The role of clinical psychology in rural mental health services: Defining problems and developing solutions.

Jameson, John Paul; Blank, Michael B.

doi:10.1111/j.1468-2850.2007.00089.x

Cited by 112 publications

(135 citation statements)

References 75 publications

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“…Psychotherapeutic treatments need to be shortterm, problem-focused interventions with demonstrated efficacy. Jameson and Blank (2007) suggest that the utilization of empirically supported treatments (ESTs) in rural community mental health center (CMHCs) may prove particularly beneficial and in fact relieve some of these issues because ESTs tend to possess these characteristics. Moreover, ESTs are by definition manualized in detail, a feature which limits training costs and promotes the feasibility of adoption in rural clinics.…”

Section: Introductionmentioning

confidence: 99%

Empirically Supported Treatments in Rural Community Mental Health Centers: A Preliminary Report on Current Utilization and Attitudes Toward Adoption

Jameson

Chambless

Blank

2009

Community Ment Health J

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Rural community mental health centers (CMHCs) face numerous problems that might be alleviated by the dissemination of empirically supported treatments (ESTs). The current study lays the groundwork for EST dissemination by examining current treatment practices in rural clinics as well as the attitudes of decision makers toward ESTs and perceived barriers to their adoption. Twenty-five rural and 38 non-rural clinical directors responded to a mailed survey. Rural respondents were as likely as non-rural respondents to report EST use in their clinic for most anxiety disorders, and more likely to report use of an EST for major depressive disorder and obsessivecompulsive disorder. However, ESTs represent a relatively small proportion of the treatments reported for depression and anxiety disorders. Attitudes toward manualized ESTs did not differ between groups. Further, rural and nonrural clinics did not see the barriers to the adoption of ESTs as insurmountable. These preliminary results suggest that rural CMHCs are open to the use of ESTs and should be included in widespread dissemination initiatives.

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Section: Introductionmentioning

confidence: 99%

Empirically Supported Treatments in Rural Community Mental Health Centers: A Preliminary Report on Current Utilization and Attitudes Toward Adoption

Jameson

Chambless

Blank

2009

Community Ment Health J

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“…Rural communities are a particularly vulnerable population in relation to mental health and mental health care [9]. Rural populations are already at increased risk for health disparities [10].…”

Section: Introductionmentioning

confidence: 99%

Cross-sectional population based study ascertaining the characteristics of US rural adults with mental health concerns who perceived a stigma regarding mental health issues

Pederson¹,

Lutfiyya²,

Palombi³

et al. 2013

Health

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Introduction: Mental health is an important component of overall health. Mental illness is a leading cause of morbidity and mortality in the US and is associated with chronic diseases such as heart disease, diabetes, and arthritis. In the US, most people with mental health issues or disorders remain untreated. Epidemiological studies have identified rural residents as being at greater risk for health disparities; as a result, rural residents are a vulnerable population in terms of mental health and mental health care. Research has demonstrated that perceived stigma can be a significant barrier to rural residents seeking mental health care. This study examined the research question: What are the characteristics of US rural adults with mental health concerns who perceived stigma? Methods: 2007 Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed using bivariate and multivariate techniques to answer the research question. 2007 BRFSS data were used because in that year non-institutionalized US adults in 37 states and territories were queried about their attitudes toward mental illness. BRFSS is a random digit telephone survey that uses a complex multi-stage sampling approach and subsequently a weighting factor is calculated for application to the data in order to ensure that they are representative of the US population based on the most recent census data.Only weighted data were analyzed. Results: Logistic regression analysis revealed that rural adults reporting mental health concerns who perceived stigma regarding mental health were more likely to be unemployed seeking work or not working and not seeking work, military veterans, or to have deferred medical care because of cost. They were also more likely to not have a health care provider and to rarely or never feel supported emotionally. Conclusions: Support systems may render people with mental health issues less vulnerable to perceiving stigma, thus assisting with removing stigma as a barrier to care. Pharmacist may play a role as support in communities, especially where access to health care providers may be limited.

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“…If rural veterans do indeed use psychotherapy less frequently than their urban counterparts, improving rural inhabitants' access to psychotherapy is likely to require novel solutions that consider the geographic, economic, and cultural features of rural environs. 14 The current study sought to examine psychotherapy utilization among rural and urban veterans with a newly diagnosed condition of depression (major depressive disorder, dysthymia, major depression not otherwise specified), anxiety (agoraphobia, anxiety disorder not otherwise specified, anxiety due to a general medical condition, generalized anxiety disorder, obsessivecompulsive disorder, panic disorder, social phobia, specific phobia, and unspecified anxiety states), or PTSD. Specifically, this study sought to examine whether differences exist between rural and urban veterans in terms of psychotherapy initiation, delay and dose (4 or more and 8 or more sessions).…”

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confidence: 99%

Use of Psychotherapy by Rural and Urban Veterans

Cully

Jameson

Phillips

et al. 2010

The Journal of Rural Health

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Purpose: To examine whether differences exist between rural and urban veterans in terms of initiation of psychotherapy, delay in time from diagnosis to treatment, and dose of psychotherapy sessions. Methods: Using a longitudinal cohort of veterans obtained from national Veterans Affairs databases (October 2003 through September 2004), we extracted veterans with a new diagnosis of depression, anxiety, or posttraumatic stress disorder (PTSD) (n = 410,923). Veterans were classified as rural (categories 6-9; n = 65,044) or urban (category 1; n = 149,747), using the US Department of Agriculture Rural-Urban Continuum Codes. Psychotherapy encounters were identified using Current Procedural Terminology codes for the 12 months following patients' initial diagnosis. Findings: Newly diagnosed rural veterans were significantly less likely (P < .0001) to receive psychotherapy (both individual and group). Urban veterans were roughly twice as likely as rural veterans to receive 4 or more (9.46% vs 5.08%) and 8 or more (5.59% vs 2.35%) psychotherapy sessions (P < .001). Conclusions: Rural veterans are significantly less likely to receive psychotherapy services, and the dose of the psychotherapy services provided for rural veterans is limited relative to their urban counterparts. Focused efforts are needed to increase access to psychotherapy services provided to rural veterans with depression, anxiety, and PTSD.

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The role of clinical psychology in rural mental health services: Defining problems and developing solutions.

Cited by 112 publications

References 75 publications

Empirically Supported Treatments in Rural Community Mental Health Centers: A Preliminary Report on Current Utilization and Attitudes Toward Adoption

Empirically Supported Treatments in Rural Community Mental Health Centers: A Preliminary Report on Current Utilization and Attitudes Toward Adoption

Cross-sectional population based study ascertaining the characteristics of US rural adults with mental health concerns who perceived a stigma regarding mental health issues

Use of Psychotherapy by Rural and Urban Veterans

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