Mental and behavioral health: Rural Health Research Products & Journal Articles

2025

The Rural and Urban Supply of Clinicians With a DEA Waiver to Prescribe Buprenorphine in 2022 Prior to the Elimination of the Waiver Requirement
WWAMI Rural Health Research Center
Date: 04/2025
This data brief describes the supply of all clinicians with a DEA waiver to prescribe medication for opioid use disorder from 2017 to 2022. The supply of eligible clinicians grew in both rural and urban counties in five years. More rural counties lacked waivered clinician compared to urban counties.

2024

Trends in the Health Workforce Supply in the Rural U.S.
Report
WWAMI Rural Health Research Center
Date: 10/2024
This report examines the availability of current and historical workforce data for a variety of health care professionals and provides estimates of the trends in the supply and distribution in the rural vs. urban U.S. workforce.
Suicide Rates and Risks Across U.S. Industries: A 29-Year Population-Based Survey
Journal Article
Rural and Underserved Health Research Center
Date: 01/2024
Combining 29 years of U.S. suicide data using the National Health Interview Survey (NHIS)-Mortality Linked data from 1986 through 2014, with mortality follow-up through 2015, this study estimates suicide risks across industries in the U.S. working population.

2023

Geographic Variations in Driving Time to U.S. Mental Health Care, Digital Access to Technology, & Household Crowdedness
Journal Article
University of South Carolina Rural Health Research Center
Date: 12/2023
This study compared travel time to mental health facilities in rural versus urban areas and potential barriers to digital devices for telemedicine access in those same rural/urban locations. In addition, the research examined private space within the home as it relates to household crowdedness.
Psychological Distress Is More Common in Some Occupations and Increases With Job Tenure: A Thirty-Seven Year Panel Study in the United States
Journal Article
Rural and Underserved Health Research Center
Date: 03/2023
This study used 1981–2017 data from the Panel Study of Income Dynamics and the Screening Scale for Psychological Distress (Kessler K6) to identify occupations with low and high risks of mental health problems in the United States.
Rural Healthy People 2030: New Decade, New Challenges
Journal Article
Southwest Rural Health Research Center
Date: 03/2023
This study reports the findings of Rural Healthy People 2030, a companion piece to the Healthy People 2030 initiative with a focus on health priorities of rural populations. Data was collected from a survey given to rural stakeholders. Mental health, substance use, health care access, and economic stability were among the most important priorities.

2022

Rural-Urban Disparities in Quality of Inpatient Psychiatric Care
Journal Article
University of South Carolina Rural Health Research Center
Date: 11/2022
Using data from the Inpatient Psychiatric Facility Quality Reporting program 2015-2019, this study examined differences and changes in the quality of inpatient psychiatric care in rural and urban hospitals.
Changes in the Supply and Rural-Urban Distribution of Counselors in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of counselors by rural-urban status and Census Division.
Changes in the Supply and Rural-Urban Distribution of Psychiatric Nurse Practitioners in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of psychiatric nurse practitioners by rural-urban status and Census Division.
Changes in the Supply and Rural-Urban Distribution of Psychiatrists in the U.S., 1995-2019
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of psychiatrists by rural-urban status and Census Division.
Changes in the Supply and Rural-Urban Distribution of Psychologists in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of psychologists by rural-urban status and Census Division.
Changes in the Supply and Rural-Urban Distribution of Social Workers in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of social workers by rural-urban status and Census Division.
Social Isolation and Safety Issues Among Rural Older Adults Living Alone: Perspectives of Meals on Wheels Programs
Journal Article
University of Minnesota Rural Health Research Center
Date: 05/2022
In this article, we share results from a survey of 42 Meals on Wheels programs in rural areas across the US. Respondents highlighted challenges to meeting both social and safety needs of rural older adults living alone, as well as policy recommendations to improve the health and safety of older adults living alone in rural areas.
Meeting the Behavioral Health Needs of Farm Families in Times of Economic Distress
Policy Brief
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 02/2022
Economic fluctuations and periods of distress in farming cannot be eliminated, however, their impact on communities and individuals can be mitigated. Strategies for meeting the behavioral health needs of farm families by supporting community-based services, and expanding behavioral health services in rural contexts are highlighted in this work.

