The Shortage of Mental Healthcare Facilities in Rural America
The Shortage of Mental Healthcare Facilities in Rural America
January 6, 2021 | Blog Post
Although the importance of mental health is increasingly being championed on celebrities’ social media and through other forms of public exposure, there are many regions in the US where it is extremely difficult- and sometimes even impossible- to receive treatment for psychological ailments. Rural communities are particularly susceptible to this problem, what with the limitation of resources, poor infrastructure, and lagging communication that often characterizes them. These elements have the effect of either fatally delaying medical assistance for those who desperately need it, or even de-incentivizes a medical presence in these regions altogether. This latter point is especially relevant when it comes to attracting new, young doctors to these areas who ideally would replace retiring practitioners. However, even for those who would otherwise be attracted to the lifestyles offered by some of these communities, the reality of unsatisfactory medical compensation makes them hesitant to accept jobs, especially because of their student-loan repayment obligations. These phenomena, paired with the growing need for prescription drugs, therapy, and in-patient facility care in these regions, make rural populations uniquely susceptible to experiencing extremely poor mental health outcomes, which discourages these communities from operating as optimally as they might otherwise.
A study published in the American Journal of Preventive Medicine, titled “Geographic Variation in the Supply of Selected Behavioral Health Providers,” illustrates these problems quite well. It reports that “65 percent of rural counties don’t have a psychiatrist, 47 percent don’t have a psychologist, and 81 percent don’t have a psychiatric nurse practitioner.”
These stunning statistics are only predicted to worsen. According to a recent report from the New American Economy on Healthcare, “The federal government estimates that almost 2,800 additional psychiatrists are needed to fill critical mental health care shortage areas. Equally concerning, the gap between the supply and demand of psychiatrists is expected to only widen as the need for psychiatrists is increasing rapidly.” The number of practitioners needed over the next ten years is estimated in the tens of thousands.
These shortages are already taking a palpable toll on rural mental healthcare providers. Their anecdotes focus largely on the nuances of insurance coverage for treatment, on the general lack of rural funding for proper physician salaries and the needed medical facilities, and on the ignored necessity for many more supportive services for doctors and citizens alike are visible on hundreds of online forums, as well as in magazine and newspaper articles that call attention to this national crisis.
In 2019, NPR interviewed a psychiatrist in International Falls, Minnesota: a small town of 6,000 whose circumstances are representative of rural America’s plight in this regard. Dr. Jeff Hardwig reported extreme overwork, the result of having to “take care of people of all ages, all the way through to the nursing home.” He treated everything from “anxiety and depression” to “ bipolar disorder and schizophrenia and anything else that came up.” When he eventually retired in the fall, he felt extremely guilty, as “he wasn't just the only psychiatrist in town; he was the only psychiatrist for more than a hundred miles around.” Nowadays, the local nursestation in International Falls is used as a makeshift psychiatric ward,” and is often occupied for hours at a time trying to find an available in-patient psychiatric bed throughout the entire state. If they are unable to house the patient in an official-ward, which is often the case, they are forced to convert their nurse ward beds into makeshift psychiatric ones.
A 2020 blogpost in Physicians Practice illustrates the national scale of this problem. Dr. Heather Cumbo, a psychiatrist based in Tampa, Florida, is frequently assigned rounds in rural areas. When asked about her job, she stated blatantly that she “works in a rural community that doesn't have a physician in their inpatient unit and another clinic that has a list of 250 patients waiting to see a doctor... I’m taking care of people that otherwise would not have any mental health care at all.”
Ultimately, it is important to recognize that mental illness does not discriminate between the people who suffer from it. This is a universal issue that most individuals deal with at one point or at many throughout the courses of their lives, regardless of socioeconomic status, race, gender or sexual orientation, religion, or zip code. Thus, as many people as possible should have access to quality resources that can help them along their personal mental health journeys. Although the struggles suffered by rural communities are only one facet of the disparity-ridden realm of mental healthcare, relieving the tensions felt by their physicians and citizens alike will be an integral part of moving the US towards an overall healthier state of mind.
Joseph Gaspero is the CEO and Co-Founder of CHI. He is a healthcare executive, strategist, and researcher. He co-founded CHI in 2009 to be an independent, objective, and interdisciplinary research and education institute for healthcare. Joseph leads CHI’s research and education initiatives focusing on including patient-driven healthcare, patient engagement, clinical trials, drug pricing, and other pressing healthcare issues. He sets and executes CHI’s strategy, devises marketing tactics, leads fundraising efforts, and manages CHI’s Management team. Joseph is passionate and committed to making healthcare and our world a better place. His leadership stems from a wide array of experiences, including founding and operating several non-profit and for-profit organizations, serving in the U.S. Air Force in support of 2 foreign wars, and deriving expertise from time spent in industries such as healthcare, financial services, and marketing. Joseph’s skills include strategy, management, entrepreneurship, healthcare, clinical trials, diversity & inclusion, life sciences, research, marketing, and finance. He has lived in six countries, traveled to over 30 more, and speaks 3 languages, all which help him view business strategy through the prism of a global, interconnected 21st century. Joseph has a B.S. in Finance from the University of Illinois at Chicago. When he’s not immersed in his work at CHI, he spends his time snowboarding backcountry, skydiving, mountain biking, volunteering, engaging in MMA, and rock climbing.