Behavioral health conditions, including mental health and substance use disorders, impacted 53 million Americans in 2022. COVID-19 exacerbated awareness of provider shortages and increased behavioral health challenges. This project seeks to examine trends in behavioral health-related emergency department visits and hospitalizations over five years (2017-2021) by urban-rural residence and age cohort and identify factors influencing these outcomes, such as geography, insurance, and socioeconomic status.

A quantitative pooled cross-sectional research design will be employed using 2017-2021 State Emergency Department Databases and the National Inpatient Sample data. This design will allow us to conduct both trend and multivariable analyses on longitudinal data to test our hypotheses.

Our research findings will highlight the growing needs for ambulatory behavioral health services in rural America and where that need is most pronounced. Additionally, given the Federal Office of Rural Health Policy's mission to increase access to care for underserved rural Americans, the findings of our work will inform the office's policy efforts to increase the availability of professionals that are equipped to address behavioral health issues in rural areas. These findings will also equip local and state decision-makers with the empirical evidence they need to justify allocating critically needed funding for these endeavors.