigma by parents living in rural Appalachia regarding the provision of mental health services for children with psychosocial issues.
Author(s): Stacey L. Williams, Jodi Polaha
Location: Psychological Assessment, 26(3), 763-773
Date: 09/2014
Type: Document
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Feasibility of a Community Intervention for the Prevention of Suicide and Alcohol Abuse with Yup'ik Alaska Native Youth: the Elluam Tungiinun and Yupiucimta Asvairtuumallerkaa Studies
Evaluates the viability of a community intervention model to prevent suicide and alcohol abuse within the youth population of two remote Alaska Native communities. Compares the implementation strategies and the available resources within the two settings, and discusses the differences in outcomes.
Author(s): Gerald V. Mohatt, Carlotta Ching Ting Fok, David Henry
Location: American Journal of Community Psychology, 54(1), 153-169
Date: 09/2014
Type: Document
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Tips for Disaster Responders: Cultural Awareness When Working in Indian Country Post Disaster
Provides information for disaster response workers to build cultural awareness for supporting Native Americans before, during, and after a traumatic event. Discusses cultural values, types of traumatic events, traditional teachings, and talking circles.
Date: 09/2014
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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A Comparison of Mental Health, Substance Use, and Sexual Risk Behaviors Between Rural and Non-Rural Transgender Persons
Evaluates the mental health, substance use, and sexual risk behaviors of transgender persons in both rural and non-rural areas to determine the need for mental and physical health services.
Author(s): Keith J. Horvath, Alex Iantaffi, Rebecca Swinburne-Romine, Walter Bockting
Location: Journal of Homosexuality, 61(8), 1117-1130
Date: 06/2014
Type: Document
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Suicide Among Young Alaska Native Men: Community Risk Factors and Alcohol Control
Discusses a study examining the variation in suicide rates among rural Alaskan Native men.
Author(s): Matthew Berman
Location: American Journal of Public Health, 104(Suppl 3), S329-S335
Date: 06/2014
Type: Document
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Implications of Rurality and Psychiatric Status for Diabetic Preventive Care Use among Adults with Diabetes
Examines patterns of diabetic preventive care use among adults with diabetes to determine whether these patterns varied according to respondents’ rural/urban residence or psychiatric status (i.e. the presence/absence of a mental health diagnosis).
Author(s): Jean A. Talbot, Erika C. Ziller, Jennifer Lenardson, David Hartley
Date: 05/2014
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Primary Care, Behavioral Health, Provider Colocation, and Rurality
Results of a study regarding the colocation of behavioral health and primary care service delivery as related to rural. Study showed that 40.2% of primary care physicians in urban areas are colocated with behavioral health providers compared with 22.8% in isolated rural areas and 26.5% in frontier areas. Challenges include payment policies separating physical and behavioral health care, workforce distribution, and supply deficiencies, particularly in rural areas.
Author(s): Benjamin F. Miller, Stephen Petterson, Shandra M. Brown Levey, et al.
Location: Journal of the American Board of Family Medicine, 27(3), 367-374
Date: 05/2014
Type: Document
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Reducing Rural Suicide
Outlines how psychologists are finding innovative ways to reach out to people in isolated communities with specific focus on Native American and Veteran communities.
Author(s): Rebecca A. Clay
Location: APA Monitor on Psychology, 45(4)
Date: 04/2014
Type: Document
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Strategies for Behavioral Health Organizations to Promote New Health Insurance Opportunities: In American Indian and Alaska Native Communities
Provides outreach and enrollment strategies for organizations to use when introducing health insurance options to American Indian and Alaska Native communities.
Date: 03/2014
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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A Pilot Project to Improve Access to Telepsychotherapy at Rural Clinics
Describes the challenges and motivators regarding the implementation of a telemental health pilot project in rural outpatient clinics to improve access to mental health services for rural veterans.
