WICHE Publications, Papers, and Reports

Working Paper

The most recent data from the National Comorbidity Study Replication (NCS-R) indicate that rural individuals with MH problems are significantly less likely to receive any MH care for their disorder than individuals in urban and suburban areas. The NCS-R also reports that of those patients who do receive mental health care, rural patients are significantly more likely to receive general medical care only and significantly less likely to receive specialty mental health care. Because patients receiving care in the specialty mental health sector are substantially more likely to receive adequate care (45.4%) than patients receiving care in the general medical sector only (12.7%), this indicates that rural individuals are receiving poorer quality care. Reduced access to MH care in rural areas are undoubtedly due to an inadequate supply of MH specialists. Additionally, primary care (PC) providers, who provide the vast majority of MH care to persons living in rural areas, do not have the training necessary to provide evidence based psychotherapy, thus eliminating one of the primary treatment modalities for people with MH problems. The lack of MH specialists in rural areas is likely due to inadequate incentives for these specialists to practice in rural areas. Furthermore, previous research has shown that health plans are more likely to rely on demand side cost containment strategies for rural enrollees than supply side strategies. This may result in rural residents paying more out-of-pocket for mental health services. Additionally, the source of funding for MH services may differ depending on the type of mental illness.

2010 ~ 21pp. ~ PDF ~ 129 KB

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  Summary Report

  Findings Brief

SUMMARY REPORT

Depression and suicide are especially relevant today in rural areas because of rapid expansion of the aging population in U.S. rural areas, and the fact that persons 65+ have led in suicide rates since 1970. Rural areas have a higher share of aging residents, with more health problems, and more limited access to health services than urban areas. Additionally, DHHS reports indicate that approximately 20% of U.S. residents aged 55+ have a mental disorder, including depression, which has been shown to be highly related to suicide attempts and completions. Accordingly, the increasing prevalence of older residents in rural areas makes these areas prime candidates for training in suicide-prevention interventions that could be extremely helpful to the principal health care resources in such rural areas – namely, primary health caregivers.

2009 ~ 34pp. ~ PDF ~ 427 KB~ DOWNLOAD

This paper assesses the needs of rural primary care providers for trraining on mental health issues.

2009 ~ 25pp. ~ PDF ~ 204 KB~ DOWNLOAD

This article, published in the Chronicle for Higher Education, discusses colleges' need for a new approach to serving students with mental-health problems, whose numbers are likely to rise as a result of the economic crisis.

2009 ~ 3pp. ~ PDF ~ LINK ~ DOWNLOAD

This Web-based Toolkit contains information and tools to implement state of the art suicide prevention practices and overcome the significant hurdles this life-saving work faces in primary care practices. The Toolkit is a collaborative project of the Suicide Prevention Resource Center (SPRC) and the Western Interstate Commission of Higher Education (WICHE), Mental Health Program. Although the tools are designed with the rural practice in mind, most are quite suitable for use in non-rural settings, as well.

order a toolkit online now

Hard copies of the toolkit are available for $25.00 (includes shipping) through WICHE Mental Health Program. A Pocket Guide for Primary Care Professionals is also available for $1 each. It reviews assessment and interventions with potentially suicidal patients and is also included in the toolkit.

For more information, please contact Joanne Brothers at jbrothers@wiche.edu

2009 ~ Printed copies available ~ Web page ~ LINK

This paper assesses the association between rural residence and the use, type, and quality of depression care

2009 ~ 24pp. ~ PDF ~ 96 KB~ DOWNLOAD

Policy Brief

From the WICHE Center for Rural Mental Health Research, this policy brief summarizes nationally representative data on community-level risk factors associated with schizophrenia hospitalizations. It examines how socio-economic factors and the makeup of local health care systems affect the rate of schizophrenia hospitalizations. It identifies geographic areas with elevated rates. It also presents a discussion about the findings. It should be of interest to government and private health plan administrators, as well as those responsible for designing mental health delivery systems – anyone interested in creating outpatient treatment programs that may prevent costly hospitalizations.

2007 ~ 2pp. ~ PDF ~ 88 KB~ DOWNLOAD

This document was produced in response to the pressing mental health needs of an underserved population. It describes the current status of deafness and hearing loss in America, the prevalence of mental health issues in deaf populations, and an overview of the behavioral health workforce as it pertains to both rural and deaf/hard of hearing populations.

2006 ~ 38pp. ~ PDF ~ 321 KB~ DOWNLOAD

Working Paper

From the WICHE Center for Rural Mental Health Research, this study explores whether enhanced depression care has comparable impact on clinical outcomes over two years for patients treated in rural and urban primary care practices and whether differences are mediated by receiving evidence-based care (pharmacotherapy and specialty care counseling).

2005 ~ 14pp. ~ PDF ~ 84 KB~ DOWNLOAD

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  Executive Summary

  1p. ~ PDF ~ 9 KB ~ DOWNLOAD