Economics

Milestone Two

Mental Health in Rural Communities

Mental health is a significant issue, and if not addressed and cared for properly, it can result in suicide or injury to others. "The National Alliance on Mental Illness (NAMI), about 60 million Americans suffer from a diagnosable mental health illness each year" according to their 2013 study (Klein, 2009). The rural populations account for 20% of the entire population. These are people that face significant barriers to health care access but even more tremendous obstacles to mental health treatment.

Urban dwellers have a better standard of life than those in rural settings. People in remote areas faces challenges of being uninsured or to have a restricted or expensive health insurance plan. Twelve percent of rural residents were not insured in 2015 especially that that are not elder according to (Healthcare Access in Rural Communities, 2018). Because there aren't many jobs available, or those that are available don't offer health insurance, they do offer has a higher price; this might be the cause. For example, “in 2006, some small company employees in Ashe County, North Carolina, had health insurance with a deductible of $2,000 more than” (RHRC, 2009). As a result of lower educational levels and/or higher poverty rates, the individuals tend to lack mental health literacy (Healthcare Access in Rural Communities, 2018). Distance and lack of transportation are two other issues that rural residents face while trying to get medical services. For other people, taking a few hours or a full day off working to see a provider means that they may not have enough money to cover their expenses. It's very uncommon for people to have follow-up visits every week, month, or even quarter; these meetings need time away from work, which often leads them to abandon their mental health treatment. Rural areas can have a stigma. Those living in rural areas may lack mental health literacy, may have privacy concerns, or maybe afraid of what their neighbors would think of them if they seek help ("Rural Mental Health," 2018). Many of the problems with providing mental health care rest on the providers, the states, and the federal government.

In terms of delivering mental health care in remote areas, one of the major challenges is a lack of caregivers. That means that barely 10 percent of all psychiatrists and psychologists are employed in rural regions, according to Dennis Mohatt (Slide4, 2018), But most healthcare professionals aren't prepared to engage with rural residents and lack the necessary cultural familiarity to handle any problems they may encounter (Slide9, 2018). They may not accept residents' insurance, require payment beforehand, or only pick medical treatments that their insurance will cover rather than those best for the patient. Mental health treatment is underfunded in rural areas, while the US spends $113 billion on it, or 5.6% of the total budget [Kli12]. Despite the fact that outpatient treatment and prescription drugs account for the vast majority of the money spent on these services in urban areas, people in areas that are rural more likely to be hospitalized for treatment because they wait much longer to seek assistance, there are no other choices available, or they have already done anything detrimental to themselves or others. More than 65 percent of rural people had relied on their primary care physician for mental health assistance when no psychotherapists, psychologists, counselors, or other mental health professionals were accessible (Slide4, 2018). Only via referrals or prescription medicines can primary care providers learn how to manage patients with mental disorders. In the US and across the world, there are groups working to improve mental health treatment in rural communities.

The American Psychological Association has established a Committee on Rural Health in the United States (CRH). According to the CRH, “The committee's goal is to guarantee that the mental healthcare requirements of rural and remote Americans are satisfied." It is the CRH's goal to make a significant difference in rural areas, and they are doing so by utilizing technology advancements to assist in training, hosting consultations, and enhancing access. In addition, they are striving to find and distribute providers in remote regions (CRH,2018). Despite the fact that there are several organizations committed to assisting rural communities, there is still an urgent need for further effective way to assisting rural people.

Programs have been established in a number of states around the country. “In Nebraska, hotline employees have been taught mental health, and mental health workers have been trained in difficulties that farmers frequently encounter” (Slide13,2018). In rural regions, Michigan's Centers for people with Mental Health problems have shut down their outpatient clinics as well as transferring their employees to family clinics. As a result, there were fewer cancellations and no-shows for appointments, and recommendations were up (Slide18, 2018). Hospital staff psychiatrists in Wyoming are sent out into the community to aid those who live in more remote areas of the state (Slide15, 2018). These effective projects must be turned into a national policy that everyone can apply. The Rural Mental Health Initiative is a policy I devised (RMHI). The RMHI's three main goals are training mental health professionals, educating the rural community, and establishing satellite clinics throughout the region. The rural cultural education of the mental health personnel will help them better comprehend the struggles of these people. There is a perception that mental health issues are taboo in small towns; this might change that perception. The primary focus of the strategy should be on establishing satellite infrastructure. A minimum of one day a week would be required of mental health professionals working in these institutions to assist the residents. They would accept all forms of insurance, but they may have to conduct the service "pro gratis." There would also have to be a monthly meeting for all the physicians to address the patients and/or similar concerns frequently brought up by the patients. A strategy like the one I envisioned may become a reality if the federal government follows the lead of states that have already implemented mental health services for rural residents.

In any given year, roughly one in every five individuals in America struggles with a mental illness (Rural Mental Health, 2018). Even while the vast majority of these people will have straightforward, or at the very least more convenient, availability of healthcare care, those who live in remote locations will almost certainly never receive assistance for their concerns. The United States is making progress, but we cannot stop thinking until we can expand availability of healthcare care in rural regions.

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