Author(s): Geri Adler, Lonique R. Pritchett, Michael R. Kauth, Danielle Nadorff
Location: Telemedicine and e-Health, 2D(1), 83-85
Date: 01/2014
Type: Document
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Feasibility and Preliminary Outcomes From a Pilot Study of an Integrated Health-Mental Health Promotion Program in School Mental Health Services
The results of a study of adolescents along with their parents who received mental health services in a school based setting for a variety of emotional and behavioral problems. The participants lived in a rural and underserved southern region of the U.S. where low income, high poverty are prevalent and where few mental health services are available.
Author(s): Melissa W. George, Nevelyn N. Trumpeter, Dawn K. Wilson, Heather L. McDaniel, Bryn Schiele, Ron Prinz, Mark D. Weist
Location: Family & Community Health, 37(1), 19-30
Date: 01/2014
Type: Document
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A Rural African American Faith Community's Solutions to Depression Disparities
Discusses how a rural African American community of faith in the Arkansas Delta could deal with depression within their community as well as in their congregation.
Author(s): Keneshia Bryant, Tiffany Haynes, Karen Hye-cheon Kim Yeary, Nancy Greer-Williams, Mary Hartwig
Location: Public Health Nursing, 31(3), 262-271
Date: 2014
Type: Document
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Telemental Health in Today's Rural Health System
Describes the organizational setting, services provided, and staff used in 53 telemental rural health programs. Also outlines the opportunities and challenges for telemental health in the rural health system.
Author(s): David Lambert, John Gale, Anush Y. Hansen, Zach Croll, David Hartley
Date: 12/2013
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Geography and the Medicaid Mental Health Care Infrastructure: Implications for Health Care Reform
Examines the availability of outpatient mental health facilities that accept Medicaid across U.S. counties and whether specific types of communities such as minorities, people living in poverty, and residents of rural areas may be less likely to access these facilities.
Author(s): Janet R. Cummings, Hefei Wen, Michelle Ko, Benjamin G. Druss
Location: JAMA Psychiatry, 70(10), 1084-1090
Date: 10/2013
Type: Document
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Traditional Living and Cultural Ways as Protective Factors Against Suicide: Perceptions of Alaska Native University Students
This study explored how the experiences of traditional Alaska Native ways including subsistence activities may prevent suicide and strengthen indigenous populations.
Author(s): Christopher R. DeCou, Monica C. Skewes, Ellen D. S. López
Location: International Journal of Circumpolar Health, 72
Date: 08/2013
Type: Document
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Needs-Based Method for Estimating the Behavioral Health Staff Needs of Community Health Centers
Discusses the estimated number of full time behavioral health providers needed to serve the health centers’ growing patient population in rural and urban areas.
Author(s): Bridget Teevan Burke, Benjamin F Miller, Michelle Proser, et al.
Location: BMC Health Services Research, 13, 245
Date: 07/2013
Type: Document
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Mental Health Services in Rural Long-Term Care: Challenges and Opportunities for Improvement
This research and policy brief examines promising practices for enhancing mental health services to the elderly living in rural long-term care facilities or in their own homes.
Author(s): Jean A. Talbot, Andrew F. Coburn
Date: 06/2013
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Challenges and Opportunities for Improving Mental Health Services in Rural Long-Term Care
Explores practices for increasing the quality, quantity, and accessibility of mental health services in rural long-term care.
Author(s): Jean A. Talbot, Andrew F. Coburn
Date: 06/2013
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Patterns of Care for Rural and Urban Children with Mental Health Problems
Reports that rural children are significantly less likely to be diagnosed and treated for non-ADHD mental health problems than urban children and are less likely to receive mental health counseling.
Author(s): Nathaniel J. Anderson, Samantha J. Neuwirth, Jennifer D. Lenardson, David Hartley
Date: 06/2013
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Evaluating the Promise of Health IT to Enhance/Expand the Reach of Mental Health Services
Discusses methods for improving the reach of mental health services and reducing the barriers that limit the expansion of mental health care services in rural America.
