Technology in rural behavioral health care practice: Policy concerns and solution suggestions.

Abstract

There is a history of expectations attached to the use of technology to better facilitate rural behavioral health care service delivery. Clinicians, scholars, and government officials alike have touted the benefits of technology to provide better, more accessible behavioral health care, and often consider it a way to bridge the "geographic divide." The use of technology is viewed as a response to problems associated with improving consumer contact. Although the use of technology has effectively addressed many service delivery concerns, it continues to fall short of being the overarching remedy to what ails rural behavioral health care needs. Often, challenges associated with the full implementation and utilization of technology into rural behavioral health care is in conflict with state and federal policies and laws. Identifying and responding to these barriers is important to move opportunities for growth forward, but requires more than hope and limited support. There is a need for committed political will matched with focus and desire along with the allocation of adequate resources. Suggestions for policy changes and responses are offered to encourage continued dialogue on this topic.

The experiences of north-central rural Appalachian clients who utilize mental health services.

“…Provider professional development through online courses, professional collaboration, and supervision would serve to enhance cultural competence in north-central Appalachia. Mackie (2015) cautioned that although technology has been effective in addressing access and service delivery, it should not be seen as a panacea for rural behavioral health care needs and must be coupled with political will and policy revisions (p. 5). A snapshot of the challenges experienced by the participants in this study reveals that improved awareness on the part of all stakeholders as it relates to diagnosis, medications, stigma, and access to services may contribute positively to improving the experiences of individuals utilizing mental health services in north-central Appalachia.…”

Child and adolescent telepsychiatry in an academic-community partnership: Providers’ perceptions on teamwork.

“…Finally, the financial viability of the community–university intervention may be limited because the service was implemented as an educational training grant. In addition, others have noted, the promise of telemental health is limited in rural communities by challenges associated with broadband infrastructure (Mackie, 2015).…”

On the frontier: Exploring rural psychologist practice in integrated behavioral health care.

“…Immense geographic isolation is a tangible marker for the barriers to behavioral health care. Intangible markers for rural populations include lack of adequate access to psychiatric services and social welfare support, cultural values that impact utilization of behavioral health services due to stigmatization, confidentiality concerns within small communities, and issues related to socioeconomic status and access to health insurance (Harowski et al, 2006;Mackie, 2015;Wagenfeld, 1997;Schank et al, 2010;Helbok, Haldeman, & Gallardo, 2010).…”

“…This included challenges with providing services to a geographically vast area and having few referral resources (Admundson, 2001;Lin et al, 2016). For example, my category Vast Catchment and Void of Resources illuminated well-documented challenges (Harowski et al, 2006;Mackie, 2015;Wagenfeld, 1997). As one participant said, "we have a significantly large geographical catchment area, but a relatively small population, which makes referrals difficult because we are located in a rural community" (Case 4).…”