2021

Suicide Mortality Rates in Farm-Related Occupations and the Agriculture Industry in the United States
Journal Article
Rural and Underserved Health Research Center
Date: 09/2021
This article examines suicide mortality among agricultural workers comparing rural and urban residents using pooled data from the Mortality‐Linked National Health Interview Survey, 1986–2014.

2020

Acuity Differences Among Newly Admitted Older Residents in Rural and Urban Nursing Homes
Journal Article
Maine Rural Health Research Center
Date: 11/2020
This study found newly admitted residents of rural nursing homes were more likely to have cognitive issues/problem behaviors than those in urban facilities. Yet rural facilities admitted less complex older (age 75+) residents than urban, raising questions about the rural long-term services and supports system and capacity of rural nursing homes.
A Comparison of Rural and Urban Specialty Hospitals
Policy Brief
Rapid Response to Requests for Rural Data Analysis
Date: 09/2020
This brief describes key differences between specialty hospitals located in rural versus urban areas.
Telebehavioral Health Use Among Rural Medicaid Beneficiaries: Relationships With Telehealth Policies
Journal Article
Rural Telehealth Research Center
Date: 09/2020
This study assesses policy levers potentially supporting sustained use of telehealth services. Among rural Medicaid fee-for-service beneficiaries with behavioral health needs, engaging patients through informed consent within provider settings that receive facility fees may facilitate improved access to telebehavioral health services.
Comparing the Health Workforce Provider Mix and the Distance Travelled for Mental Health Services by Rural and Urban Medicare Beneficiaries
Journal Article
WWAMI Rural Health Research Center
Date: 08/2020
This study used 2014 administrative Medicare claims data to describe the mix of health professionals who care for rural and urban patients with mood and/or anxiety disorders. It further describes where these beneficiaries received care and the one-way distance (miles) and time (minutes) they travelled to receive it.
Measure and Data Element Identification for the HRSA Evidence-Based Tele-Behavioral Health Network Program and the HRSA Substance Abuse Treatment Telehealth Network Grant Program
Policy Brief
Rural Telehealth Research Center
Date: 04/2020
This brief details work to identify measures and develop data elements appropriate to tele-behavioral health, create an Excel-based tool, and collect data from grantees in the Health Resources and Services Administration's Evidence-Based Tele-Behavioral Health Network Grant Program and Substance Abuse Treatment Telehealth Network Grant Program.
Early-Career and Graduating Physicians More Likely to Prescribe Buprenorphine
Journal Article
Rural and Underserved Health Research Center
Date: 01/2020
Only a small percentage of people who need treatment for opioid use disorder receive it, including buprenorphine. This paper shows differences in rates of prescribing buprenorphine and intentions to prescribe buprenorphine between early- and mid-to-late career family physicians, based on a survey of physicians taking a certification examination.
Practice Predictors of Buprenorphine Prescribing by Family Physicians
Journal Article
Rural and Underserved Health Research Center
Date: 01/2020
Physicians may prescribe buprenorphine if they obtain a waiver, but relatively few family physicians do so. This paper examines the association between practice characteristics and the likelihood that a family physician will prescribe buprenorphine, based on a survey of physicians seeking board certification in family medicine.

2019

Tele-Emergency Behavioral Health in Rural and Underserved Areas
Journal Article
Rural Telehealth Research Center
Date: 11/2019
This paper describes how two distinct tele-emergency department (ED) behavioral health models address challenges in access and placement for patients in rural and underserved areas presenting to EDs. The notable difference in disposition rates between cases and controls shows the impact each model is having on care practices and processes.
Prescribing Practices of Nurse Practitioners and Physician Assistants Waivered to Prescribe Buprenorphine and the Barriers They Experience Prescribing Buprenorphine
Journal Article
WWAMI Rural Health Research Center
Date: 10/2019
This study surveyed rural and urban nurse practitioners (NPs) and physician assistants (PAs) with Drug Enforcement Agency waivers to provide medication treatment for opioid use disorder by prescribing buprenorphine. Rural NPs and PAs reported facing many of the same barriers to providing buprenorphine as rural physicians have reported.