Author(s): Greg Clarke, Bobbi Jo Yarborough,
Location: General Hospital Psychiatry, 35(4), 339-344
Date: 05/2013
Type: Document
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Farmworkers and Mental Health
A general overview of mental health as it relates to farmworker health. Includes information on symptoms, treatment options, facts and figures, and recommendations for providers.
Date: 05/2013
Type: Document
Sponsoring organization: National Center for Farmworker Health
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Practice Based Versus Telemedicine Based Collaborative Care for Depression in Rural Federally Qualified Health Centers: A Pragmatic Randomized Comparative Effectiveness Trial
Reports on a research trial comparing practice-based collaborative primary care for depression involving mental health providers on-site to telemedicine-based collaborative primary care with off-site mental health providers.
Author(s): John C. Fortney, Jeffrey M. Pyne, Sip B. Mouden, et al.
Location: American Journal of Psychiatry, 170(4), 414-25
Date: 04/2013
Type: Document
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Increasing Access to Behavioral Health Care Through Technology
Presents insights on establishing a telebehavioral health program shared at a meeting convened by the U.S. Department of Health and Human Services (HHS) and the Health Resources and Services Administration’s (HRSA) Office of Special Health Affairs with participants from HRSA-funded health centers in urban and rural areas.
Date: 02/2013
Type: Document
Sponsoring organization: Health Resources and Services Administration
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Suicide Prevention Toolkit for Rural Primary Care
Provides tools, information, and resources to implement suicide prevention practices in rural primary care settings.
Author(s): Tamara Dehay, David Litts, Mini McFaul, Christa Smith, Margaret West
Date: 2013
Type: Document
Sponsoring organization: Western Interstate Commission for Higher Education
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Causes, Consequences, and Prevention of Burnout Among Substance Abuse Treatment Counselors: A Rural Versus Urban Comparison
An analysis of the differences in substance abuse counselor burnout from the counselors' perspective in rural versus urban treatment centers.
Author(s): Carrie B. Oser, Elizabeth P. Biebel, Erin Pullen, Kathi LH Harp
Location: Journal of Psychoactive Drugs, 45(1), 17-27
Date: 2013
Type: Document
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Behavioral Health, United States, 2012
A comprehensive resource for behavioral health statistics for large and small metropolitan areas, and non-metropolitan areas of the U.S. Information compiled is from a diverse set of data sources, journal articles, and online tools.
Date: 2013
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Compendium of Rural Best Practices/Models Innovations to Strengthen Rural Health Care: Technology, Quality Improvement, Collaboration, and Training
Summaries of innovative programs occurring in rural areas, featuring a medical home model, a Lean/Six Sigma hospital program, a community health center telehealth program, and a statewide behavioral health network.
Date: 2013
Type: Document
Sponsoring organization: National Rural Health Association
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Medicaid Handbook: Interface with Behavioral Health Services
Provides a basic understanding of the Medicaid program with a specific emphasis on the interplay between Medicaid principles and the provision of behavioral health services in both rural and urban settings.
Date: 2013
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Continuing Education Training Focused on the Development of Behavioral Telehealth Competencies in Behavioral Healthcare Providers
Provides a baseline for developing a best practice model for behavioral telehealth service delivery by identifying specific provider competencies for administering effective behavioral telehealth services that incorporates rural ethics, cultural competency and vicarious trauma training.
Author(s): Valerie Gifford, Britton Niles, Inna Rivkin, Catherine Koverola, Jodi Polaha
Location: Rural and Remote Health, 12, 2108
Date: 12/2012
Type: Document
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Rural Older Adults’ Mental Health: Status and Challenges in Care Delivery
Examines the mental health service needs of, and use by, independently living rural older adults, with a focus on depression.
Author(s): Emilee Bocker, Michael Glasser, Kimberly Nielsen, Vicki Weidenbacher-Hoper
Location: Rural and Remote Health, 12, 2199
Date: 11/2012
Type: Document
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Rural Mental Health Workforce Needs Assessment: A National Survey
Examines the shortages of mental health professionals in rural communities and the impact of inadequate mental health services access on rural hospitals.
