Problems in, and Prospects for, Rural Mental Health Services in the United States

Wagenfeld, Morton O.; Buffum, William E.

doi:10.1080/00207411.1983.11448938

Cited by 12 publications

(10 citation statements)

References 14 publications

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“…Elkin and Boyer (1987), in examining the characteristics of those who enjoyed working in rural areas, found that they have a predisposition to small-community life; are patient oriented rather than profession or prestige oriented; have a pioneering spirit; have a significant other to share in the experience; possess an ability to be innovative, resourceful, open, and flexible; have an array of general skills; have a tolerance for risk taking; and are able to cope with the stress of being highly visible in the community. Wagenfeld and Buffum (1983) asserted that rural practice affords one the opportunity to be a true generalist, allowing one to experience autonomy, diversity, and creativity. The psychologist in a rural community can have a visible impact within an entire community, which can be more rewarding than practicing in the relative anonymity of an urban community.…”

Section: Resultsmentioning

confidence: 99%

“…Sundet and Mermelstein (1983) pointed out that competence also includes awareness of the interdependence and interaction of residents with social institutions and that one needs to be aware of community standards. Wagenfeld and Buffum (1983) related that psychologists need to appreciate the unique culture of a rural area, that many practitioners were educated in urban areas and may "be inclined to impose an urban value system or an urban model of service delivery where it is not appropriate" (p. 93). Cook et al (1998) pointed out that there may still be some debate as to whether a distinct rural culture exists, but they highlighted many characteristics common to rural communities I have mentioned in this article (e.g., strong family ties, avoidance of conflict, strong independent character, fatalistic and stoic attitudes, limited tolerance of diversity, fear and stigmatization of mental illness).…”

Section: Related Respectivelymentioning

confidence: 97%

“…HELBOK Several writers have discussed the lack of specialists and referral sources in rural communities and mentioned that psychologists may be called on to provide care outside their usual areas of expertise without optimal supports (Birk, 1992;Cook et al, 1998;Hargrove, 1982;Murray & Keller, 1991;Roberts et al, 1999;Wagenfeld & Buffum, 1983). Keller, Murray, Hargrove, and Dengerink (1983) stated that the single most accepted element for rural mental health training is that such persons must be generalists … the same individual may be required to provide services to children; senior citizens; marital couples; deinstitutionalized , chronically mentally ill; persons in crisis; and alcoholics (p. 14).…”

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confidence: 98%

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The Practice of Psychology in Rural Communities: Potential Ethical Dilemmas

Helbok¹

2003

Ethics & Behavior

130

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The practice of psychology in rural areas offers unique challenges for psychologists as they try to provide optimal care, often with a minimum of resources. Psychologists are frequently required to be creative and flexible in order to provide effective services to a wide range of clients. However, these unique challenges often confront psychologists with ethical dilemmas and problems for which their urban-based training has not prepared them. The author examines how certain characteristics of rural communities may lead to specific ethical dilemmas. By being a part of a small community, psychologists will inevitably face multiple relationship dilemmas. Confidentiality is harder to maintain in a small town, particularly with its informal information-sharing network. To provide services to meet community needs, with a limited number of referral options, psychologists typically need to be generalists. This may lead to concerns about scope of practice, training, and experience with diverse populations. Psychologists also face other competency issues, such as a lack of supervision and consultation resources. Other concerns addressed include the psychologist's personal life, and the blurring of professional and personal roles. Suggestions are made for coping with each of these ethical issues, although more quantitative research and discussion are needed on the practice of psychology in rural areas.

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Section: Resultsmentioning

confidence: 99%

Section: Related Respectivelymentioning

confidence: 97%

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confidence: 98%

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The Practice of Psychology in Rural Communities: Potential Ethical Dilemmas

Helbok¹

2003

Ethics & Behavior

130

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“…For instance, when an entire town knows where the psychologist's office is located, it is difficult for an individual to even park at that office without word spreading of his use of services. The increased stigma and decreased anonymity likely combine to leave rural residents less likely to seek care than their urban counterparts (Wagenfeld & Buffum, 1983), and may contribute to rural residents' perceptions that psychological services are less available and accessible to them (Rost, Fortney, Zhang, Smith, & Smith, 1999). Because of lowered accessibility, availability, and acceptability, rural residents suffering from mental health disorders tend to require a higher ''need-for-care threshold'' before seeking treatment, leading them to enter care later, enter with more serious symptoms, and require more intensive treatment (Rost, Fortney, Fischer, & Smith, 2002;Wagenfeld, Murray, Mohatt, & DeBruyn, 1994).…”

Section: The State Of Mental Health In Rural Areasmentioning

confidence: 97%

Rural mental health and psychological treatment: a review for practitioners

et al. 2010

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Practitioners in rural areas face particular challenges in providing psychological services, ranging from disparate rates of mental disorders to unique circumstances in treating special populations. In this article, we discuss the burden of mental disorders in rural areas, current trends in integration of mental health care and primary care, and unique concerns practitioners face in treating two special populations in rural areas (children and families, and older adults and their caregivers). Implications for practice are also discussed.

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“…The myth of the rural resident as being independent, strong, and living a peaceful nonstressful life has lead many to underestimate the need for mental health services in such communities. However, there is considerable evidence that the prevalence of social and health problems in rural areas generally exceed those in urban areas (Wagenfeld & Buffum, 1983).…”

Section: Characteristics Of Rural Communitiesmentioning

confidence: 99%

National survey of psychological practices across rural and urban communities

Helbok¹

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The purpose of this study was to examine potential differences in the practice of psychology across urban and rural communities. The review of the rural literature suggests that psychologists in rural areas are likely to encounter numerous ethical dilemmas and problems that are related specifically to the characteristics of such communities. To date, however, much of this literature has been based on theory and the individual experiences of practitioners. This study sought to quantify any differences in the practice of psychology across communities for such ethical issues as multiple relationships, competency, burnout, confidentiality, and visibility in the community. A survey instrument was created based on previous surveys of ethical practices. A national sample of 1000 psychologists, stratified into urban and non-urban practitioners, was obtained from the American Psychological Association. After several mailings 447 usable surveys were returned. Data analysis revealed significant differences between urban/suburban and small town/rural groups, particularly for the dependent variables of multiple relationships and visibility. Significant differences were found across gender such that male psychologists are more likely than female psychologists to engage in a range of multiple relationship behaviors, and female psychologists are significantly more likely to make use of support from supervisors, colleagues, family and friends. Psychologists in private practice are significantly more likely than those in institutional settings to engage in multiple relationships, to find their work satisfying and rewarding, and to have control over their work environment; whereas practitioners in institutional settings are more likely to have support from colleagues and supervisors, and to work when too distressed to be effective. Psychologists with more experience are significantly more likely to engage in multiple relationship behaviors than those with less experience. Psychologists with a psychodynamic orientation are more likely to make use of supervision and to discuss case work with colleagues than other orientations. The most common concern listed, across community type and gender, is a lack of alternative referral sources. Results from this survey are compared to previous surveys of ethical practices. Qualitative results are categorized and discussed. Suggestions are made for future research based on these findings.

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Problems in, and Prospects for, Rural Mental Health Services in the United States

Cited by 12 publications

References 14 publications

The Practice of Psychology in Rural Communities: Potential Ethical Dilemmas

The Practice of Psychology in Rural Communities: Potential Ethical Dilemmas

Rural mental health and psychological treatment: a review for practitioners

National survey of psychological practices across rural and urban communities

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