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Is Anybody There? The Penurious STATE Of Health Care Access in Small Town America

(Rural Health) -Travel distance, lack of public transportation, and the lack of health insurance covering mental health services are commonly identified as challenges to accessing healthcare in rural areas.

Reimbursement issues and the social stigma associated with mental health services are also identified as significant challenges that affect access and the provision of mental health services in rural areas.


The reimbursement offered by payers such as Medicaid, Medicare, and private insurers has a significant impact on the ability of rural providers to offer mental health services.

The publication Encouraging Rural Health Clinics to Provide Mental Health Services: What are the Options? notes that Rural Health Clinics may be reluctant to start providing mental health services when reimbursement rates are low.

In addition, high no-show rates among mental health clients and high numbers of uninsured patients further exacerbate the issue of low reimbursement rates paid by Medicaid and others.

Providing mental health services via telehealth, sometimes referred to as telehealth or telebehavioral health, has shown real promise in helping to alleviate the lack of mental health services in rural areas.


Nearly 1 in 5 adults in the U.S. experiences a mental disorder within any given year according to the National Alliance on Mental Illness. Yet, the misconceptions, myths, and cultural stigma associated with mental illness are significant barriers that keep people with mental health disorders from seeking and receiving treatment in rural areas.

Factors that may influence rural residents to avoid seeking care include such issues as:

  • Lack of understanding and knowledge of mental illness, sometimes even among healthcare staff

  • Prejudice or stigma towards people with mental health disorders, often based on fear and unease

  • Secrecy about mental illness in the community and general hesitancy to seek care

  • Perception of a lack of confidentiality and privacy in small towns with closely-tied social networks

While there are drawbacks to small communities when it comes to mental health, there are positives as well. The close-knit nature of rural communities can also mean that residents are more likely to rally around each other and provide community support in times of need. A strong external support group can help facilitate a person's success in treatment and also help support the family's efforts in attending to the care seeker.

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Article title, video inclusion and cover photo by SMW - Rural News Today.

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