Author(s): Daniel Thomas, Martin MacDowell, Michael Glasser
Location: Rural and Remote Health, 12, 2176
Date: 10/2012
Type: Document
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Behavioral Health Aides: A Promising Practice for Frontier Communities
Provides information on the seven emerging BHA models: care coordinators and case managers; support workers; mental health first aid certified laypeople; peer counselors and peer specialists; promotoras with supplemental behavioral health training; Alaska’s BHA model; and behavioral health practitioners.
Author(s): Saskia van Hecke
Date: 08/2012
Type: Document
Sponsoring organization: National Center for Frontier Communities
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Preventing Suicide: A Toolkit for High Schools
Helps high schools, school districts, and their partners design and implement strategies to prevent suicide and promote behavioral health among students with a special focus on American Indian students and other minority student populations in rural and urban areas.
Date: 06/2012
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Lost in the Rush to National Reform: Recommendations to Improve Impact on Behavioral Health Providers in Rural Areas
Highlights the challenges faced by behavioral health agencies, providers, and clients in rural New Mexico via a piloted version of the health home and presents recommendations to improve access to and quality of services.
Author(s): Rafael Semansky, Cathleen Willging, David Ley, Barbara Rylko-Bauer
Location: Journal of Health Care for the Poor and Underserved, 23(2), 842-856
Date: 05/2012
Type: Document
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Suicide Among Patients in the Veterans Affairs Health System: Rural-Urban Differences in Rates, Risks, and Methods
Discusses and compares the suicide rates, risks and methods of suicide for rural and urban veterans.
Author(s): John F. McCarthy, Frederic C. Blow, Rosalinda V. Ignacio, et al.
Location: American Journal of Preventive Medicine, 102(Suppl 1), S111–S117
Date: 03/2012
Type: Document
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Humboldt County, California: A Promising Model for Rural Human Services Integration for Transformation
Summary of an in-depth assessment of the Humboldt County, CA fully integrated health and human services delivery model, which included multiple extended site visits to Humboldt County in 2010 by the Rural Human Services Panel, RUPRI and others.
Author(s): Mario Gutierrez, Kathleen Belanger, Jane Forrest Redfern, Larry Goolsby, Jocelyn Richgels
Date: 02/2012
Type: Document
Sponsoring organization: Rural Policy Research Institute
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Partnership for Implementation of Evidence-Based Mental Health Practices in Rural Federally Qualified Health Centers: Theory and Methods
Discusses the findings of a study to develop an effective implementation strategy between an academic health center and a rural community health center to facilitate the modification and adoption of an evidence-based mental health program to be used by primary care providers in rural community health centers located in Arkansas.
Author(s): Justin B. Hunt, Geoffrey Curran, Teresa Kramer, et al.
Location: Progress in Community Health Partnerships: Research, Education, and Action, 6(3), 389-398
Date: 2012
Type: Document
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Depression Literacy: Rates and Relation to Perceived Need and Mental Health Service Utilization in a Rural American Sample
Reports on a study that evaluated the depression literacy of a rural American sample, and examined the relationship of depression literacy with perceived need for and utilization of different types of services for those with emotional problems.
Author(s): Tisha Deen, Ana Bridges
Location: Rural and Remote Health, 11, 1803
Date: 11/2011
Type: Document
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Assessment of Awareness of Connectedness as a Culturally-Based Protective Factor for Alaska Native Youth
A quantitative assessment of connectedness within Native American communities as a culturally based protective factor against substance abuse and suicide.
Author(s): Nathaniel V. Mohatt, Carlotta C. Ting Fok, Rebekah Burket, David Henry, James Allen
Location: Cultural Diversity and Ethnic Minority Psychology, 17(4), 444–455
Date: 10/2011
Type: Document
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Rural Mental Health Research White Paper for National Institute of Mental Health
Focuses on the nature of rural mental health research, issues in rural mental health, and future areas for research addressing the needs and disparities in rural mental health.