2018

Patterns of Telehealth Use Among Rural Medicaid Beneficiaries
Journal Article
Rural Telehealth Research Center
Date: 10/2018
This study uses data from the 2011 Medicaid Analytic eXtract (MAX) to examine the prevalence of telehealth use among rural and urban Medicaid beneficiaries, characteristics of telehealth users, types of telehealth services provided, and diagnoses associated with telehealth use.
Geographic Variation in the Supply of Selected Behavioral Health Providers
Journal Article
WWAMI Rural Health Research Center
Date: 06/2018
This study examined the supply of select behavioral health providers by metropolitan, micropolitan, and non-core county and Census Division. Psychiatrists, psychologists, and psychiatric nurse practitioners are unequally distributed throughout the U.S., with disparities between Census Divisions and rural vs. urban areas.

2017

Barriers to Nursing Home Care for Nonelderly Rural Residents
Journal Article
University of Minnesota Rural Health Research Center
Date: 12/2017
This study uses data from 23 semi-structured interviews with rural hospital discharge planners in five states to identify specific barriers to finding nursing home care for nonelderly rural residents. We found three primary themes—payment status, fit, and medical complexity—as well as two minor themes—caregivers and bureaucratic processes.
Identifying Variability in Patient Characteristics and Prevalence of Emergency Department Utilization for Mental Health Diagnoses in Rural and Urban Communities
Journal Article
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 10/2017
Patients needing behavioral healthcare can get more appropriate, cost-effective treatment if they are redirected from emergency departments (EDs). This study examined whether a larger proportion of rural versus urban patients went to went to EDs.
Barriers Rural Physicians Face Prescribing Buprenorphine for Opioid Use Disorder
Journal Article
WWAMI Rural Health Research Center
Date: 07/2017
Opioid use disorder is a serious public health problem. Management with buprenorphine is an effective medication-assisted treatment, but 60.1% of rural counties lack a physician with a Drug Enforcement Agency waiver to prescribe buprenorphine. This national study surveyed all rural physicians who have received a waiver in the United States.
Use of the Emergency Department for Mental Health and Substance Abuse Among Women
Fact Sheet
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 07/2017
This study identifies trends among women in rural and urban communities who utilize the emergency department for mental health and substance abuse. The information can be used to help communities provide more relevant, appropriate, and less costly care.
Rural and Urban Utilization of the Emergency Department for Mental Health and Substance Abuse
Policy Brief
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 06/2017
Utilizes data from the Healthcare Cost and Utilization Project's (HCUP's) State Emergency Department Databases (SEDD) for seven states. Researchers explore, and describe in this brief, the use of the Emergency Department for mental health and substance abuse among Urban, Large Rural, Small Rural, and Isolated Small Rural residents.
Changes in the Supply of Physicians With a DEA DATA Waiver to Prescribe Buprenorphine for Opioid Use Disorder
Policy Brief
WWAMI Rural Health Research Center
Date: 05/2017
This project mapped the location of physicians with a DEA DATA 2000 waiver to prescribe buprenorphine for opioid use disorder in July 2012 and April 2016. The number of counties without a waivered physician and the ratio of waivered physicians per 100,000 population is reported by the rural/urban status of the county.

2016

Health-Related Quality of Life Among Adults 65 Years and Older in the United States, 2011-2012: A Multilevel Small Area Estimation Approach
Journal Article
University of South Carolina Rural Health Research Center
Date: 10/2016
This study compiled estimates, at the county level, of poor health-related quality of life among those ages 65 and older. The study examined physical and mental health and found significant differences in health across the United States.
Supply and Distribution of the Behavioral Health Workforce in Rural America
Policy Brief
WWAMI Rural Health Research Center
Date: 09/2016
This brief uses National Provider Identifier (NPI) data to report on the variability of the supply and provider to population ratios of five types of behavioral health workforce providers (psychiatrists, psychologists, social workers, psychiatric nurse practitioners, counselors) in Metropolitan, Micropolitan and Non-core rural areas across the U.S.
Understanding the Business Case for Telemental Health in Rural Communities
Journal Article
Maine Rural Health Research Center
Date: 07/2016
This article describes the current landscape and characteristics of rural telemental health programs and then examines their business case.
Adverse Childhood Experiences in Rural and Urban Contexts
Policy Brief
Maine Rural Health Research Center
Date: 04/2016
This study was designed to address the gap in the literature examining rural-urban differences in adults' exposure to adverse childhood experiences (ACEs) and to inform health system initiatives geared toward mitigating the impacts of ACEs on rural populations.
Mental Health First Aid in Rural Communities: Appropriateness and Outcomes
Journal Article
Maine Rural Health Research Center
Date: 01/2016
Mental Health First Aid (MHFA), an early intervention training program for general audiences, has been promoted as a means for improving population-level behavioral health in rural communities by encouraging treatment-seeking. This study examined MHFA's appropriateness and impacts in rural contexts.

