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Rural Mental Health – Resources

Selected recent or important resources focusing on Rural Mental Health.

Mortality in Rural Areas: Insights from National Research and Community-Based Initiatives
Webinar recording discusses mortality rates in rural and urban areas, as well as the causes of rural mortality. Features presentations from representatives of the Health Resources and Services Administration, the National Center for Health Statistics, and the Armstrong-Indiana-Clarion Drug & Alcohol Commission.
Additional links: Audio Recording, PowerPoint Handout, Webinar Transcript
Date: 11/2020
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Association of Rurality With Availability of Youth Mental Health Facilities With Suicide Prevention Services in the US
Presents a study on the availability of suicide prevention services for youths age 15-19 at mental health facilities in rural versus urban areas. Compares the rates of prevalence of mental health facilities, youth-serving mental health facilities, and youth-serving mental health facilities with suicide prevention programs by rural-urban continuum codes.
Author(s): Janessa M. Graves, Demetrius A. Abshire, Jessica L. Mackelprang, et al.
Citation: JAMA Network Open, 3(10), e2021471
Date: 10/2020
Type: Document
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American Indian Addendum for the Suicide Prevention Toolkit for Primary Care Practices
Highlights suicide prevention guidance for primary care providers in tribal communities. Accompanies the Suicide Prevention Toolkit for Primary Care Practices and provides information specific to American Indian and Alaska Native populations. Includes risk assessment and intervention information on suicide prevention strategies in tribal settings.
Date: 10/2020
Type: Document
Sponsoring organizations: Montana Department of Public Health and Human Services, Western Interstate Commission for Higher Education
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Telebehavioral Health: An Effective Alternative to In-Person Care
Issue brief discussing telehealth treatment modalities based on a 2019 review of clinical outcomes related to telebehavioral health. Covers three state-level approaches: the Portland Veterans Affairs Medical Center Rural Telemental Health Program (VA RTMH), which serves rural Oregon veterans, and Medicaid policies in Texas and Massachusetts. Addresses telebehavioral health policy details, implementation, and considerations for states looking to develop new telebehavioral health policies during the COVID-19 pandemic.
Author(s): Brittany Lazur, Lily Sobolik, Valerie King
Date: 10/2020
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Costs of Emergency Department Visits for Mental and Substance Use Disorders in the United States, 2017
Examines the costs of emergency department (ED) visits with diagnoses of mental and substance use disorders compared to total ED visits, with data on total costs and cost per visit. Includes information by hospital location for large metropolitan, small metropolitan, micropolitan, and rural areas.
Author(s): Zeynal Karaca, Brian J. Moore
Date: 10/2020
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Medicare Payment Basics: Inpatient Psychiatric Facilities Services Payment System
Overview of Medicare's payment system for services provided in freestanding hospitals or specialized hospital-based units. Demonstrates how payments for these services are adjusted to reflect geographic differences in labor costs, and cost of care by facility and patient characteristics.
Date: 10/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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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: data.HRSA.gov
Date: 10/2020
Type: Map/Mapping System
Sponsoring organization: Rural Health Information Hub
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Mental Health Treatment Among Adults: United States, 2019
Reports on the percentage of adults who have taken prescription medication for mental health or received counseling or therapy from a mental health professional in the past year. Includes data for adults living in large metropolitan, medium and small metropolitan, and nonmetro areas.
Author(s): Emily P. Terlizzi, Benjamin Zablotsky
Date: 09/2020
Type: Document
Sponsoring organization: National Center for Health Statistics
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Mental Health Treatment Among Children Aged 5–17 Years: United States, 2019
Reports on U.S. children between the ages of 5 and 17 who had counseling or therapy from a mental health professional or took prescription medication for mental health in the past year. Includes data for children living in nonmetropolitan areas, small or medium metro areas, and large metro areas.
Author(s): Benjamin Zablotsky, Emily P. Terlizzi
Date: 09/2020
Type: Document
Sponsoring organization: National Center for Health Statistics
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Results from the 2019 National Survey on Drug Use And Health: Detailed Tables
Presents data on use of illicit drugs, alcohol, and tobacco, trends in substance use disorder and mental health, and access to treatment for youth and adults. Features statistics for a variety of demographic and geographic characteristics, including rural versus urban status.
Date: 09/2020
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Frequent Mental Distress Among Adults, by Disability Status, Disability Type, and Selected Characteristics — United States, 2018
Reports on prevalence of mental distress among adults with and without disabilities, by disability type and selected demographic characteristics. Features statistics with breakdowns by metropolitan or nonmetropolitan designation.
Author(s): Robyn A. Cree, Catherine A. Okoro, Matthew M. Zack, Eric Carbone
Citation: MMWR (Morbidity and Mortality Weekly Report), 69(36), 1238-1243
Date: 09/2020
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Emergency Department Visits Related to Suicidal Ideation or Suicide Attempt, 2008–2017
Examines trends in emergency department (ED) visits related to suicidal ideation or suicide attempt by age group for those 5 years and older. Includes data by patient location for rural, medium/small metropolitan, and large metropolitan areas. Includes maps showing by state whether rural, medium/small metro, or large metro areas had the highest rate of ED visits related to suicidal ideation or suicide attempt for those age 5-24, 25-64, and 65 or older.
Author(s): Pamela L. Owens, Kimberly W. McDermott, Rachel N. Lipari, Megan M. Hambrick
Date: 09/2020
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Strategies for the Delivery of Behavioral Health Crisis Services in Rural and Frontier Areas of the U.S.
Report highlights the challenges of providing behavioral health crisis services to rural and frontier communities. Details the barriers to crisis service delivery such as lack of transportation, travel distance, and broadband access, among others. Includes a discussion on the effect of COVID-19 pandemic rural crisis service delivery.
Author(s): Kristin A. Neylon
Date: 08/2020
Type: Document
Sponsoring organization: National Association of State Mental Health Program Directors
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Suicide Prevention in Primary Care
Two-part webinar recording on integrating suicide prevention measures into a rural primary care setting. Part one discusses rural suicide rates, screening, and risk assessment. Part two covers interventions, post-intervention follow-ups, and telehealth.
Date: 08/2020
Type: Video/Multimedia
Sponsoring organization: Mountain Plains Mental Health Technology Transfer Center
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Small Rural Hospital Transition (SRHT) Project Behavioral Health Care Coordination Summit: Summit Findings
Summarizes the findings from a two-day summit on the role of rural hospitals in addressing behavioral health as part of a community-wide initiative. Identifies barriers to behavioral health care coordination in rural areas. Describes four areas of opportunity to advance care coordination. Includes resources for each area of opportunity identified.
Author(s): Amy Harding
Date: 08/2020
Type: Document
Sponsoring organizations: Advocates for Human Potential, National Rural Health Resource Center
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Lessons Learned: Pediatric Tele-Mental Health in a Rural Medical Center in the Age of SARS-CoV-2
Explores a study on the use of telemedicine to expand mental healthcare access to rural children during the COVID-19 pandemic. Discusses implementation concerns such as a need to protect patient privacy and expand internet-based infrastructure.
Author(s): Komal Satti, Olutosin Ojugbele
Citation: Journal of Rural Health
Date: 08/2020
Type: Document
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Reversing the Rising Tide of Suicide
Issue guide covering suicide risk factors, statistics, prevention strategies, and impacts of suicide on specific populations, including veterans, first responders, and LGBTQ youth. Discusses state-level initiatives including Mental Health First Aid training, Applied Suicide Intervention Skills Training (ASIST), and the Zero Suicide framework, with examples of state legislation to implement these models.
Author(s): Charlie Severance-Medaris
Date: 08/2020
Type: Document
Sponsoring organization: National Conference of State Legislatures
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Urban–Rural Differences in Suicide Rates, by Sex and Three Leading Methods: United States, 2000–2018
Reports on trends in suicide mortality from 2000 through 2018 among all ages for urban and rural counties. Includes data by sex for the leading methods of suicide: firearms, suffocation, and poisoning.
Additional links: Visual Abstract
Author(s): Kristen Pettrone, Sally C. Curtin
Date: 08/2020
Type: Document
Sponsoring organization: National Center for Health Statistics
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Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic - United States, June 24-30, 2020
Reports on the number of adults experiencing elevated adverse mental health conditions associated with COVID-19. Features statistics on self-reported incidence of anxiety or depressive disorder, trauma- and stressor-related disorder (TSRD) related to the pandemic, and substance use, with breakdowns by rural or urban residence.
Author(s): Mark E. Czeisler, Rashon I. Lane, Emiko Petrosky, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 69(32),1049-1057
Date: 08/2020
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Rural-Urban Mental Health Disparities in the United States During COVID-19
Explores rural and urban mental health access during the COVID-19 pandemic. Discusses the expanded use of telehealth, the lack of broadband access, and mental health provider shortages in rural areas.
Author(s): Nicole M. Summers-Gabr
Citation: Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S222-S224
Date: 08/2020
Type: Document
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Rural Social Isolation and Loneliness: Rates, Importance, and Identifying Risk
Three-part webinar recording discussing loneliness and isolation in rural areas before and during the COVID-19 pandemic. Part one details isolation rates and risk assessment; part two highlights programs working to make connections with the aging rural populations during the pandemic; and part three explores community building and grief support during COVID-19.
