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There's a severe shortage of mental health professionals in rural areas

By AJ Willingham and Elizabeth Elkin, CNN

(CNN) - Almost every American will, at some point or another, face a mental health challenge. It may be related to depression, anxiety, suicidal thoughts, substance abuse or maybe something more circumstantial like grief over a loss or trouble adjusting to a life change. The CDC reports 43.4 million adults suffered from some sort of behavioral health issue in 2015 alone.

Now, imagine there wasn't a psychiatrist or psychologist for miles around, let alone another specialist who these millions of people could trust with their specific needs. This is what life is like for many Americans in rural communities.

A new study in the American Journal of Preventive Medicine finds that a majority of non-metropolitan counties (65%) do not have a psychiatrist and almost half of non-metropolitan counties (47%) do not have a psychologist.
This is troubling because poor access to mental health care, according to experts, is a serious issue that overlaps with other public health crises like drug abuse and suicide.


Limited access means care is a last resort

Jackson Rainer is a clinical psychologist who has practiced in rural communities in western North Carolina and South Georgia. He says the problem is obvious: There's just not enough options; in some areas, no options at all.

"People in rural communities have limited access to the diversity of care they may need. There are very few services offered and people have to travel to reach them," he says. "Typically, the first closest providers are generalists, and there is very little specialized care. There is no community (public) mental health care, and often there are no relevant hospital services within a reasonable distance. So, people are just left on their own."


Behavioral health practitioners by county type
Providers per 100,000 people

Census Division Psychiatrists Psychologists Psychiatric NPs
Overall US 15.6 30.0 2.1
Metropolitan 17.5 33.2 2.2
Non-metropolitan 5.8 13.7 1.6
Non-core 3.4 9.1 0.9
Non-cores are counties whose major city or clusters of cities have populations of < 10K or do not have a substantial population center
Source: American Journal of Preventive Medicine, 2018

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