15 - Adjunctive Treatments for Rural Populations

Abstract

This chapter reviews the various definitions of rural versus urban areas, epidemiologic facts and trends, and the prevalence of mental health disorders in rural areas of the United States. It addresses some of the resulting clinical, social, and policy implications. It presents a discussion of the three major barriers to rural mental health services. It discusses evidence-based adjunctive treatments (EBATs) and the issues surrounding the development of an EBAT in rural communities. It presents a hypothetical implementation of a telehealth system and addresses cultural issues. Demographics, economics, and cultural values have a dynamic impact upon mental health and mental health care. Numerous barriers contribute to disparities in access to care and utilization of services and treatment of mental health disorders for rural residents. There is clear evidence that the availability of mental health services and the number of mental health providers in rural areas are severely inadequate. According to the Office of Rural Health Policy (1997), telemental health is one of the five most common applications for telemedicine in rural hospitals. In a healthcare environment that is technology-oriented, providers and patients are recognizing the benefits of telemental health services. Technology has the potential to decrease the gap in services by increasing education, support, and connectedness between the client and the provider. Health care providers are leveraging the power of video networks to link patients, specialists, and clinicians, thus extending the reach of health care to rural regions. Due to the use of telemental health, patients experience lower out-of-pocket costs, less travel, and shorter wait times as they receive medical care.