Additional links: Session Three: Rural but Reachable: How to Build Grief Support by Creating Community, Session Two: The Evolving Nature of Social Connections: Promoting Well-Being in Times of Crisis
Date: 07/2020
Type: Video/Multimedia
Sponsoring organization: Mountain Plains Mental Health Technology Transfer Center
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Responding to Behavioral Health Needs in Rural America
Presentation slides discussing behavioral health issues and needs in rural America. Describes approaches to enhance behavioral health service delivery and implications for public policy.
Author(s): Keith J. Mueller
Date: 07/2020
Type: Document
Sponsoring organization: Rural Policy Research Institute
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American Communities Experience Deaths of Despair at Uneven Rates
Analyzes nationally representative data from 2014-2018 on deaths of despair (DoD), or deaths resulting from substance use or suicide. Includes county-level statistics on DoD, with information broken down by rurality and race/ethnicity.
Author(s): Dante Chinni
Date: 07/2020
Type: Document
Sponsoring organization: American Communities Project
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Supporting the Health and Wellbeing of Middle-Aged Adults Living Alone in Rural Counties
Results of a study exploring the characteristics of adults ages 35-64 who live alone, and the heightened health risks and challenges related to social isolation, especially in the midst of the COVID-19 pandemic. Uses data from a survey of 14 healthcare providers in rural counties with a high percentage of middle-aged adults living alone. Features a county-level map with breakdowns by percentage of people living alone in rural areas.
Author(s): Carrie Henning-Smith, Mariana Tuttle, Ashley Hernandez, Jonathan Schroeder, Katy Kozhimannil
Date: 07/2020
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Suicide Rates on the Rise: National Trends and Demographics in Suicide Deaths from 2000 to 2018
Brief details the national trends in deaths by suicide from 2002-2018 by demographics, such as age, race, gender, and urbanization, among others. Includes a state-level brief that highlights suicide trends by state.
Additional links: State-level Brief
Date: 06/2020
Type: Document
Sponsoring organization: State Health Access Data Assistance Center
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Improving Mental Health Care by Understanding the Culture of Farming and Rural Communities
Session one of a four-part webinar series on the interplay of COVID-19 and the mental health crisis in rural and agricultural communities. Discusses co-occurring substance use disorders, telehealth, and provider compassion fatigue, among other issues.
Additional links: Session 2: Approaching and Treating Co-Occurring Mental and Substance Use Disorders in Farming and Rural Communities, Session 3: Providing Mental Health Telehealth Services in Farming and Rural Communities, Session 4: Co-Occurring Mental and Substance Use Disorders in Farming and Rural Communities: Assessment, Ethics, and Preventing Compassion Fatigue
Date: 06/2020
Type: Video/Multimedia
Sponsoring organizations: Mental Health Technology Transfer Center Network, Mountain Plains Mental Health Technology Transfer Center
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The Importance of Video Visits in the Time of COVID-19
Highlights the importance of video-to-home telemedicine (VTH) for maintaining mental healthcare during the COVID-19 pandemic. Discusses the usefulness of VTH in expanding access to mental healthcare broadly, as well as some of the infrastructure-based limitations that currently exist.
Author(s): Jan A. Lindsay, Julianna B. Hogan, Anthony H. Ecker, et al.
Citation: Journal of Rural Health
Date: 06/2020
Type: Document
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Report to Congress: Reducing Barriers to Furnishing Substance Use Disorder (SUD) Services Using Telehealth and Remote Patient Monitoring for Pediatric Populations under Medicaid - Final Report
Details methods to reduce barriers to the use of telehealth for mental health and substance abuse disorder treatment for pediatric patients covered by Medicaid. Highlights barriers, best practices, and costs, among other measures. Features several case studies across the U.S., including in rural communities.
Date: 05/2020
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, HHS Office of the Assistant Secretary for Planning and Evaluation
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Projected Deaths of Despair from COVID-19
Report looks at the potential effect of the COVID-19 pandemic on the rates of deaths of despair, or those related to drugs, alcohol, and from suicide. Discusses potential increases in rates and details a number of policy solutions to prevent an increase in deaths.
Author(s): Stephen Petterson, John M. Westfall, Benjamin F. Miller
Date: 05/2020
Type: Document
Sponsoring organizations: Robert Graham Center, Well Being Trust
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Pain in the Nation Update: Alcohol, Drug, and Suicide Deaths in 2018
Report details updated rates of deaths related to drugs, alcohol, and suicide for 2018. Breaks down data by race, age, and regionally, including rural versus metro areas.
Date: 05/2020
Type: Document
Sponsoring organization: Trust for America's Health
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Mental Health in a Pandemic: Q&A with Thomasine Heitkamp and Dennis Mohatt
An interview with Mountain Plains Mental Health Technology Transfer Center co-directors Thomasine Heitkamp and Dennis Mohatt on the mental health impacts of the COVID-19 pandemic. Discusses telehealth, economic insecurity, broadband, and mental health under COVID-19 and self-isolation.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 05/2020
Type: Document
Sponsoring organization: Rural Health Information Hub
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Suicide in the Time of COVID-19: A Perfect Storm
Examines the risk of suicide in rural communities during the COVID-19 pandemic. Looks at suicide rates in Kentucky and nationally and discusses how the COVID-19 pandemic could potentially increase those rates.
Author(s): Sabrina Brown, Donna L. Schuman
Citation: Journal of Rural Health
Date: 05/2020
Type: Document
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National Alliance on Mental Health: COVID-19 Resource and Information Guide
Provides guidance on maintaining mental health during the COVID-19 pandemic. Features frequently asked questions and a number of contacts for more information.
Additional links: En Español
Date: 05/2020
Type: Document
Sponsoring organization: National Alliance on Mental Health
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Depression, Alcohol and Farm Stress: Addressing Co-Occurring Disorders in Rural America
Offers resources to help rural healthcare providers screen farmers, farmworkers, and farm families for alcohol use disorder and depression. Discusses farm stress and covers three categories of barriers to rural substance use and mental health services: accessibility, availability, and acceptability. Includes a hypothetical case scenario to illustrate the obstacles and challenges rural farm families experience when attempting to receive care for co-occurring mental health and substance use disorders.
Author(s): Maridee Shogren, Robin Landwehr, David Terry, Abby Roach-Moore, Andrew McLean
Date: 04/2020
Type: Document
Sponsoring organizations: Addiction Technology Transfer Center Network, Mental Health Technology Transfer Center Network, Substance Abuse and Mental Health Services Administration
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Preventing Suicide in Rural Communities During the COVID‐19 Pandemic
Explores the potentially increased risk of suicide during the COVID-19 pandemic and the challenges of providing mental healthcare. Highlights some of the factors related to COVID-19 that could increase the risk, such as self isolation, access to firearms, and decreased access to healthcare.
Author(s): Lindsey L. Monteith, Ryan Holliday, Talia L. Brown, Lisa A. Brenner, Nathaniel V. Mohatt
Citation: Journal of Rural Health
Date: 04/2020
Type: Document
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Increase in Suicide Mortality in the United States, 1999–2018
Reports on changes in suicide rates in the U.S. from 1999 through 2018. Includes 2018 age-adjusted suicide rates for men and women by county of residence for urban and rural counties.
Author(s): Holly Hedegaard, Sally C. Curtin, Margaret Warner
Date: 04/2020
Type: Document
Sponsoring organization: National Center for Health Statistics
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Your Recovery Is Important: Virtual Recovery Resources
Information providers and programs can share with people in recovery, to help them find virtual support options for recovery from mental and substance use disorders. Includes resources to help recovery programs create virtual meetings.
Date: 03/2020
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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QuickStats: Percentage of Children and Adolescents Aged 4–17 Years with Serious Emotional or Behavioral Difficulties, by Sex and Urbanization Level — National Health Interview Survey, 2016–2018
Bar chart comparing metropolitan and nonmetro rates of serious emotional and behavioral difficulties among children and adolescents aged 4-17 overall, for boys, and for girls.
Citation: MMWR (Morbidity and Mortality Weekly Report), 69(10), 276
Date: 03/2020
Type: Chart/Graph
Sponsoring organization: Centers for Disease Control and Prevention
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Predictors of Substance Use Disorder and Mental Health Treatment Use Among Rural Adults using Stimulants over Three Years
Details a study on the factors that predict mental health and substance use treatment utilization among rural stimulant users. Breaks down data from 2002 to 2008 by race, age, and substance use, among other measures.
Author(s): Michael A. Cucciare, Songthip T. Ounpraseuth, Geoffrey M. Curran, Brenda M. Booth
Citation: Substance Abuse, 40(3), 363-370
Date: 02/2020
Type: Document
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2018 National Survey on Drug Use and Health: American Indians and Alaska Natives (AI/ANs)
Highlights data from the 2018 National Survey on Drug Use and Health pertaining specifically to American Indians and Alaska Natives (AI/AN). Compares AI/AN rates of drug use and mental illness, as well as co-occurring disorders, to rates for the U.S. as a whole.
