Rural mental health and psychological treatment: a review for practitioners

Smalley, K. Bryant; Yancey, C. Thresa; Warren, Jacob C.; Naufel, Karen Z.; Ryan, Rebecca G.; Pugh, James L.

doi:10.1002/jclp.20688

Cited by 159 publications

(177 citation statements)

References 45 publications

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“…The internet offers a method for delivering psychological interventions that is time-and resource-efficient, and has the benefit of providing treatment to those who may otherwise lack access to available services [53,54]. Moreover, online interventions have the potential to overcome many of the barriers to help-seeking that depressed individuals have reported in the past, including: cost, a shortage of trained professionals, concerns about anonymity, convenience, perceived stigma, and ease of accessibility [19][20][21][55][56][57].…”

Section: Online Psychological Interventions For Depressionmentioning

confidence: 99%

A Self-Paced, Web-Based, Positive Emotion Skills Intervention for Reducing Symptoms of Depression: Protocol for Development and Pilot Testing of MARIGOLD (Preprint)

Cheung¹,

Addington²,

Bassett³

et al. 2018

Preprint

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Background: Living with elevated symptoms of depression can have debilitating consequences for an individual's psychosocial and physical functioning, quality of life, and healthcare utilization. A growing body of evidence demonstrates that skills for increasing positive emotion can be helpful to individuals with depression. Although online interventions to reduce negative emotion in individuals with depression are available, these interventions frequently suffer from poor retention and adherence, and do not capitalize on the potential benefits of increasing positive emotion.

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Section: Online Psychological Interventions For Depressionmentioning

confidence: 99%

A Self-Paced, Web-Based, Positive Emotion Skills Intervention for Reducing Symptoms of Depression: Protocol for Development and Pilot Testing of MARIGOLD (Preprint)

Cheung¹,

Addington²,

Bassett³

et al. 2018

Preprint

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“…For example, these underserved areas display a shortage in medical and behavioral health providers which can impact patient access to health care. Also, stigma regarding the treatment of certain conditions (e.g., depression, sexually transmitted infection) also hinders patient engagement with time-sensitive treatment [1,2]. Research has shown that the use of telemedicine, especially in rural primary care settings, has been able to alleviate patient barriers to care and improve treatment efficiency [3,4].…”

Section: Introductionmentioning

confidence: 99%

Rural Provider Attitudes toward the Use of Social Media for Patient Engagement and Retention: A Brief Report

Stermensky¹

2017

IJCAM

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BackgroundRural clients and providers function with many barriers in place not necessarily barriers in urban settings. Common barriers to accessing healthcare services in rural communities include financial means to pay for services, distance to provider (transportation, the need to take time off of work), ability to communicate needs to healthcare providers, ability to utilize services without compromising privacy, and confidence in the quality of care they will receive. The use of social media in rural health services can be a tool to effectively reduce or eliminate some of these barriers for patients and providers. To determine feasibility of provider's willingness or belief social media can be used in patient services, it is important to track and identify current attitudes of providers toward the use of social media in rural settings. ObjectiveThe purpose of the study was to identify the attitudes and beliefs of healthcare providers in rural areas toward social media use as a means to improve patient engagement and retention in several domains of services. MethodsThe authors collected the rural provider data from a nationwide survey of healthcare providers towards the use of social media in patient services (N = 1,469). A subset of providers that identified themselves as working in rural areas was used for data analysis purposes. Data was collected electronically through survey questions disseminated through various alumni associations, professional association list serves, and university or college "email blasts". The survey solicited attitudes towards social media use in patients services across several domains. The authors analyzed the factor structure of the social media scale (including the following areas): ResultsOverall, providers demonstrated support for the utilization of social media. Analysis of the factor structure of the survey indicated two distinct factors, one for personal, protected information and another for social networking, compliance, outreach, and information dissemination. Providers were more likely to support social media utilization in healthcare services for the second factor.Exploration of the qualitative data indicate a perceived need for an enhanced role for mental health services (including access, policy, insurance coverage, length of treatment, and appropriate referrals made by medical professionals when necessary), more population based, preventative services, and different methods of holding patients accountable for compliance. Providers demonstrated overall advocacy for the utilization of social media. ConclusionsWhile a majority of practitioners support the use of social media in patient services (for the second factor), privacy, HIPPA, ethical, and other concerns are prevalent. The author concludes by discussing training implications, future directions for healthcare policy, and the need for regulatory bodies to invest time in developing social media policies and best practices..

