Rural Behavioral Health: Where Are We & Where Are We Going

Rural Behavioral Health: Where Are We & Where Are We Going

Rural Behavioral Healthcare Landscape

Open spaces, green fields, a slower way of life, a stronger sense of community – there are many perceived beneficial aspects to living in a rural area. However, like everywhere, the mental and behavioral health needs of rural communities are critical. 

Healthcare shortages in rural communities is common when it comes to physical medical treatment and is even more common with mental health treatment. The disparity between availability of behavioral health services for urban and rural is obvious yet research shows us that both populations experience behavioral health disorders at nearly the same rate.  

  • One in five Americans live in a rural area (60+ mil)
  • 80% of rural counties do not have a psychologist
  • Rural suicide rate is 55% higher than urban counterparts and increases more year over year
  • Rural overdose death rate surpassed the urban rate in 2015
  • Mental health and substance use treatment are often siloed
  • Primary care has become the front line for rural behavioral health

Medical organizations have called for a collective effort from lawmakers and lawyers to physicians and community leaders to help bring forth solutions. Below are the challenges they are up against in impacting the mental health HPSA (Health Professional Shortage Areas) and encouraging patient care.

Rural Behavioral Healthcare Challenges


  • Availability of care
  • Transportation
  • Social stigma / Privacy
  • Costs
  • Internet limitations
  • Work demands

Healthcare Facility

  • Shortage of healthcare professionals
  • Professional isolation
  • Compensation
  • High caseloads
  • Technology limitations

Mebs Counseling Increases 100+ Encounters In One Week Using Telehealth

Mebs Counseling began delivering behavioral health services almost twenty years ago, providing children, families, adults and couples with evidence-based behavioral health and substance abuse wrap-around services in the Northern Kentucky area.

Mebs Counseling is unique in that most of their services and support are provided outside of the clinic. They work across schools, institutions, and off-site centers, often through a team approach that engages multiple caregivers for a single patient. While many of these sessions are conducted in person, Mebs Counseling needed a way to help ease connections between patients and caregivers through a remote care option like Azalea Health’s telehealth.

Trends In Rural Behavioral Healthcare

Integrated Behavioral Healthcare with Primary Care

Mental health and physical health are so deeply intertwined it isn’t always clear which is at the root. It can be a classic chicken and egg scenario. Is unhealthy eating leading to depression? Or is chronic pain causing depression that results in unhealthy eating?

Compounding health issues, patients suffering from MHD (mental health disorder) or SUD (substance use disorder) are less likely to seek preventative care or treatment.

We are starting to see rural primary care settings offering more behavioral health diagnosis and treatment. It is important to intertwine these services and facilities as a first step in diagnosis and treating the patient.

Behavioral Health Cost Impact on Chronic Conditions

Research has shown that healthcare costs rise considerably when treating patients with chronic health conditions – such as diabetes or congestive heart failure(CHF) – and a behavioral health disorder (BHD).

Teletherapy for Farmworkers

We are hearing first reports from projects such as the new teletherapy project with farmworkers in North Carolina. Recently published by Civil Eats and Food and Wine publications, details of farmworker conditions and lack of access to MHD and SUD specialists are coming to light.

The articles state that many of America’s two to three million farm workers suffer from behavioral health disorders. The project in North Carolina allowed farmworkers access to mental health professionals via an iPad and hotspot.

The impact was positive and the organization, NCFHP (North Carolina Farmworker Health Program) hopes it can serve as a model for others.

Communities Investing in Behavioral Health Services

More and more states are looking to fund new and expanded behavioral health services within their communities. For instance, Washington’s governor recognized the benefit of treating mental health and substance use disorders locally. In 2019, Washington debuted a $117 million dollar capital investment program that will work to expand behavioral health services in local communities.

In California, a seven million dollar grant was divided and awarded to 16 community college districts in the state to support expanding mental health services to their students. Some students will delay their degrees to seek treatment and this funding can help students obtain their degree while undergoing treatment.

Behavioral Health EHR Solutions

While many specialties have experienced technological growth within the EHR sector, behavioral health has seen slower adoption and less product development. Behavioral health hospitals and clinics need flexible solutions that can be tailored to their needs.

Azalea Health is committed to empowering underserved providers and communities using affordable, modern technology. If your rural behavioral health hospital or outpatient clinic is looking for the right Behavioral Health EHR solution, schedule a meeting with one of our rural health technology experts.

Sources: Rupri.orgFood & Wine,