Date: 01/2020
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Supporting the Mental Health Well-being of High School Students
Report evaluates the perceived need for school-based mental health services and the levels of access to those services by rural students and students of color. Bases results on surveys of high school students and makes corresponding recommendations. Compares the access to mental health services in rural, urban, and suburban schools.
Additional links: Infographic
Author(s): Michelle Croft, Shannon Hayes, Raeal Moore
Date: 01/2020
Type: Document
Sponsoring organization: ACT Center for Equity in Learning
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Caring for People with Mental Health and Substance Use Disorders in Primary Care Settings
Report explores how primary care providers can best provide mental health and substance use disorder services to their patients. Discusses the barriers to behavioral healthcare in rural areas such as insurance coverage, workforce shortages, and lack of transportation, among others, and highlights the role primary care providers can play in overcoming those barriers.
Additional links: Read Online
Date: 2020
Type: Document
Sponsoring organization: National Academies of Sciences, Engineering, and Medicine
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Introducing the Rural Suicide Prevention Toolkit
Webinar recording discusses the Rural Suicide Prevention Toolkit developed by NORC Walsh Center for Rural National Center for Health Statistics. Provides an overview of the toolkit and highlights evidence-based models for preventing suicide in rural communities.
Additional links: Audio Recording, PowerPoint Handout, Webinar Transcript
Date: 12/2019
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Issue Brief: Integrated Behavioral Health is High-value Care
Highlights the advantages of behavioral health integration. Addresses costs and healthcare outcomes and presents several models for integration in healthcare settings.
Date: 12/2019
Type: Document
Sponsoring organization: American Hospital Association
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Behavioral Health in Rural America: Challenges and Opportunities
Examines the prevalence of behavioral health disorders in rural populations with an emphasis on high-risk populations. Discusses access to behavioral health services in rural areas, and the barriers associated with the provision of prevention, treatment, and recovery services. Highlights programs and policy strategies known to demonstrate improvements in behavioral health systems, and offers policy recommendations for change supporting improved outcomes in rural populations.
Additional links: Executive Summary
Author(s): John Gale, Jaclyn Janis, Andrew Coburn, Hanna Rochford
Date: 12/2019
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Partial Psychiatric Hospitalization Program Availability in Non-Metropolitan and Metropolitan Hospitals Nationally
Describes the purpose of partial psychiatric hospitalization programs (PPHPs), and compares 2016 American Hospital Association (AHA) Annual Survey of Hospitals data on the availability and the characteristics of PPHPs among non-metropolitan and metropolitan hospitals in the U.S.
Author(s): Timothy Williams, Tyrone F. Borders, Lindsey Jasinski
Date: 12/2019
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Self-identified Barriers to Rural Mental Health Services in Iowa by Older Adults with Multiple Comorbidities: Qualitative Interview Study
Highlights a study on the perceived barriers to mental healthcare for chronically ill elders in rural Iowa. Bases finding on phone interviews with participants where they detailed their experiences accessing mental healthcare. Breaks down data by age, gender, and mental health diagnosis, among other factors.
Author(s): Lauren Elizabeth Pass, Korey Kennelty, Barry L Carter
Citation: BMJ Open, 9(11), e029976
Date: 11/2019
Type: Document
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Rural Women's First-person Perspectives on the Role of Mental Health in Substance Use
Presents a study highlighting rural women's perspectives on the co-occurring mental health and substance use disparities among rural populations. Analyzes interviews with incarcerated rural women with co-occurring substance use and mental health symptoms.
Author(s): Claire Snell-Rood, Michele Staton, Athena Kheibari
Citation: Rural and Remote Health, 19(4), 5279
Date: 11/2019
Type: Document
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Inequalities in Elevated Depressive Symptoms in Middle-aged and Older Adults by Rural Childhood Residence: The Important Role of Education
Measures the disparities in the prevalence of elevated depressive symptoms by rural childhood residence and the influence of childhood socioeconomic conditions and educational attainment. Identifies the prevalence of depressive symptoms among U.S.-born adults ages 50 years and older using data from 1998–2014 Health and Retirement Studies – ongoing publicly available datasets of non-institutionalized adults.
Author(s): Audrey R. Murchland, Chloe W. Eng, Joan A. Casey, Jacqueline M. Torres, Elizabeth Rose Mayeda
Citation: International Journal of Geriatric Psychiatry, 34(11), 1633–1641
Date: 11/2019
Type: Document
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Loneliness in the United States: A 2018 National Panel Survey of Demographic, Structural, Cognitive, and Behavioral Characteristics
Highlights a cross-sectional study on loneliness in adults in the U.S. Aims to evaluate rates of loneliness by age group, gender, race, and urban or non-urban location, as well as by several other measures. Bases conclusions on the results of a national survey of 20,096 adults.
Author(s): Liana DesHarnais Bruce, Joshua S. Wu, Stuart L. Lustig, Daniel W. Russell, Douglas A. Nemecek
Citation: American Journal of Health Promotion, 33(8), 1123-1133
Date: 11/2019
Type: Document
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Building Interventions When Distress Is under Debate: A Case Study from Appalachia
Discusses the various forms of distress experienced by women living in Appalachia and the challenges for healthcare professionals seeking to create culturally acceptable methods of identifying distress and developing appropriate resources for recovery. Describes a 3-year program to identify and adapt an evidence-based culturally appropriate intervention for this patient population.
Author(s): Claire Snell-Rood, Ryan Jenkins, Keisha Hudson, et al.
Citation: Transcultural Psychiatry, 56(5), 918-946
Date: 10/2019
Type: Document
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Behavioral Health Service Provision by Primary Care Physicians
Results of a 2019 survey of 313 physicians, examining physician medical specialty and practice characteristics, patient population characteristics, physician practices for screening and diagnosing patients for behavioral health disorders, and roles in managing patients with behavioral health disorders. Features statistics on various types of disorders, with breakdowns by rural and nonrural settings.
Additional links: Policy Brief
Author(s): Angela J. Beck, Cory Page, Jessica Buche, Victoria Schoebel, Caitlyn Wayment
Date: 10/2019
Type: Document
Sponsoring organization: University of Michigan Behavioral Health Workforce Research Center
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Who and How: Exploring the Preferred Senders and Channels of Mental Health Information for Wisconsin Farmers
Presents a study on the dissemination of mental health information to farmers. Farmers were surveyed on how they would like to receive this information and who they think should present it to them.
Author(s): Josie M. Rudolphi, Richard Berg, Barbara Marlenga
Citation: International Journal of Environmental Research and Public Health, 16(20), 3836
Date: 10/2019
Type: Document
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Addressing a Crisis: Cross-Sector Strategies to Prevent Adolescent Substance Use and Suicide
Report discusses different methods for adolescent substance use and suicide prevention. Highlights rates of suicide and substance use, such as binge drinking, misuse of pain medication, and vaping. Explores differences in rates for youth in rural and urban areas.
Date: 10/2019
Type: Document
Sponsoring organization: Trust for America's Health
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Rural First Responder Access to Mental Health Care: A National Crisis
Explores mental health challenges experienced by first responders and increased risk of suicide. Describes barriers to accessing adequate mental healthcare within the scope of their employment, especially in rural areas where services remain limited and stigma may be associated with the need for assistance.
Author(s): Jeffrey Hintz, Carrie Hintz
Date: 10/2019
Type: Document
Sponsoring organization: Journal of Emergency Medical Services
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Peer‐adult Network Structure and Suicide Attempts in 38 High Schools: Implications for Network‐informed Suicide Prevention
Presents a study on a school-based, youth-adult network as an intervention to prevent youth suicide in rural and micropolitan communities. Measures rates of suicidal ideation and suicide attempts in 38 high schools in New York and North Dakota.
Author(s): Peter A. Wyman, Trevor A. Pickering, Anthony R. Pisani, et al.
Citation: The Journal of Child Psychology and Psychiatry, 60(10), 1065-1075
Date: 10/2019
Type: Document
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Provider Shortages and Limited Availability of Behavioral Health Services in New Mexico's Medicaid Managed Care
Examines the supply and distribution of behavioral health providers and prescribers across New Mexico, with a focus on services available to Medicaid managed care enrollees. Includes data for rural and frontier counties. Discusses rural broadband connectivity challenges that impact the use of telehealth to address access. Offers policy recommendations. Findings are likely to be relevant to behavioral healthcare access in other states' rural and frontier counties.
Date: 09/2019
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Contextual Factors Associated With County-Level Suicide Rates in the United States, 1999 to 2016
Explores a study of the demographic variables associated with suicides, such as age, race, gender, and social capital. Details how the variables and rates vary based on rural or urban status.
Author(s): Danielle L. Steelesmith, Cynthia A. Fontanella, John V. Campo, et al.
Citation: JAMA Network Open, 2(9)
Date: 09/2019
Type: Document
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The Prevalence of Mental Illness and Substance Abuse Among Rural Latino Adults with Multiple Adverse Childhood Experiences in California
Presents a study on the role of adverse childhood experiences (ACEs) in adult mental health and substance use issues among rural Latinos in California. Breaks down participants by age, sex, income, and education, among other measures.