2014

Implications of Rurality and Psychiatric Status for Diabetic Preventive Care Use Among Adults With Diabetes
Policy Brief
Maine Rural Health Research Center
Date: 05/2014
This brief examines patterns of diabetic preventive care use among adults with diabetes to determine whether these patterns vary according to respondents' rural/urban residence or the presence/absence of a mental health diagnosis.

2013

Telemental Health in Today's Rural Health System
Maine Rural Health Research Center
Date: 12/2013
This policy brief describes the organizational setting, services provided, and staff used in 53 telemental rural health programs. It also outlines the opportunities and challenges for telemental health in the rural health system.
Challenges and Opportunities for Improving Mental Health Services in Rural Long-Term Care
Maine Rural Health Research Center
Date: 06/2013
This study explores practices for increasing the quality, quantity, and accessibility of mental health services in rural long-term care.
Patterns of Care for Rural and Urban Children With Mental Health Problems
Maine Rural Health Research Center
Date: 06/2013
This study reports that rural children are significantly less likely to be diagnosed and treated for non-ADHD mental health problems than urban children and are less likely to receive mental health counseling.

2010

Access to Mental Health Services and Family Impact of Rural Children With Mental Health Problems
Maine Rural Health Research Center
Date: 10/2010
Rural children are more likely to have mental health problems, to have behavioral difficulties, and to be usually or always affected by their conditions than urban children. Rural children also are more likely to go without access to all parent-reported needed mental health services, and their families spend more time coordinating their care.
Mental Health Problems Have Considerable Impact on Rural Children and Their Families
Policy Brief
Maine Rural Health Research Center
Date: 10/2010
This policy brief provides information on the prevalence of children's mental health needs and associated access to care and family impact across rural and urban areas. Analyses are based on the 2005-06 National Survey of Children with Special Health Care Needs.
Mental Health Services in Rural Jails (Working Paper)
Maine Rural Health Research Center
Date: 08/2010
This study explored the role of rural jails in the mental health systems in rural communities, investigating how rural jails manage mental health and substance abuse problems among inmates, determining barriers to providing mental health services faced by rural jails, and identifying promising practices for service delivery.
Encouraging Rural Health Clinics to Provide Mental Health Services: What Are the Options?
Maine Rural Health Research Center
Date: 05/2010
This study examined changes in the delivery of mental health services by rural health clinics (RHCs), their operational characteristics, barriers to the development of services, and policy options to encourage more RHCs to deliver mental health services.
The Provision of Mental Health Services by Rural Health Clinics
Maine Rural Health Research Center
Date: 05/2010
This study examined changes in the delivery of mental health services by rural health clinics (RHCs), their operational characteristics, barriers to the development of services, and policy options to encourage more RHCs to deliver mental health services.
Assessment of the Mental Health Funding Marketplace in Urban vs. Rural Settings for Individuals With Serious Mental Illness (Findings Brief)
WICHE Center for Rural Mental Health Research
Date: 03/2010
This study was designed to assess the impact of rurality on the source of payment for mental health treatments and determine whether urban-rural differences in payment sources vary for the seriously mentally ill relative to all other mental health conditions.
Assessment of the Mental Health Funding Marketplace in Rural vs. Urban Settings (Working Paper)
WICHE Center for Rural Mental Health Research
Date: 02/2010
Rural residents are less likely to have mental health services funded through private insurance and more likely through public sources than urban residents, suggesting that targeting policies through public funding sources could be the most effective method to reduce urban-rural disparities in mental healthcare.

