There’s an urban-rural divide in Minnesota that doesn’t get talked about much: mental health.
Many believe that “big city” problems like drugs, crime, gangs and violence pose a greater threat to mental health than life in a rural, small town.
However, research shows that this is not the case.
Rural Americans experience higher rates of depression and suicide than their urban counterparts, and new research suggests that these long-standing mental health inequities stem from a variety of factors, including affordability, access to care, and persistent stigmas around seeking medical care.
The study, published in JAMA Network Open by the University of Minnesota School of Public Health, University of Minnesota School of Medicine and School of Social Work, addresses a rural mental health workforce shortage that has long been a barrier to care by analyzing factors that influence where medical professionals choose to practice.
The study used survey data collected by the Minnesota Department of Health from February 2022 to February 2023 and incorporated responses from four groups of mental health care professionals: mental health clinicians who prescribe medications, such as psychiatrists, licensed mental health professionals, including professional clinical counselors, licensed psychologists and licensed alcohol and drug counselors.
Key findings include:
- Professionals with rural backgrounds were significantly more likely to practice in rural areas. The association between growing up in a rural area and practicing in a rural area was consistent across all professional groups, but was highest for licensed alcohol and drug counselors at 75%.
- The decision to practice in a rural area varies greatly by profession, with licensed alcohol and drug counselors most likely to practice in a rural area and psychologists least likely.
- Seeking autonomy in clinical practice was an important factor for rural clinical practice among psychologists and other prescribers, suggesting that the ability to work independently and make professional decisions is an important motivator for these groups.
- Financial incentives, such as loan forgiveness programs, were important factors influencing the decision to practice in rural areas, especially for licensed mental health professionals and licensed psychologists.
“There is an urgent need to address the lack of and disparities in access to mental health care in rural areas of the United States,” SPH associate professor and lead author Carrie Henning Smith said in a news release. “While there is no one-size-fits-all solution to this challenge, there is a clear need for targeted, multifaceted recruitment strategies to encourage more people in rural areas to engage in mental health care.”
The authors suggest that policy interventions to encourage rural residents to enter the mental health professions should focus on strengthening education, training, and licensure pathways and tailoring recruitment strategies to the specific motivations of different professional groups.
The study builds on research published by the authors in 2023 that focused on factors related to health care providers’ decisions about where to practice and was supported by a 3M Social Justice Rural Health Research Award.
There are resources to help people experiencing a mental health crisis. Minnesota has mobile mental health crisis teams available 24/7 in every county. These crisis teams will work with you over the phone to assess what’s happening and determine the best next steps to take, which may include dispatching a mobile team to your location.
Mental Health Minnesota has a database of mental health crisis teams on their website, making it easy to find what you need no matter what county you live in. Mental Health Minnesota’s search tool allows you to search by county to find the closest crisis team. In Douglas County, the phone number is 1-701-364-0431 and is provided by the Region 4 South Adult Mental Health Consortium (https://www.r4sconversations.org/).
You can also call or text 988 to connect with the 988 Suicide and Crisis Lifeline, which is also available 24 hours a day, 7 days a week. Lifeline Centers will work with you if you’re experiencing a mental health crisis and connect you to additional resources and crisis interventions if needed.