Author(s): Irán Barrera, Vrinda Sharma, Yumiko Aratani
Citation: Journal of Immigrant and Minority Health, 21, 971-976
Date: 08/2019
Type: Document
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Results from the 2018 National Survey on Drug Use And Health: Detailed Tables
Presents data on use of illicit drugs, alcohol, and tobacco, trends in substance use disorder and mental health, and access to treatment for youth from age 12-17 and adults. Features statistics for a variety of demographic and geographic characteristics, including rural versus urban status.
Additional links: PDF Version
Date: 08/2019
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Effectiveness of Peer-Delivered Trauma Treatment in a Rural Community: A Randomized Non-inferiority Trial
Discusses a study on the effectiveness of a peer-provided treatment of PTSD and substance use disorder compared to clinician-provided treatment in a rural county in a Southwestern state. Breaks down data by age, race, and diagnosis, among other factors.
Author(s): Annette S. Crisanti, Cristina Murray-Krezan, Jessica Reno, Cynthia Killough
Citation: Community Mental Health Journal, 55(7), 1125–1134
Date: 07/2019
Type: Document
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Community Mobilization for Rural Suicide Prevention: Process, Learning and Behavioral Outcomes from Promoting Community Conversations about Research to End Suicide (PC CARES) in Northwest Alaska
Presents a study evaluating the Promoting Community Conversations About Research to End Suicide (PC CARES) program's effectiveness at preventing suicide in rural Alaskan communities. Details the PC CARES model and presents a survey-based evaluation.
Author(s): Lisa Wexler, Suzanne Rataj, Jerreed Ivanich, et al.
Citation: Social Science and Medicine, 232, 398-407
Date: 07/2019
Type: Document
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Critical Crossroads: Pediatric Mental Health Care in the Emergency Department: A Care Pathway Resource Toolkit
Toolkit designed to support hospitals that provide high-quality, effective emergency care to pediatric patients in psychiatric distress. Includes case stories from rural emergency departments in various states.
Date: 07/2019
Type: Document
Sponsoring organizations: Health Resources and Services Administration, Maternal and Child Health Bureau
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Guidance to States and School Systems on Addressing Mental Health and Substance Use Issues in Schools
Report provides guidance to school systems and state governments about mental health and substance use in schools. Highlights examples of methods to identify and address mental health issues and substance use in schools. Discusses state-level Medicaid funding for behavioral health.
Author(s): Elinore McCance-Katz, Calder Lynch
Date: 07/2019
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Substance Abuse and Mental Health Services Administration
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Pain in the Nation: Building a National Resilience Strategy: Alcohol and Drug Misuse and Suicide and the Millennial Generation - a Devastating Impact
Report highlights the rates of alcohol and drug misuse and suicide among the millennial generation (people in their 20s and 30s). Discusses the role of the opioid crisis in the increases in "deaths of despair" among millennials. Chart on page 6 compares rates in rural and metro areas.
Date: 06/2019
Type: Document
Sponsoring organizations: Trust for America's Health, Well Being Trust
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Modeling the Importance of Within- and Between-County Effects in an Ecological Study of the Association Between Social Capital and Mental Distress
Examines association between social capital and mental distress at the county level and explores between-county effects. Features county-level maps showing levels of mental distress and social capital, and demographic statistics with breakdowns by rural residence.
Author(s): Tse-Chuan Yang, Stephen A. Matthews, Feinuo Sun, Marina Armendariz
Citation: Preventing Chronic Disease, 16
Date: 06/2019
Type: Document
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Preventing Farmer Suicide: Collaboration and Communication
Video focused on farmer mental health. Discusses the stressors impacting farmers, such as difficult economic conditions and extreme weather. Features experts explaining the warning signs of suicide and how communities can help farmers and their families address mental health concerns.
Date: 06/2019
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Behavioral Health Barometer: United States, Volume 5
Provides a broad overview of behavioral 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 2017 National Survey on Drug Use and Health and the National Survey of Substance Abuse Treatment Services.
Date: 06/2019
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Suicidal Thoughts, Plans, and Attempts by Non-Metropolitan and Metropolitan Residence
Compares trends in prevalence of suicidal thoughts, plans, and attempts, and identifies demographic, social, and economic factors associated with these thoughts and actions. Includes statistics by county type from 2010-2016, with breakdowns by nonmetro, small metro, and large metro areas.
Author(s): Kathi Harp, Tyrone F. Borders
Date: 05/2019
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Preventing Farmer Suicides through Helplines and Farm Visits
Discusses the financial and other challenges farmers face that impact their mental health. Highlights the efforts of the Minnesota Farm & Rural Helpline and NY FarmNet, which work to improve farmers' mental health and prevent suicides.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 05/2019
Type: Document
Sponsoring organization: Rural Health Information Hub
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Association Between Rural Residence and Nonfatal Suicidal Behavior Among California Adults: A Population-Based Study
Presents a study on nonfatal suicide behaviors, such as suicidal ideation, in rural and urban areas in California. Breaks down data by age, gender, and race, among other measures.
Author(s): Claire E. Margerison, Sidra Goldman-Mellor
Citation: Journal of Rural Health, 35(2), 262-269
Date: 03/2019
Type: Document
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Controlled Substance Use Among Psychiatric Patients in a Rural North Carolina Emergency Department
Features a study on common substances used by patients entering rural emergency departments (EDs) seeking mental health treatment. Focuses on a single ED in North Carolina and presents data by race, gender, and substance used.
Author(s): Elizabeth Gignac, Godwin Y. Dogbey, Gregory Capece, et al.
Citation: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 20(2), 419-425
Date: 03/2019
Type: Document
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Behavioral and Mental Health Care Among Urban, Suburban, and Rural Respondents: Differences in Reported Need, Reasons for Not Getting Care, and Travel Time
Data snapshot featuring statistics on percentages of people needing behavioral or mental health care or having difficulty finding a provider, and reported length of travel time to a provider, with breakdowns by urban, suburban, and rural location.
Date: 03/2019
Type: Document
Sponsoring organization: Association of American Medical Colleges
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Randomized Control Trial of Culturally Adapted Cognitive Processing Therapy for PTSD Substance Misuse and HIV Sexual Risk Behavior for Native American Women
Presents a study on culturally adapted Cognitive Processing Therapy (CPT) to improve PTSD and substance abuse outcomes and lower the risk of contracting HIV in Native American women. Details data by age, education, and employment status, among other measures.
Author(s): Cynthia R. Pearson, Debra Kaysen, David Huh, Michele Bedard-Gilligan
Citation: AIDS and Behavior, 23(3), 695-706
Date: 03/2019
Type: Document
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Inpatient Stays Involving Mental and Substance Use Disorders, 2016
Examines inpatient stays involving mental and substance use disorders at community hospitals among patients 5 years old or older. Provides data on costs, length of stay, discharge status, patient demographics, primary expected payer, and hospital region. Table 2 includes data by location of patient residence for rural and urban areas.
Author(s): Pamela L. Owens, Kathryn R. Fingar, Kimberly W. McDermott, Pradip K. Muhuri, Kevin C. Heslin
Date: 03/2019
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Behavioral Health: Research on Health Care Costs of Untreated Conditions is Limited
Report discusses the lack of sufficient research on the total cost healthcare when behavioral health services are inaccessible. Discusses some of the challenges to providing behavioral health access in rural areas.
Additional links: Full Report
Date: 02/2019
Type: Document
Sponsoring organization: Government Accountability Office
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Case Studies of 6 Safety Net Organizations That Integrate Oral and Mental/Behavioral Health With Primary Care Services
Features an analysis of 6 Federally Qualified Health Centers (FQHCs) integrating oral health and behavioral health with primary care across the country. Features one rural example.
Additional links: Policy Brief
Author(s): M. Langelier, S. Surdu, N. Goodwin
Date: 02/2019
Type: Document
Sponsoring organization: Oral Health Workforce Research Center
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Peer Support Specialists Care for and Connect Rural Behavioral Health Clients
Discusses peer support specialists, trained laypeople in recovery with a mental health condition or substance use disorder, and describes the roles they play as mentors and coordinators for clients with similar behavioral health issues. Features peer support specialist programs in rural Arizona, Michigan, and North Dakota.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 02/2019
Type: Document
Sponsoring organization: Rural Health Information Hub
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An Innovative Approach to Care: Integrating Mental Health Services Through Telemedicine in Rural School-based Health Centers
Presents a study on the use of telemedicine to provide behavioral healthcare to rural children and adolescents through school-based health centers. Discusses the West Virginia Children's Access Network (WVCAN) and evaluates the successes and shortcomings of both the school-based health center model and telemedicine at providing behavioral healthcare to rural children.
Author(s): Taniya Pradhan, E. Ashley Six-Workman, Kari-Beth Law
Citation: Psychiatric Services, 70(3), 239-242
Date: 2019
Type: Document
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Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth
Report highlights research on mental, emotional, and behavioral development in children and youth. Describes the different challenges for cognitive development in both urban and rural areas and explores the necessary structures that facilitate regular development. Available for free download with login.