2009

Differences in Prescribing Patterns of Psychotropic Medication for Children and Adolescents Between Rural and Urban Prescribers
WICHE Center for Rural Mental Health Research
Date: 10/2009
This study reports that prescriptions of all psychotropic drug categories increased for urban and rural populations during the 10-year study period. Urban youth were more likely to be prescribed psychotropic medications by psychiatrists. In contrast, rural youth were more likely to have psychotropics prescribed by generalists or other prescribers.
Rural-Urban Differences in Depression Care (Working Paper)
WICHE Center for Rural Mental Health Research
Date: 10/2009
This paper assesses the association between rurality and depression care. It reports that rural individuals are more reliant on pharmacotherapy than psychotherapy.
Mental Health Services in Rural Jails (Policy Brief)
Policy Brief
Maine Rural Health Research Center
Date: 09/2009
The prevalence of mental illness among prison and jail inmates has attracted increasing attention in both mental health and criminal justice circles.
Addressing Suicide Potential and Prevention in Rural and Frontier Areas: Suicide Prevention Toolkit for Rural Primary Care Providers
WICHE Center for Rural Mental Health Research
Date: 08/2009
Suicide rates in rural areas are significantly higher than they are in urban areas for men of all ages and for young women. Research shows that many people visit their primary care physician instead of a mental health provider for mental health problems. A Suicide Prevention Toolkit for rural primary care providers is provided.
Distance Education Training in Behavioral Health: A Rural Primary Care Needs Assessment and Pilot Webcast
WICHE Center for Rural Mental Health Research
Date: 08/2009
Primary care providers (PCPs) are often the only resource for rural/frontier residents needing mental healthcare. Mental health training is not easily accessible for PCPs working in rural settings. Distance education offers a low-cost, convenient way for PCPs to obtain the information necessary to treat the mental health needs of their patients.
The Association Between Rural Residence and the Use, Type, and Quality of Depression Care
Policy Brief
WICHE Center for Rural Mental Health Research
Date: 05/2009
The purpose of the project was to assess the association between rurality and the use, type (pharmacotherapy versus psychotherapy), and quality of care among individuals in the Medical Expenditure Panel Survey with self-reported depression.
Rural Children Don't Receive the Mental Health Care They Need
Policy Brief
Maine Rural Health Research Center
Date: 01/2009
Controlling for other characteristics that affect access to care, rural children are 20% less likely to have a mental health visit than urban children. Having Medicaid or SCHIP increases the likelihood that a child will receive services, and this is pronounced in rural areas.

2008

Rural Adults Face Parity Problems and Other Barriers to Appropriate Mental Health Care
Maine Rural Health Research Center
Date: 11/2008
The findings of this policy brief suggest that a multi-level approach is essential for meeting the mental health service needs of rural residents.

2007

Rural Inpatient Psychiatric Units Improve Access to Community-Based Mental Health Services, but Medicare Payment Policy a Barrier
Maine Rural Health Research Center
Date: 08/2007
This study investigates the characteristics/admission processes of inpatient psychiatric units (IPUs) in rural hospitals with less than 50 beds and the community-based services available to them when discharging patients. Reasons for developing IPUs, barriers to opening and operating a rural IPU, and factors leading some to close are also explored.
Preventing Hospitalizations in Depressed Rural Primary Care Patients
WICHE Center for Rural Mental Health Research
Date: 05/2007
This study investigated the substitution of higher cost hospitalization for lower cost outpatient specialty care for depression and the extent to which insurance barriers impact service substitution patterns of outpatient specialty care for depression in rural and urban areas.
Use of Critical Access Hospital Emergency Rooms by Patients With Mental Health Symptoms
Journal Article
Maine Rural Health Research Center
Date: 2007
Describes the results of a study investigating the use of critical access hospital (CAH) emergency rooms by patients with mental health problems to understand the role these facilities play in rural mental health needs and the challenges they face.