Author(s): Jacqueline S. Gray
Date: 09/2011
Type: Document
Sponsoring organization: University of North Dakota Center for Rural Health
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American Indian/Alaska Native National Behavioral Health Strategic Plan (2011-2015)
Provides a strategic plan for substance abuse, mental health, and social work counselors working for the Indian Health Service (IHS), and other tribal and urban Indian health programs, with a focus on integrating primary health with behavioral health services to improve health outcomes for the American Indian and Alaska Native (AI/AN) populations.
Date: 08/2011
Type: Document
Sponsoring organization: Indian Health Service
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Obesity and Related Health Behaviors Among Urban and Rural Children in the United States: Data from the National Health and Nutrition Examination Survey 2003-2004 and 2005-2006
Evaluates and compares the rates of overweight, obesity and related health behaviors among rural and urban children using data from the National Health and Nutrition Examination Survey (NHANES).
Author(s): Ann McGrath Davis, Kevin J Bennett, Christie Befort, Nikki Nollen
Location: Journal of Pediatric Psychology, 36(6), 669-676
Date: 07/2011
Type: Document
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Rural Behavioral Health Programs and Promising Practices
Examines rural behavioral health programs that were involved in a 2008 study. Reports information gathered from the study, the value of collecting and using the data to make program improvements, and finding funding for sustainability.
Date: 06/2011
Type: Document
Sponsoring organization: Health Resources and Services Administration
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Adolescent Suicide Prevention Program Manual: A Public Health Model For Native American Communities
Describes a community-based suicide prevention program in a rural Native American community.
Author(s): Patricia Serna
Date: 04/2011
Type: Document
Sponsoring organization: Suicide Prevention Resource Center
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Altitude, Gun Ownership, Rural Areas, and Suicide
Analyzes the relationship between the mean county and state altitude with total age-adjusted firearm and non-firearm suicide rates, gun ownership, and population densities within the western part of the United States.
Author(s): Namkug Kim, Jennie B. Mickelson, Barry E. Brenner, et al.
Location: American Journal of Psychiatry, 168(1), 49-54
Date: 01/2011
Type: Document
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Town-level Comparisons May be an Effective Alternative in Comparing Rural and Urban Differences: A Look at Accidental Traumatic Brain Injuries in North Texas Children
Summarizes the results of examined data on North Texas pediatric traumatic brain injury among four levels of rurality: urban city, large town, small town, and isolated town.
Author(s): Brian Robertson, Charles McConnell
Location: Rural and Remote Health, 11, 1521
Date: 01/2011
Type: Document
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PTSD Treatment-Seeking Among Rural Latino Combat Veterans: A Review of the Literature
Contains a review of literature regarding post-traumatic stress disorder treatment faced by rural Latino veterans.
Author(s): Michael R. Duke, Roland S. Moore, Genevieve M. Ames
Location: Journal of Rural Social Sciences, 26(3), 157-180
Date: 2011
Type: Document
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Mental Health Status and Perceived Barriers to Seeking Treatment in Rural Reserve Component Veterans
Reports on National Guard and Reserve troops from the Appalachian Region in Pennsylvania who returned from deployment. Troops responded to a survey that assessed their demographics, mental health symptoms, help-seeking behaviors, barriers for not seeking treatment, deployment history, and stressors.
Author(s): Elizabeth A. Bennett, Michael Crabtree, Mary E. Schaffer, Thomas W. Britt
Date: 2011
Type: Document
Sponsoring organization: Southern Rural Sociological Association
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The Investigation of the Developmental Course of Burnout Among Rural Clinicians
Discusses rural mental health clinician burnout - a significant concern for clinicians as well as mental health organizations.
Author(s): Monika E. Kos, Thomas J. DeStefano
Location: Journal of Rural Community Psychology, E14(1)
Date: 2011
Type: Document
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Identifying Barriers to Treatment for PTSD Among Reserve Component Veterans in Rural Pennsylvania: An Analysis of Five Focus Groups
Provides insight into reasons combat veterans were not seeking or receiving the behavioral health treatment they may need after deployment in a combat zone.