Date: 2019
Type: Document
Sponsoring organization: National Academies of Sciences, Engineering, and Medicine
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Depression in a Depressed Area: Deservingness, Mental Illness, and Treatment in the Contemporary Rural U.S.
Examines the concepts of health-related deservingness and local moral economics to understand the diversity of moral responses to depression for rural women living in central Appalachia, Kentucky where economic distress has contributed to poor mental health. Women from a variety of ages, treatment encounters, work experiences, and family sizes, along with healthcare professionals from a variety of backgrounds and settings, participated in semi-structured interviews and focus groups.
Author(s): Claire Snell-Rood, Elizabeth Carpenter-Song
Citation: Social Science & Medicine, 219: 78-86
Date: 12/2018
Type: Document
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Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders and Poverty Among Children Aged 2–8 Years — United States, 2016
Examines parental reports of mental, behavioral, and developmental disorders in children 2-8 years of age, comparing children in higher-income households with those in lower-income households. Includes data by urban/rural community status for urban, large rural, small rural, and isolated areas.
Author(s): Robyn A. Cree, Rebecca H. Bitsko, Lara R. Robinson, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 67(50), 1377-1383
Date: 12/2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Suicide Mortality in the United States, 1999-2017
Reports on trends in suicide mortality from 1999 through 2017. Includes data by urbanization level of the decedent's county of residence, with information for metropolitan, micropolitan, and noncore counties.
Author(s): Holly Hedegaard, Sally C. Curtin, Margaret Warner
Date: 11/2018
Type: Document
Sponsoring organization: National Center for Health Statistics
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Suicide Rates by Major Occupational Group — 17 States, 2012 and 2015
Examines suicide deaths by occupational group for men and women aged 16-64 years from the 17 states participating in both the 2012 and 2015 National Violent Death Reporting System. Includes information on suicide rates among male farmers, ranchers, and other agricultural managers and among male agricultural workers.
Additional links: Erratum, Table 2
Author(s): Cora Peterson, Deborah M. Stone, Suzanne M. Marsh, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 67(45), 1253-1260
Date: 11/2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Suicide and Firearm Injury in Utah: Linking Data to Save Lives
Report highlights data pertaining to suicides, homicides, and injuries from firearms in Utah. Compares data between rural and metro areas on a number of measures, such as suicides among youth, firearm ownership and storage, and suicide completion rates, among others.
Date: 10/2018
Type: Document
Sponsoring organization: Harvard T. H. Chan School of Public Health
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Developing Telemental Health Partnerships Between State Medical Schools and Federally Qualified Health Centers: Navigating the Regulatory Landscape and Policy Recommendations
Provides recommendations for overcoming barriers to promoting telemental health services partnerships between medical schools and health centers. Discusses rural-urban disparities in provision of mental health services, credentialing, remote electronic health records access, insurance issues, and billing.
Author(s): John C. Fortney, Richard C. Veith, Amy M. Bauer, et al.
Citation: The Journal of Rural Health, 35, 287–297
Date: 10/2018
Type: Document
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Key Informant Perspectives on Rural Social Isolation and Loneliness
Describes challenges and opportunities related to health impacts of social isolation in rural areas, using data from interviews with 22 experts from 11 states and the District of Columbia. Addresses gaps in the literature on rural-urban differences in social isolation and offers suggestions for policy changes and programmatic interventions.
Author(s): Carrie Henning-Smith, Alexandra Ecklund, Megan Lahr, et al.
Date: 10/2018
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Addressing the Needs of Young People with Serious Emotional Disturbance (SED) Through a Comprehensive Continuum of Services and Supports
Recorded webinar discussing strategies to assist children and youth with serious emotional disturbance in schools and communities located in rural and tribal areas. Includes discussion on involving public and private organizations to support youth and providing culturally competent care. Highlights the Montana Tribal Wraparound Approach, a program that balances professional services and culturally appropriate natural healing methods.
Additional links: Download Video Recording
Author(s): Kurt D. Michael, Lynda Gargan, Don Wetzel, Crystal Hickman
Date: 09/2018
Type: Video/Multimedia
Sponsoring organization: Rural Behavioral Health Initiative for Children, Youth, and Families
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Pacific County, Wash.: Connection to Services Through Jail Screening and Referral
Describes efforts of a rural Washington State community to address the number of people with mental illnesses in their jail, as part of the national "Stepping Up" initiative. Examines the process of screening and providing connections to community-based providers.
Author(s): Nastassia Walsh
Date: 09/2018
Type: Document
Sponsoring organization: National Association of Counties
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Calaveras County, Calif.: Connecting Justice-Involved People to Treatment and Services
Describes best practice strategies used by a rural northern California county as part of the national "Stepping Up" initiative for the purpose of reducing the number of adults with mental illness in jails and connecting them to community-based treatment.
Author(s): Nastassia Walsh
Date: 09/2018
Type: Document
Sponsoring organization: National Association of Counties
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Trajectory Classes of Cannabis Use and Heavy Drinking among Rural African American Adolescents: Multilevel Predictors of Class Membership
Presents a study on cannabis and alcohol use among African American youth in rural Georgia. Features data assessments over nine years beginning when the participants are 16 and ending when they are 25 and looks a perceived stress and other psychological risk factors.
Author(s): Allen W. Barton, Gene. H. Brody, Tamika C. B. Zapolski, et al.
Citation: Addiction, 113(8), 1439-1449
Date: 08/2018
Type: Document
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County-Level Trends in Suicide Rates in the U.S., 2005–2015
Presents an analysis of national suicide rates for 2005-2015 by county. Highlights rate changes in rural versus urban areas.
Author(s): Lauren M. Rossen, Holly Hedegaard, Diba Khan, Margaret Warner
Citation: American Journal of Preventive Medicine, 55(1), 72-79
Date: 07/2018
Type: Document
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Understanding Rural Communities
Podcast featuring an interview with Dennis Mohatt, the Vice President for Behavioral Health at the Western Interstate Commission for Higher Education (WICHE), discussing rural health and the stigma surrounding mental healthcare in rural communities. Covers what it means to work and collaborate with rural partners.
Date: 07/2018
Type: Audio
Sponsoring organization: Hogg Foundation for Mental Health
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Adequacy of Depression Treatment in Spouses of Cancer Survivors: Findings from a Nationally Representative US Survey
Examines data from the Medical Expenditures Panel Survey to compare depression treatment for spouses of cancer survivors with treatment for other married individuals across the United States. Explores socioeconomic and rural/urban disparities in treatment rates to improve mental health outcomes for cancer survivors and their families.
Author(s): Kristin Litzelman, Abiola Keller, Amye Tevaarwerk, Lori DuBenske
Citation: Journal of General Internal Medicine, 33(6), 869-876
Date: 06/2018
Type: Document
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State Legislative Approach to Enumerating Behavioral Health Workforce Shortages: Lessons Learned in New Mexico
Describes the model developed in New Mexico (NM) as a result of the Health Care Work Force Data Collection, Analysis and Policy Act, initially enacted in 2011, to address behavioral health workforce shortages, particularly in rural areas, and the increased demand for services due to Medicaid expansion in the state. Highlights the purpose of the legislation, the development of a statewide workforce committee, policies implemented, lessons learned, and offers suggestions for other states considering legislation supporting behavioral health workforce initiatives.
Author(s): Deborah B. Altschul, Caroline A. Bonham, Martha J. Faulkner, et al.
Citation: American Journal of Preventive Medicine, 54(6S3), S220-S229
Date: 06/2018
Type: Document
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Closing Behavioral Health Workforce Gaps: A HRSA Program Expanding Direct Mental Health Service Access in Underserved Areas
Commentary describing HRSA's Behavioral Health Workforce Education and Training program, an initiative to address behavioral health disparities through supply and distribution of providers to underserved areas. Includes statistics on employment status and location of 1,975 graduates of the program.
Author(s): Hayden O. Kepley, Robin A. Streeter
Citation: American Journal of Preventive Medicine, 54(6), Supplement 3, S190-S191
Date: 06/2018
Type: Document
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Mental Health-related Physician Office Visits by Adults Aged 18 and Over: United States, 2012–2014
Examines adult mental health-related physician office visits by specialty and patient characteristics. Includes information on visits to psychiatrists, primary care physicians, and other physicians in large metropolitan, medium to small metropolitan, and rural areas.
Additional links: Questions for the Lead Author, NCHStats blog
Author(s): Donald Cherry, Michael Albert, Linda F. McCaig
Date: 06/2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Providing Access to Mental Health Services for Children in Rural Areas
Policy brief discussing options for improving access to mental health services for rural children, including telemedicine, integration of behavioral health and primary care, and school-based care. Features three brief case studies.
Date: 05/2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Preventing Suicide In Rural America
Policy brief focused on rural suicide prevention. Provides an overview of rural suicide rates and key suicide risk factors for rural residents. Identifies policy options for preventing suicide in rural areas and includes two brief case studies.
Date: 05/2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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NACRHHS Policy Brief on Understanding the Impact of Suicide in Rural America
Webinar recording discusses the National Advisory Committee on Rural Health and Human Services (NACRHHS) policy brief on the impact of suicide in rural areas. Features presentations from the NACRHHS Committee Chair and Executive Secretary, as well as a representative from the Centers for Disease Control and Prevention and and a retired professor of social work at Stephen F. Austin State University.
