Providing Psychiatric Services in a Rural Setting

Abstract

The provision of psychiatric services in rural areas is complicated by difficult and frustrating obstacles that tax the resourcefulness of the psychiatrist. Psychiatric care is at a premium because of the small number of psychiatrists practicing in rural areas. Moreover, the psychiatrists services must be efficiently organized if they are to have a significant impact on the mental health of the community being served. Rural areas are generally under served by psychiatrists. The Presidents Commission on Mental Health [l] noted the lack of mental health professionals, including the scarcity of psychiatrists, in rural areas and recommended specific actions to correct the manpower deficits. The National Institute of Mental Health (NIMH) [ 2] has called attention to the major disparity in psychiatric manhours between innercity mental health facilities and those in rural areas: inner-city facilities were found to have available to them 1,149.0 psychiatric hours per 100,000 population, whereas rural areas had only 72.0. The reasons for such a maldistribution of psychiatric manpower are varied. Tucker, Turner, & Chapman [ 3] have mentioned, for example, the influences of rural culture, personal needs, and professional isolation as factors that discourage psychiatrists from practicing in rural areas. There are additional stresses and barriers to effective rural