Author(s): Mary Schaffer, Michael Crabtree, Elizabeth Bennett, Matthew McNally, Amanda
Location: Journal of Rural Community Psychology, E14(1)
Date: 2011
Type: Document
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Rural Ethics: Culture, Dilemmas, and Strengths-Based Resolutions
Psychologists face multiple ethical challenges in rural settings due to distinctive cultural constraints inherent within the environment. Suggestions for community-based and training strategies which integrate a strengths-based approach are presented.
Author(s): Tina D. Hoffman
Location: Journal of Rural Community Psychology, E14(1)
Date: 2011
Type: Document
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Itinerant Counseling Services for Rural Communities: A Win/Win Opportunity
Offers a personal narrative of the experience of establishing an itinerant counseling practice in a rural area.
Author(s): Steve F. Bain
Location: Journal of Rural Community Psychology, E13(1)
Date: 11/2010
Type: Document
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Access to Mental Health Services and Family Impact of Rural Children with Mental Health Problems
Provides information on prevalence of children's mental health needs and associated access to care and family impact across rural and urban areas.
Additional links: Policy Brief: Mental Health Problems Have Considerable Impact on Rural Children and their Families
Author(s): Jennifer D. Lenardson, Erika C. Ziller, David Lambert, Melanie M. Race, Anush Yousefian
Date: 10/2010
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Mental Health Care Services in Primary Care: Tackling the Issues in the Context of Health Care Reform
Considers the various issues in mental health care and suggests options for reform, highlighting those that are facilitated by the provisions of the Patient Protection and Affordable Care Act, or ACA. The principal focus is on the role of primary care in the delivery of mental health care services including services in rural areas and how this can be improved.
Author(s): Lesley Russell
Date: 10/2010
Type: Document
Sponsoring organization: Center for American Progress
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Utilizing Quality Clinical Supervision as a Workforce Retention Strategy in Rural Community Mental Health
Discusses how rural community mental agencies are vulnerable to increased turnover rates for mental health care professionals. Identifies challenges that face community mental health staff that can be addressed using clinical supervision to alleviate weary clinicians and promote accountability and best-practices.
Author(s): Daniel R. Mitchell, Thomas J. Destefano, Lori Martinez, Thomas Potter
Location: Journal of Rural Community Psychology, E12(2)
Date: 06/2010
Type: Document
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Assessment of the Mental Health Funding Marketplace in Rural vs. Urban Settings
Reports on the source of payment for mental health treatment for urban and rural residents. Source of payment is identified as private insurance, public insurance, or self-pay.
Additional links: Findings Brief: Assessment of the Mental Health Funding Marketplace in Urban vs. Rural Settings for Individuals with Serious Mental Illness, Summary Report: Assessment of the Mental Health Funding Marketplace in Urban vs. Rural Settings
Author(s): Jeffrey S. Harman, Fran Dong, Stan Xu, Nathan Ewigman, John C. Fortney
Date: 02/2010
Type: Document
Sponsoring organization: WICHE Center for Rural Mental Health Research
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Mental Health Services Are a Critical Rural Need
Reports high rates of depression, suicide, and addiction among rural people, and notes barriers to treatment including lack of anonymity, shortage of detoxification centers, transportation-related problems, and cultural reluctance to seek help with emotional and behavioral stresses. Notes that telemedicine has enabled psychiatrists to treat distance patients effectively, yet initiatives such as this have received little support.
Author(s): Patrick T. Reardon
Location: Health Progress, 91(5)
Date: 2010
Type: Document
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Addressing Suicide Potential and Prevention in Rural and Frontier Areas: Suicide Prevention Toolkit for Rural Primary Care Providers
Provides an overview of suicide in rural areas and discusses the role of primary care providers in suicide prevention.