Additional links: Audio Recording, PowerPoint Handout, Webinar Transcript
Date: 04/2018
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Expanding Care for Rural Patients
Discusses the telehealth psychology program at Texas A&M and the effect the program has had on mental health access across the state. Details the program's implementation and the ways it is overcoming barriers for rural people.
Author(s): Amy Novotney
Citation: APA Monitor on Psychology, 49(3), 64
Date: 03/2018
Type: Document
Sponsoring organization: American Psychological Association
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Behavioral Health Integration into Primary Care
Profile of a rural health system, Western Wisconsin Health (WWH), and its work to deliver behavioral health services. Provides an overview of how behavioral health providers and services were integrated with primary care, with a cultural change to focus on whole-person care. Includes information on Medicare and Medicaid reimbursement for the behavioral health services provided at WWH's Rural Health Clinic. Discusses how WWH behavioral health providers offer telehealth services to other rural areas of Wisconsin.
Date: 03/2018
Type: Document
Sponsoring organization: Rural Health Value
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Suicides Among American Indian/Alaska Natives — National Violent Death Reporting System, 18 States, 2003-2014
Compares differences in suicide characteristics and circumstances between American Indian/Alaska Natives (AI/AN) and Whites. Includes data on age, sex, nonmetropolitan residence, mechanism and location of suicide, interpersonal circumstances, life stressors, mental health, and substance use.
Author(s): Rachel A. Leavitt, Allison Ertl, Kameron Sheats, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 67(8), 237-242
Date: 03/2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Reducing Depressive Symptoms Through Behavioral Activation in Churches: A Hybrid-2 Randomized Effectiveness-Implementation Design
Details a study on an intervention partnering with churches to address depressive symptoms in rural African American communities. Details the stressors that commonly affect African Americans, the ways faith communities can offer support, and how church leaders can work with mental health professionals to improve mental health outcomes.
Author(s): Tiffany Haynes, Jerome Turner, Johnny Smith, et al.
Citation: Contemporary Clinical Trials, 64, 22-29
Date: 01/2018
Type: Document
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Mental Health and Drivers of Need in Emergent and Non-Emergent Emergency Department (ED) Use: Do Living Location and Non-Emergent Care Sources Matter?
Highlights a study on mental health as cause of non-emergent emergency department (ED) use. Breaks down data by age, race, reason for admission, and whether the patient lives in an urban or rural location, among other factors.
Author(s): Moira C. McManus, Robert J. Cramer, Maureen Boshier, Muge Akpinar-Elci, Bonnie Van Lunen
Citation: International Journal of Environmental Research and Public Health, 15(1), 129
Date: 01/2018
Type: Document
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Trends and Characteristics of Occupational Suicide and Homicide in Farmers and Agriculture Workers, 1992–2010
Presents a study on rates of work-related suicide and homicide among farmworkers from 1992-2010. Breaks down rates by year and region, and compares farmworkers to other occupations.
Author(s): Wendy Ringgenberg, Corinne Peek-Asa, Kelley Donham, Marizen Ramirez
Citation: Journal of Rural Health, 34(3), 246-253
Date: 2018
Type: Document
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Suicide Surveillance Strategies for American Indian and Alaska Native Communities
Features a report on suicide data collection strategies for American Indian and Alaska Native communities. Presents case studies from different tribal communities and supporting resources for each strategy discussed.
Date: 2018
Type: Document
Sponsoring organization: Suicide Prevention Resource Center
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Rural Suicide: One California County's Fight to Save Lives
Series of articles exploring the causes for high rates of suicide in rural areas of Northern California, including Amador, Calaveras, and Mariposa counties. Topics include shortages of mental health professionals and the higher risk of suicide among veterans and Native Americans.
Author(s): Sammy Caiola
Date: 2018
Type: Website
Sponsoring organization: Capital Public Radio
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Behavioral Health Integration into Primary Care: A Microsimulation of Financial Implications for Practices
Evaluates the financial impact of integrating behavioral health services into primary care practices by simulating data using Medicare payments. Compares the potential impact for Federally Qualified Health Centers (FQHCs), rural versus urban non-FQHCs in high-poverty areas, and practices in lower-poverty areas. Addresses the costs and revenues for two types of behavioral health integration, the collaborative care model (CoCM) and the primary care behaviorist model (PCBM).
Citation: Journal of General Internal Medicine, 32(12), 1330-1341
Date: 12/2017
Type: Document
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Suicide Clusters Within American Indian and Alaska Native Communities: A Review of the Literature and Recommendations
Analyzes suicide clusters within American Indian and Alaska Native (AI/AN) populations to develop recommendations to prevent and address suicide clusters within AI/AN communities. Discusses risk, developmental, and protective factors influencing likelihood that individuals will consider, attempt, or complete suicide.
Date: 12/2017
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Understanding the Impact of Suicide In Rural America
Analyzes suicide rates and the impact of suicide in rural areas, highlights suicide in Indian country and suicide prevention among U.S. veterans. Covers state and federal prevention strategies and discusses recommendations for research and evaluation, and outreach, promotion, and awareness.
Date: 12/2017
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Pain in the Nation: The Drug, Alcohol and Suicide Crises and the Need for a National Resilience Strategy
Examines current trends, causes, costs, and potential solutions to the drug, alcohol, and suicide crises in the U.S. Includes rural data and discussion of rural-specific issues.
Author(s): Laura M. Segal, Anne De Biasi, Jennifer L. Mueller, Kendra May, Molly Warren
Date: 11/2017
Type: Document
Sponsoring organization: Trust for America's Health
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Rural Health Research Recap: Rural Behavioral Health
Summarizes key findings from the Rural Health Research Centers' most recent rural behavioral health projects. Discusses mental illness prevalence in rural areas, adverse childhood experiences (ACEs) among rural children, access to behavioral health services in rural communities, and rural behavioral health interventions. Provides links to each of the referenced source documents.
Date: 11/2017
Type: Document
Sponsoring organization: Rural Health Research Gateway
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Mental Health Best Practices with Kari Oyen
Kari Oyen, professor of School Psychology at the University of South Dakota, discusses mental health issues including suicidal behavior in rural America, the role played by school psychologists, and prevention services based on risk factors including single-parent homes, poverty, and poor attendance at school.
Date: 10/2017
Type: Audio
Sponsoring organizations: Center for Rural Affairs, National Rural Education Association
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Suicide Trends Among and Within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death — United States, 2001–2015
Reports on county-level trends in suicide rates during 2001–2015 for large metropolitan, medium/small metropolitan, and nonmetro counties. Includes data by gender, race/ethnicity, and age group. Covers the mechanism of death, with data on firearms, hanging/suffocation, drug poisoning, non-drug poisoning, and other causes.
Author(s): Asha Z. Ivey-Stephenson, Alex E. Crosby, Shane P. D. Jack, Tadesse Haileyesus, Marcie-jo Kresnow-Sedacca
Citation: MMWR Surveillance Summaries, 66(18), 1-16
Date: 10/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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A Toolkit for Legislative Reform: Improving Criminal Justice Responses to Mental Illness in Rural States
Toolkit details methods to improve access to mental health treatment in rural communities through the criminal justice system. Presents options for state policy reform, using South Dakota's mental illness intervention law as a case study.
Author(s): Barbara A. Pierce
Date: 09/2017
Type: Document
Sponsoring organization: Crime and Justice Institute
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Behavioral Health Workforce Supply
Webinar recording presents a discussion on the supply and distribution of behavioral health professionals across the U.S. Breaks down data by U.S. Census regions.
Additional links: Webinar Slides, Webinar Transcript
Date: 08/2017
Type: Video/Multimedia
Sponsoring organization: Rural Health Research Gateway
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Use of the Emergency Department for Mental Health and Substance Abuse among Women
Fact sheet identifying trends among rural and urban women who utilize the emergency department (ED) for treatment of substance abuse (SA) and/or mental health (MH) issues. Research seeks to help communities understand who is using the ED for MH and SA so they can provide more effective, less costly care.
Author(s): Shawnda Schroeder, Mandi-Leigh Peterson, Jordan Jaeger
Date: 07/2017
Type: Document
Sponsoring organization: Rural Health Reform Policy Research Center
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The Supply and Distribution of the Behavioral Health Workforce in America: A State-Level Analysis
State-level analysis of the supply and distribution of the behavioral health workforce. Provides individual data briefs for each state and includes information on the following health professionals: psychiatrists, psychologists, social workers, psychiatric nurse practitioners, and counselors. Findings are shown in actual numbers, as a ratio of providers per 100,000 population, and by metro/non-metro status. Builds on the work and research of an earlier companion brief.
Author(s): C. Holly A. Andrilla, Lisa A. Garberson, Davis G. Patterson, Eric H. Larson
Date: 07/2017
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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Addressing Mental Health Needs: Perspectives of African Americans Living in the Rural South
Examines mental health, mental health treatment, and barriers to treatment for rural South African American residents to develop culturally competent treatment approaches. Includes characteristics data for age group, race/ethnicity, education, marital status, employment, and gender.
