More rural Americans have medical insurance that covers mental-health services, but that increase may be tempered by a lack of professionals who provide those services, a new report says.

Researchers have previously documented a disparity in the number of psychiatrists who serve nonmetropolitan counties. But the shortage extends to other metal-health professionals such as social workers, counselors, and psychologists, according to a brief from the Rural Health Research Center and the Rural Health Research & Policy Centers.

“Accurate estimates of the number of rural psychiatrists and other behavioral health providers are especially important now, when an increasing number of rural residents are insured for behavioral health care and demand is growing,” the report said, citing a journal article in the Journal of the American Board of Family Medicine.

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Public and private insurers are now required to offer mental-health benefits under the Affordable Care Act. Although the report does not go into how implementing health-care reform has affected the use mental-health services in rural America, the implication is that expanded benefits, plus an increase in the number of residents who have health-care insurance, will increase demand for mental-health services.

Nonmetropolitan counties have one-third as many psychiatrists per capita as metropolitan counties do, the report said. Nonmetro counties have about half the number of psychologists and social workers per capita.

The gap widens when researchers look at the nation’s smallest counties – so-called “non-core” counties, which aren’t a part of a multi-county statistical area and have no town of 10,000 residents and up. Those counties have less than a fifth of the number of the psychiatrists per capita than metropolitan counties do.

“Over 15 million rural Americans face some kind of behavioral health issue—substance abuse, mental illness, or medical-psychiatric co-morbid conditions,” the research brief said.

The brief also noted that primary-care physicians are more likely to treat mental-health conditions than their urban counterparts.

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