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“…1 Implementation of integrated primary care in rural areas faces several additional challenges, most notably a higher prevalence of behavioral health conditions and difficulties with "accessibility, availability, and acceptability of mental health services." 18 Rural youth and adults suffer from depression and substance abuse at higher rates than nonrural youth and adults, and they also have a higher rate of completed suicides. 18,19 As of 1999, 87% of mental health professional shortage areas are in nonmetropolitan areas, making access to behavioral health care a major difficulty.…”

mentioning

confidence: 99%

“…18 Rural youth and adults suffer from depression and substance abuse at higher rates than nonrural youth and adults, and they also have a higher rate of completed suicides. 18,19 As of 1999, 87% of mental health professional shortage areas are in nonmetropolitan areas, making access to behavioral health care a major difficulty. 17 The stigma surrounding mental health persists and is especially strong in rural areas; maintaining confidentiality is difficult, as in the classic example of recognizing a neighbor's vehicle parked in a mental health facility's parking lot.…”

mentioning

confidence: 99%

“…These factors work together to decrease the likelihood that rural residents will seek care for behavioral health problems. 11,18 Regardless of how well designed an integrated primary care system is, both PCPs and BHPs must "buy in" for it to succeed and remain viable; therefore, obtaining the perspectives of these 2 groups is an important part of the integration process and can help identify philosophical and practical discrepancies between the 2 that may hinder successful integration. Proactively addressing these concerns has the potential to expedite the integration process and produce a more sustainable and successful end product.…”

mentioning

confidence: 99%

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Provider Perspectives on Integrating Primary and Behavioral Health: A Report from the High Plains Research Network

Burfeind

Seymour

Sillau

et al. 2014

The Journal of the American Board of Family Medicine

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Background: Integrated primary care, a health care delivery model that combines medical and behavioral health services, provides better patient access to care at a lower cost, with better outcomes compared with usual nonintegrated care models. The perspectives of primary care providers (PCPs) and behavioral health care providers (BHPs) toward integration are especially valuable because their input and endorsement are key to successful and sustained integration. However, there is little research assessing or comparing PCP and BHP perspectives on integration, especially in rural areas. The objective of this study was to identify rural PCP and BHP perspectives on integration.Methods: Written and electronic surveys were distributed to PCPs and BHPs in the High Plains Research Network in rural eastern Colorado. Items included perspectives on improving behavioral health care, barriers to integration, and confidence in the ability to integrate primary and behavioral care.Results: Surveys were completed by 88 PCPs (60%), and 49 BHPs (63%), for an overall response rate of 61%. PCPs were significantly more likely than BHPs to prefer improving referral methods (odds ratio [OR], 2.2; P ‫؍‬ .03) and significantly less likely to prefer colocation (OR, 0.2; P < .0001), warm handoffs (OR, 0.3; P < .01), improved behavioral health training for PCPs (OR, 0.4; P < .01), and shared visits (OR, 0.4; P ‫)30.؍‬ as ways to improve health care. Lack of sufficient methods of payment for behavioral health care services was the most commonly selected barrier to integration by both groups. PCPs were significantly more likely than BHPs to select recruitment (OR, 3.8; P < .001) and retention (OR, 2.7; P < .01) of behavioral health care staff as a major barrier. BHPs were slightly more optimistic than PCPs about the achievability of integration.Conclusions: Important differences of perspective exist between rural PCPs and BHPs regarding the best ways to improve behavioral health care, barriers to integration, and the achievability of integration. These differences may have important implications for rural communities and health care systems considering a transition to an integrated primary care model. (J Am Board Fam Med 2014;27:375-382.)

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Rural mental health and psychological treatment: a review for practitioners

Cited by 159 publications

References 45 publications

A Self-Paced, Web-Based, Positive Emotion Skills Intervention for Reducing Symptoms of Depression: Protocol for Development and Pilot Testing of MARIGOLD (Preprint)

A Self-Paced, Web-Based, Positive Emotion Skills Intervention for Reducing Symptoms of Depression: Protocol for Development and Pilot Testing of MARIGOLD (Preprint)

Rural Provider Attitudes toward the Use of Social Media for Patient Engagement and Retention: A Brief Report

Provider Perspectives on Integrating Primary and Behavioral Health: A Report from the High Plains Research Network

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