Economic fluctuations and periods of distress in farming cannot be eliminated, however, their impact on communities and individuals can be mitigated by improving access to behavioral health and other support services. These have been historically compromised by inadequate rural community resources, and rural shortages of behavioral health treatment facilities and limited infrastructure for delivering other forms of needed support. Many of the unmet behavioral health needs among rural farm families are tied to social determinants of health, as well as access challenges and limited coordination with community-based services.

The strategies offered here to support the development of systems and improved integration of services across health care and community-based organizations include (1) leveraging select payment systems and demonstrations to support coordinated care for families in distress, and (2) aligning grant programs from multiple federal agencies to address mental health and substance use disorders among farm families. Further, the existing rural health care infrastructure is inadequate to meet ongoing rural behavioral health needs, and has limited capacity to respond to surges in demand. The strategies included here that relate to expanding behavioral health services in rural settings are: (3) integrating primary and behavioral care to provide initial treatment of mental health and substance abuse concerns, (4) expand the workforce to improve rural behavioral health services capacity, (5) increasing telehealth services and repurposing available space to expand access to behavioral health services, and (6) expanding private and public insurance coverage to improve access to essential behavioral health services.