Author(s): Tiffany F. Haynes, Ann M. Cheney, J. Greer Sullivan, et al.
Citation: Psychiatric Services, 68(6), 573-578
Date: 06/2017
Type: Document
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Innovating Mental Healthcare in Texas and Beyond: Q&A with Dr. Octavio Martinez
An interview with Dr. Octavio Martinez, the executive director of the Hogg Foundation for Mental Health. Discusses the mission of the foundation and how it is addressing mental health in Texas, as well as some of the challenges of providing mental healthcare in Texas and throughout the U.S.
Author(s): Beth Blevins
Citation: Rural Monitor
Date: 06/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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Online Screening Helps Michigan Men Gauge Mental Health
Features the Healthy Men Michigan campaign, which uses an anonymous online survey to evaluate the risk of depression and suicide among men in the state. Focuses on working-age Michigan men and on reaching those in male-dominated industries, using mental health messaging targeted to this audience.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 06/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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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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Mental and Behavioral Health of Rural Children - Insights from the CDC MMWR Rural Health Series
Webinar recording details a CDC report on children with mental, behavioral, and developmental disorders (MBDD) and the differences in healthcare, family and community support available to them in both rural and urban areas. Highlights the Ben Archer Health Center that services a rural area along the U.S. border in New Mexico and discusses some of the strategies for overcoming challenges, such as language and access barriers for children with MBDD, and how those strategies can be applied to other rural areas.
Additional links: Audio Recording, PowerPoint Handout, Transcript
Date: 05/2017
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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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
Citation: 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.
Citation: MMWR Surveillance Summaries, 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
Citation: Rural Monitor
Date: 03/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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Understanding Treatment Gaps for Mental Health, Alcohol, and Drug Use in South Dakota: A Qualitative Study of Rural Perspectives
Details a study on gaps in access to behavioral health treatment in rural South Dakota. Discusses data collected from interviews with people in rural and tribal areas of the state with co-occurring mental health and substance use disorders.
Author(s): Lauren Broffman, Margaret Spurlock, Kristen Dulacki, et al.
Citation: Journal of Rural Health, 22(1), 71-81
Date: 01/2017
Type: Document
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Agricultural Workers and Mental Health
Provides an overview of mental health for agricultural workers. Includes information on symptoms, treatment options, mental health risk factors, and recommendations for providers.
Date: 2017
Type: Document
Sponsoring organization: National Center for Farmworker Health
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Suicide Prevention Toolkit for Primary Care Practices
Provides tools, information, and resources to implement suicide prevention practices in primary care settings, including those in rural areas.
Author(s): Elizabeth Tupa, April Hendrickson, Ken Cole, Hannah Koch
Date: 2017
Type: Document
Sponsoring organizations: Suicide Prevention Resource Center, WICHE Mental Health Program
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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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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 nonmetro (micropolitan and non-core) U.S. counties. A state-level analysis of the study is also available with information for all states.
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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After Rural Suicide: A Guide for Coordinated Community Postvention Response
Provides information and resources to help California rural counties, including local behavioral and public health agencies, law enforcement and other suicide prevention organizations develop a formal, locally controlled and coordinated response to a community after a suicide has occurred. Although the focus is on California rural counties the guidance is applicable to other rural counties planning a suicide postvention response.
Author(s): Sandra Black, Anara Guard
Date: 08/2016
Type: Document
Sponsoring organization: California Mental Health Services Authority (CalMHSA)
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Age at First Birth and Psychiatric Disorders in Low-Income Pregnant Women
Details a study on the correlation between women's age at the time of first giving birth and the prevalence of psychiatric disorders. Features data from low-income pregnant women from 5 rural counties in Missouri. Looks at the subjects' age, diagnoses, and income, among other factors.
Author(s): Maya Tabet, Louise H. Flick, Cynthia A.L. Cook, et al.
Citation: Journal of Women's Health, 25(8), 810-817
Date: 08/2016
Type: Document
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Disparities in Alcohol, Drug Use, and Mental Health Condition Prevalence and Access to Care in Rural, Isolated, and Reservation Areas: Findings From the South Dakota Health Survey
Presents a study comparing disparities in drug and alcohol use and mental health issues in rural and urban areas. Explores data from a cross-sectional survey of people in South Dakota in rural and urban areas, including on American Indian reservations.
Author(s): Melinda M. Davis, Margaret Spurlock, Kristen Dulacki, et al.
Citation: Journal of Rural Health, 32(3), 287-302
Date: 06/2016
Type: Document
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I Got You: Healthy Life Choices for Teens (IGU)
Video featuring I Got You: Healthy Life Choices for Teens (IGU), an outreach program working to improve the mental health of students in Mississippi. Features program leaders and participating students sharing stories of how IGU is making a difference.
Date: 06/2016
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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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 that examines and compares 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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Adverse Childhood Experiences in Rural and Urban Contexts
Reports on a study analyzing the prevalence of rural 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 Talbot, Donald Szlosek, Erika C. Ziller
Date: 04/2016
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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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 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
Citation: Rural and Remote Health, 15(4), 3392
Date: 11/2015
Type: Document
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Mental Health and Substance Use Disorders in America: Priorities, Challenges, and Opportunities
Presents the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) hearing on mental health and substance abuse challenges in the U.S. Includes testimonies from the Substance Abuse and Mental Health Services Administration, Health Resources and Services Administration, and National Institute of Mental Health regarding the federal government's role, how well their programs are working, obstacles, and recommendations. Additional link to HRSA administrator's testimony highlights efforts focused on rural areas.
Additional links: Jim Macrae Testimony
Date: 10/2015
Type: Document
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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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.
Citation: 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 and 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.
Citation: 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. Includes differences by sex.
Author(s): Cynthia A. Fontanella, Danielle L. Hiance-Steelesmith, Gary S. Phillips, et al.
Citation: 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
Bar chart comparing suicide rates in nonmetropolitan and metropolitan counties, with data for 2004 and 2013. Shows higher suicide rates for less urbanized counties.
Citation: 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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Child Health USA 2014
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.
Date: 03/2015
Type: Document
Sponsoring organization: Maternal and Child Health Bureau
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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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Evaluation and Disposition of Medicaid-Insured Children and Adolescents with Suicide Attempts
Examines differences in the evaluation of youth ages 7–18 enrolled in Medicaid with suicidal behavior in rural, urban and suburban areas of Tennessee. Addresses differences associated with sociodemographic characteristics.
Author(s): Candice L. Williams, William O. Cooper, Leanne S. Balmer, et al.
Citation: 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: Evidence from the National Survey of Drug Use and Health
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 nonmetropolitan 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
Citation: 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
Citation: Psychological Assessment, 26(3), 763-773
Date: 09/2014
Type: Document
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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
Citation: 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
Results of a study examining the variation in suicide rates among rural Alaskan Native men.
Author(s): Matthew Berman
Citation: 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 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.
Citation: Journal of the American Board of Family Medicine, 27(3), 367-374
Date: 05/2014
Type: Document
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Reducing Rural Suicide
Describes the efforts of psychologists searching for innovative ways to reach out to people in isolated communities. Includes a specific focus on Native American and veteran populations to address stigma and access to care, and create a preventive environment.
Author(s): Rebecca A. Clay
Citation: APA Monitor on Psychology, 45(4), 36
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 examples of successful 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
Citation: Telemedicine Journal 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
Results of a study of adolescents and their parents who received mental health services in a school-based setting for 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, et al.
Citation: 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
Citation: 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 rural telemental health programs based on a study of 53 telemental health providers. Outlines the opportunities and challenges for telemental health in the rural health system.
Author(s): David Lambert, John A. Gale, Anush Y. Hansen, Zach T. 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 population groups such as minorities, people living in poverty, and rural residents may be less likely to access these facilities.
Author(s): Janet R. Cummings, Hefei Wen, Michelle Ko, Benjamin G. Druss
Citation: 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
Examines the experiences of traditional Alaska Native ways. Covers subsistence activities that may prevent suicide and strengthen indigenous populations.
Author(s): Christopher R. DeCou, Monica C. Skewes, Ellen D. S. López
Citation: International Journal of Circumpolar Health, 72(1)
Date: 08/2013
Type: Document
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A Needs-Based Method for Estimating the Behavioral Health Staff Needs of Community Health Centers
Analyzes data, from the 2010 Uniform Data System and 2010 National Survey on Drug Use and Health, to estimate the number of full time behavioral health providers are 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.
Citation: 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. Addresses finances, workforce challenges, physical access barriers, integrated care, and policy considerations.
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
Examines the prevalence of mental health diagnoses in rural and urban children, as well as variation in treatment rates and psychotropic medication prescriptions. Addresses the effect of insurance type and income on mental health service use.
Additional links: Policy Brief: Rural Children Experience Different Rates of Mental Health Diagnosis and Treatment
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 access to mental health services and reducing barriers limiting the expansion of mental healthcare services in rural America.