2006

Rural-Urban Differences in Depression Prevalence: Implications for Family Medicine
Journal Article
University of South Carolina Rural Health Research Center
Date: 10/2006
Examined the prevalence of depression in rural vs. urban areas. An estimated 2.6 million rural adults suffer from depression. The unadjusted prevalence of depression was significantly higher among rural than urban populations. After adjusting for rural/urban population characteristics, the odds of depression did not differ by residence.
Differential Effectiveness of Depression Disease Management for Rural and Urban Primary Care Patients
Journal Article
WICHE Center for Rural Mental Health Research
Date: 09/2006
Is there a differential impact of enhanced depression care on patient outcomes in rural vs. urban primary care settings? Differences may be mediated by receiving evidence-based care (pharmacotherapy and specialty care counseling). Findings indicate that care for depression improved mental health for urban populations, but not rural patients.
Mental Health and Rural America: 1994-2005
WICHE Center for Rural Mental Health Research
Date: 2006
This report provides a summary of the current knowledge base surrounding mental health issues in America's rural and frontier areas and an overview of the environment of mental health in rural areas over three decades.
Mental Healthcare in Rural Communities: The Once and Future Role of Primary Care
Journal Article
Maine Rural Health Research Center
Date: 2006
Discusses issues related to the delivery of mental health services in the United States. Addresses how these issues complicate the delivery of services in rural areas. Offers an argument for integrating primary care and mental health in rural areas.
Modeling the Mental Health Workforce in Washington State: Using State Licensing Data to Examine Provider Supply in Rural and Urban Areas
Journal Article
WWAMI Rural Health Research Center
Date: 2006
Identifies mental health shortage areas using existing licensing and survey data. Shortages of mental health providers exist throughout the state, especially in rural areas. Urban areas had 3x the psychiatrist full-time equivalents (FTEs) per 100,000 and more than 1.5x the nonpsychiatrist mental health provider FTEs per 100,000 as rural areas.
Posttraumatic Stress Disorder in Rural Primary Care: Improving Care for Mental Health Following Bioterrorism
Journal Article
FORHP-funded Individual Grantees
Date: 2006
Describes the need to educate rural primary care providers who will be the frontline providers of mental health services following bioterrorism, given the limited availability of tertiary mental healthcare in rural communities.
PTSD and Substance Use: Unrecognized Sequelae of Bioterrorism in Primary Care Providers
Journal Article
FORHP-funded Individual Grantees
Date: 2006
Study looks at rural primary care providers' knowledge of likely mental disorders, their risk factors, and preferred treatment options following a public health emergency.
Rural and Frontier Mental and Behavioral Health Care: Barriers, Effective Policy Strategies, Best Practices
Maine Rural Health Research Center
Date: 2006
This report discusses barriers to mental and behavioral health service delivery in rural America. It includes model programs and model policy strategies for rural mental and behavioral healthcare delivery and discusses the roles that telehealth and that the State Offices of Rural Health should play in service delivery.
Smallest Rural Hospitals Treat Mental Health Emergencies
Maine Rural Health Research Center
Date: 2006
This research and policy brief discusses the extent to which rural emergency rooms encounter and treat mental health patients.
Stakeholder Benefit From Depression Disease Management: Differences by Rurality?
WICHE Center for Rural Mental Health Research
Date: 2006
Despite increasing consensus about the value of depression disease management programs, the field has not identified which stakeholders should absorb the relatively small additional costs associated with these programs. This paper investigates whether two stakeholder groups economically benefit from improved depression.

2005

Community-Level Risk Factors for Depression Hospitalizations
Policy Brief
WICHE Center for Rural Mental Health Research
Date: 09/2005
This policy brief examines the association between depression hospitalization rates and community-level socio-demographic, economic, and healthcare system characteristics.
Differential Effectiveness of Enhanced Depression Treatment for Rural and Urban Primary Care Patients
WICHE Center for Rural Mental Health Research
Date: 09/2005
This paper explored whether a depression disease management program has a comparable impact on clinical outcomes over two years in patients treated in rural and urban primary care practices.
Mental Health Encounters in Critical Access Hospital Emergency Rooms: A National Survey
Maine Rural Health Research Center
Date: 09/2005
This survey investigates the extent and types of cases that present with mental health problems in critical access hospital emergency rooms (ERs), as well as the resources available to ER staff for addressing such problems and what actually happens to these patients.
One Size Fits Some: The Impact of Patient Treatment Attitudes on the Cost-Effectiveness of a Depression Primary Care Intervention
Journal Article
WICHE Center for Rural Mental Health Research
Date: 2005
This study reports the estimated impact of patient receptivity to antidepressant medication on the cost-effectiveness of an evidence-based primary-care depression intervention.