Author(s): Mimi McFaul, Jim Ciarlo, Jean Demmler, Christa Smith, Tamara DeHay
Date: 08/2009
Type: Document
Sponsoring organization: WICHE Center for Rural Mental Health Research
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Health Equity Change Makers: Elk's Story
A video describing the Northern Arapaho Horse Culture class, a suicide and substance abuse prevention program that uses Native American culture and horsemanship to encourage youth to work through challenges and build resiliency. The program is part of the Northern Arapaho Suicide Prevention Program on the Wind River Reservation in Wyoming funded by the Indian Health Service. Length: 2:25
Type: Video/Multimedia
Sponsoring organization: U.S. Department of Health and Human Services Office of Minority Health
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IHS Suicide Prevention Program
Provides information and resources to support suicide prevention programs in American Indian and Alaska Native (AI/AN) communities. Also provides the resources to help AI/AN communities and individuals recover from the grief caused by suicide.
Type: Website
Sponsoring organization: Indian Health Service
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Child Health USA 2014
A collection of data on the physical, mental, and emotional health of the Nation’s children. Addresses poverty, education, child care, and health service utilization and financing. Includes selected data by rural and urban residence.
Type: Website
Sponsoring organization: Maternal and Child Health Bureau
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SAMHSA’s Tribal Training and Technical Assistance Center
Provides culturally relevant and evidence-based training and technical assistance on mental health and substance use disorders, and suicide prevention to federally recognized tribes, other American Indian/Alaska Native (AI/AN) communities, SAMHSA tribal grantees and other organizations that serve Indian Country.
Type: Website
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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National Survey on Drug Use and Health (NSDUH)
Provides access to results for this annual survey focused on substance abuse and mental health issues. Includes information on prevalence and services. Rural-specific data is available in detailed tables that list "geographic characteristics." Data is also made available by state and for regions within states.
Type: Website
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Rural Mental Health: Challenges and Opportunities Caring for the Country
An overview of the mental health crisis in rural America and what can be done to improve the crisis. Includes brief examples of programs that have shown to be successful.
Author(s): Dennis F. Mohatt
Type: Document
Sponsoring organization: WICHE Center for Rural Mental Health Research
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Partners in Health: Mental Health, Primary Care and Substance Use Interagency Collaboration Tool Kit
Designed to help primary care clinics and behavioral health agencies, including FQHCs and RHCs, to build collaborative relationships. Provides job descriptions, sample agreements and contracts, screening instruments and evaluation measures, operational forms, strategies and prototypes for integrating mental and physical services, practical advice, issues to consider when brokering agreements, and mutual role descriptions.
Type: Document
Sponsoring organization: Integrated Behavioral Health Project
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Journal of Rural Mental Health
A peer-reviewed publication that includes papers on rural mental health research, practice, and policy. Official journal of the National Association for Rural Mental Health. Subscription required.
Type: Journal/Newsletter
Sponsoring organization: National Association for Rural Mental Health
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Suicide Prevention Online Training
Listing of free online courses for training service providers, educators, health professionals, public officials, and community-based coalitions to develop effective suicide prevention programs and policies.
Type: Tutorial/Training
Sponsoring organization: Suicide Prevention Resource Center
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PubMed Search: Suicide and Rural Health
Searches PubMed's collection of journal article citations on the topics of suicide and rural health.
Type: Literature Search
Sponsoring organization: National Library of Medicine
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Mental Health First Aid
A public education program that helps the public identify, understand, and respond to signs of mental illnesses and substance use disorders. Provides a "Find a Course" link to access mental health first aid instructors who will train residents in rural areas.
Type: Website
Sponsoring organization: National Council for Behavioral Health
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VA Community Provider Toolkit
Delivers support, therapeutic tools, and resources to community providers treating veterans for mental health concerns.
Type: Website
Sponsoring organization: U.S. Department of Veterans Affairs
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PubMed Search: Mental Health and Rural Populations
Searches PubMed's collection of journal article citations on the topic of mental health and rural populations.