Author(s): Greg Clarke, Bobbi Jo Yarborough
Citation: General Hospital Psychiatry, 35(4), 339-344
Date: 05/2013
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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A Population-Based Cross-Sectional Study of Health Service Deficits among U.S. Adults with Depressive Symptoms
Examines the prevalence of health service deficits in rural versus non-rural adults with depressive symptoms. Looks at factors contributing to health service deficits including: no health insurance, no health provider, deferred medical care due to cost and no routine medical exam in the past year. Table 4 lists demographics of adults with current depressive symptoms by rural versus urban.
Author(s): Krista L. Huot, May Nawal Lutfiyya, Michael F. Akers, et al.
Citation: BMC Health Services Research, 13, 160
Date: 2013
Type: Document
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Compendium of Rural Best Practices/Models: Innovations to Strengthen Rural Health Care: Technology, Quality Improvement, Collaboration, and Training
Summarizes 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, specifically emphasizing 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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Partners in Health: Mental Health, Primary Care and Substance Use Interagency Collaboration Tool Kit
Designed to assist primary care clinics and behavioral health agencies, including Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (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.
Date: 2013
Type: Document
Sponsoring organization: Integrated Behavioral Health Project
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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
Citation: 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
Citation: Rural and Remote Health, 12(4), 2176
Date: 10/2012
Type: Document
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Behavioral Health Aides: A Promising Practice for Frontier Communities
Provides information on seven emerging behavioral health aide (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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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 model and presents recommendations to improve access to and quality of services.
Author(s): Rafael Semansky, Cathleen Willging, David Ley, Barbara Rylko-Bauer
Citation: Journal of Health Care for the Poor and Underserved, 23(2), 842-856
Date: 05/2012
Type: Document
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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.
Citation: Progress in Community Health Partnerships: Research, Education, and Action, 6(3), 389-398
Date: 2012
Type: Document
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Preventing Suicide: A Toolkit for High Schools
Provides tools and resources for high schools, school districts, and their partners to design and implement strategies to prevent suicide. Promote behavioral and mental health among students with a special focus on American Indian students and other minority student populations in rural and urban areas.
Date: 2012
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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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
Citation: Rural and Remote Health, 11(4), 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
Describes development of the Awareness of Connectedness Scale, a quantitative scale tested with 284 Alaska Native youth to assess risk, resiliency, and change, based on cultural concepts of disorder, wellness, and healing.
Author(s): Nathaniel V. Mohatt, Carlotta C. Ting Fok, Rebekah Burket, David Henry, James Allen
Citation: 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
Discusses the methods and focuses 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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Building Blocks for Cultural Integration in the Development and Establishment of Rural VA Telemental Health Clinics for Native Veterans
Offers an overview, suggestions, and tips for setting up, operating, and maintaining telemental health clinics for rural Native veterans.
Date: 08/2011
Type: Document
Sponsoring organization: Veterans Rural Health Resource Centers
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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.
Citation: American Journal of Psychiatry, 168(1), 49-54
Date: 01/2011
Type: Document
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Access to Mental Health Services and Family Impact of Rural Children with Mental Health Problems
Provides information on the 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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Encouraging Rural Health Clinics to Provide Mental Health Services
Examines changes in the delivery of mental health services by Rural Health Clinics (RHCs), their operational characteristics, barriers to the development of services, and policy options to encourage more RHCs to deliver mental health services.
Author(s): John Gale, David Hartley, Barbara Shaw, Stephanie Loux
Date: 05/2010
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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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. Seeks to understand rural payer mix and inform future policies and finance-based interventions with the hope of reducing rural/urban mental healthcare disparities.
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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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. Focuses on identifying high risk rural counties and equipping rural primary providers to care for suicidal patients. Includes suicide risk data for five states based on rurality.
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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Rural Resilience: Farm Stress Training
A self-paced online course for groups that work with farmers and ranchers to learn to recognize the signs and symptoms of stress and suicide, ways to effectively communicate with people under stress, and how to reduce stigma related to mental health concerns.
Type: Tutorial/Training
Sponsoring organizations: American Farm Bureau Federation, Farm Credit, Michigan State University Extension, National Farmers Union, University of Illinois Extension
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HRSA Center of Excellence for Behavioral Health Technical Assistance
Provides training and technical assistance for HRSA-funded grantees working to integrate behavioral healthcare into primary care settings. Features information and resources on models and best practices for behavioral healthcare integration.
Type: Website
Sponsoring organization: Health Resources and Services Administration
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E-learning Program: Improving Cultural Competency for Behavioral Health Professionals
Presents a 5-hour on demand e-learning program to help behavioral health professionals increase their cultural and linguistic competency. The program is accredited for contact hours for many behavioral health professionals.
Type: Tutorial/Training
Sponsoring organization: U.S. Department of Health and Human Services Office of Minority Health
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Farm State of Mind
A collection of resources and information for farmers addressing stress and mental health. Includes information on the American Farm Bureau Federation and National Farmers Union Rural Resilience Training Program, an online training to recognize signs of stress on the farm.
Type: Website
Sponsoring organization: American Farm Bureau Federation
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Farm Stress and Mental Health
Presents trainings and resources pertaining to farm stress and farmers' mental health. Features several webinars discussing issues surrounding farmers' mental health, as well as listing a number of sources for information and data.
Type: Website
Sponsoring organization: Mountain Plains Mental Health Technology Transfer Center
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FindTreatment.gov
Tool allows users to find mental health providers and treatment for substance use disorder by zip code. Features treatment options, payment information, and information about addiction and mental health.
Type: Directory
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Best and Promising Practices for the Implementation of Zero Suicide in Indian Country
Outlines methods for creating suicide-safe practices for healthcare systems in American Indian communities. Breaks down the framework by steps in the intervention and highlights best and promising practices for each.
Type: Document
Sponsoring organization: Zero Suicide in Health and Behavioral Health Care
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Rural Suicide Prevention Toolkit
Resources and best practices to develop rural suicide prevention programs. Identifies program models and examples, and discusses implementation, evaluation, sustainability, and dissemination of program results.
Type: Website
Sponsoring organization: Rural Health Information Hub
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Mental Health Explorer
An interactive web-based mapping tool focused on mental health. Provides access to data on mental health and wellness; the mental health workforce; and related social, behavioral, and health measures. Part of the HealthLandscape set of tools.
Type: Map/Mapping System
Sponsoring organization: American Academy of Family Physicians
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Mental Health in Rural Communities Toolkit
Resources and best practices to develop rural mental health programs, with a primary focus on adult mental health. Identifies program models and examples, and discusses implementation, evaluation, sustainability, and dissemination of program results.
Type: Website
Sponsoring organization: Rural Health Information Hub
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Scopes of Practice for Behavioral Health Professionals
Tool for finding state-by-state characteristics of the behavioral health professional workforce, including credentialing requirements and services they are allowed to perform.
Type: Tool
Sponsoring organization: Behavioral Health Workforce 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, updated daily.
Type: Map/Mapping System
Sponsoring organization: Health Resources and Services Administration
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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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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 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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Journal of Rural Mental Health
Peer-reviewed publication including articles on rural mental health research, practice, and policy. Serves as the 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
Provides a listing of free online courses for training healthcare and other service providers, educators, health professionals, public officials, and community-based coalitions to develop effective suicide prevention programs and policies. Courses are free but registration is required.
Type: Tutorial/Training
Sponsoring organization: Suicide Prevention Resource Center
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PubMed Search: Rural Populations, Rural Health Services and Suicide
Searches PubMed's collection of journal article citations on the topic of suicide related to rural populations and rural health services.
Type: Literature Search
Sponsoring organization: U.S. National Library of Medicine
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Mental Health First Aid
Details a public education program to assist the public in identifying, understanding, and responding 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: U.S. 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
Provides information, resources, and suicide prevention plans for all 50 states and the District of Columbia. Includes contacts, events, current legislation, and news updates for each state on the topic of suicide prevention.
Type: Website
Sponsoring organization: Suicide Prevention Resource Center
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Center of Excellence for Integrated Health Solutions
Provides access to evidence-based resources, tools, and support for organizations working to integrate primary and behavioral healthcare. Formerly the SAMHSA-HRSA Center for Integrated Health Solutions.
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 for professionals and other individuals working with American Indian and Alaska Native populations to support suicide prevention and promote mental health. Includes information on a culturally relevant approach to suicide prevention.
Type: Website
Sponsoring organization: Suicide Prevention Resource Center
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2-1-1 Information and Referral Service
Provides a free, confidential information and referral service for help with employment, food, housing, healthcare, addiction prevention programs, and counseling.
Type: Hotline
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APA: Rural Health
Provides a listing of publications, agencies, organizations, and other resources 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)
Interactive database system that provides fatal and nonfatal injury, violent death, and cost of injury data from a variety of sources. Offers fatal injury data available by metropolitan/nonmetro status in the Fatal Injury Reports section. Fatal Injury Mapping section provides access to county-level data.
Type: Database
Sponsoring organization: Centers for Disease Control and Prevention
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Behavioral Health Treatment Services Locator
Locate treatment facilities addressing substance use, 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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Additional resources are available related to this guide. See the full list of resources by topic for:


Last Updated: 11/25/2020