2004

Are Advanced Practice Nurses a Solution to Rural Mental Health Workforce Shortages?
Maine Rural Health Research Center
Date: 04/2004
This paper summarizes the clinical skills and prescriptive authority of advanced practice psychiatric nurses and investigates current trends in their geographic distribution to determine what their future role may be in addressing rural mental health needs.

2003

Rural Health Research in Progress in the Rural Health Research Centers Program, 7th edition
Maine Rural Health Research Center
Date: 03/2003
This book provides policy makers with a concise source of rural health services research underway in the Rural Health Research Centers funded by the Office of Rural Health Policy. It provides a context for legislation current and proposed that affects rural health services and populations.

2002

The Role of Community Mental Health Centers as Rural Safety Net Providers
Maine Rural Health Research Center
Date: 05/2002
This paper investigates the extent to which those organizations formerly designated as community mental health centers currently act as a rural mental health safety net, e.g., provide mental health services for free or at reduced charges to rural populations not covered by public or private insurance or grants.
State Licensure Laws and the Mental Health Professions: Implications for the Rural Mental Health Workforce
Maine Rural Health Research Center
Date: 05/2002
This paper investigates whether and the extent to which licensure laws that determine the permissible scope of practice for each of these professions may affect the availability of mental health services, particularly in rural communities.
Essential Research Issues in Rural Health: The State Rural Health Directors' Perspective
NORC Walsh Center for Rural Health Analysis
Date: 03/2002
This policy brief describes the key issues confronting state rural health directors. Issues repeatedly raised by directors from a wide variety of states included workforce, telemedicine, emergency medical services, mental health, and lack of local data.

2001

Addressing Mental Health Workforce Needs in Underserved Rural Areas: Accomplishments and Challenges
Maine Rural Health Research Center
Date: 10/2001
This study reviews efforts to address mental health workforce needs in rural areas and addresses the questions: How is workforce adequacy measured? How do characteristics of communities and the mental health service delivery system challenge methods for determining workforce adequacy? What role has government played in addressing workforce needs?
Admission Severity and Mortality Rates Among Rural and Urban Nursing Facility Residents With Dementia (Research & Policy Brief)
Maine Rural Health Research Center
Date: 09/2001
This brief assesses whether the potentially higher use of nursing facility services in rural communities can be tied to differences in use patterns by older adults with dementia. Specifically, it addresses whether residents with dementia are less impaired at the time of their admission to a nursing facility than urban residents with dementia.
Medicaid Managed Behavioral Health Programs in Rural Areas
Policy Brief
Maine Rural Health Research Center
Date: 08/2001
This research and policy brief studies which states have implemented Medicaid-managed behavioral health programs in rural areas. It describes the programs in terms of Medicaid populations served, program design, and implementation model and the experience of programs regarding access to/coordination of services.
Medicaid Managed Behavioral Health in Rural Areas
Maine Rural Health Research Center
Date: 01/2001
This study of which states have implemented Medicaid managed behavioral health (MMBH) programs in rural areas describes these programs in terms of Medicaid populations served, program design, and implementation model. It also describes the experience of programs regarding access to and coordination of services.

1996

Integrating Primary Care and Mental Health Services: Current Practices in Rural Areas
Maine Rural Health Research Center
Date: 1996
This publication provides information on models for integrating mental health services in rural community health centers, viability of linkages between primary care and mental health providers, resources available, reimbursement, treatment philosophy, diversification, referral, and enhancement.

Unknown year

Assessment of the Mental Health Funding Marketplace in Urban vs. Rural Settings (Summary Brief)
WICHE Center for Rural Mental Health Research
Data from the National Comorbidity Survey Replication show that rural individuals with mental health problems are significantly less likely to receive mental health services than individuals in urban and suburban areas.
The Association Between Rural Residence and the Use, Type, and Quality of Depression Care (Final Paper)
WICHE Center for Rural Mental Health Research
Rural individuals are more reliant on pharmacotherapy than psychotherapy, which may be a concern if this is due to poor access to psychotherapy rather than a preference for antidepressants.