Type: Literature Search
Sponsoring organization: National Library of Medicine
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American Indian and Alaska Native Mental Health Research
A professionally refereed scientific journal. Contains empirical research, program evaluations, case studies, unpublished dissertations, and other articles in the behavioral, social, and health sciences which relate to the mental health status of American Indians and Alaska Natives.
Type: Journal/Newsletter
Sponsoring organization: Centers for American Indian and Alaska Native Health
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Suicide Prevention Resource Center: States and Communities
Provides information, resources, contacts and lists events for each state on the topic of suicide prevention.
Type: Website
Sponsoring organization: Suicide Prevention Resource Center
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Building Blocks for Cultural Integration in the Development and Establishment of Rural VA Telemental Health Clinics for Native Veterans
Offers an overview, plus suggestions and tips for setting up, operating, and maintaining telemental health (TMH) clinics for rural Native Veterans.
Type: Document
Sponsoring organization: Veterans Rural Health Resource Center: Western Region
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SAMHSA-HRSA Center for Integrated Health Solutions
Promotes the development of integrated primary and behavioral health services to better address the needs of individuals with mental health and substance use conditions, whether seen in specialty behavioral health or primary care provider settings. Includes resources to address integrated care in rural settings.
Type: Website
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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American Indian / Alaska Native Suicide Prevention
Provides resources and information developed for professionals and other individuals working with American Indian and Alaska Native populations to support suicide prevention and mental health promotion.
Type: Website
Sponsoring organization: Suicide Prevention Resource Center
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Tools For Transforming Rural Mental Health Programs Into Promising and/or Evidence-based Practices
Webinar provides an overview of a technical assistance guide for promising practices in rural mental health including the strategies, methodologies, and resources needed to become evidenced based practices.
Type: Website
Sponsoring organization: Western Interstate Commission for Higher Education
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2-1-1 Information & Referral Service
2-1-1 provides free and confidential information and referral for help with employment, food, housing, health care, addiction prevention programs, and counseling.
Type: Hotline
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APA: Rural Health
A listing of publications, agencies, organizations and programs on the topic of rural behavioral health.
Type: Website
Sponsoring organization: American Psychological Association
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WISQARS (Web-based Injury Statistics Query and Reporting System)
An interactive database system that provides fatal and nonfatal injury, violent death, and cost of injury data from a variety of sources. Fatal injury data is available by metropolitan/nonmetro status in the Fatal Injury Reports section. Fatal Injury Maps provides access to county-level data.
Type: Database
Sponsoring organization: Centers for Disease Control and Prevention
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Ensuring the Seventh Generation: A Youth Suicide Prevention Toolkit for Tribal Child Welfare Programs
Toolkit intended for tribal child welfare workers and care providers discussing: child and youth suicide risk factors, specific risk factors associated with children served in child welfare, warning signs for caseworkers and care providers to be alert to, suicide prevention and intervention strategies that can be applied in child welfare agencies, and mobilization of support networks around particular children.
Type: Website
Sponsoring organization: National Indian Child Welfare Association
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Resources on Substance Abuse and Mental Health for Military Families
Offers information to returning veterans on accessing mental health and substance abuse services and for military families on coping with trauma.
Type: Website
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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National Registry of Evidence-based Programs and Practices (NREPP)
Searchable database of interventions for the prevention and treatment of mental and substance use disorders. Includes option to focus on interventions used in a rural/frontier or tribal setting.
Type: Website
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Behavioral Health Treatment Services Locator
Locate treatment facilities addressing substance abuse, addiction, and mental health problems by zip code or city and state.
Type: Directory
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Journal of Rural Community Psychology
A peer-reviewed, scholarly journal in electronic form. Devoted to sociological, psychological and mental health issues in rural and small community settings.
Type: Journal/Newsletter
Sponsoring organization: Marshall University
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Additional resources are available related to this guide. See the full list of resources by topic for:


Last Updated: 6/20/2017