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Rural Behavioral Health Care

Key Considerations

In 2015, an estimated 27.1 million people in the United States used an illicit drug in the prior month- this equates to one in ten Americans. According to the National Institute on Drug Abuse, abuse of substances including tobacco, alcohol, and illicit drugs 

costs the United States more than $740 billion annually in crime, loss of productivity, and heath care. Rural areas are likely to face exacerbated risk for substance use disorders and substance use has been identified as a public health crisis in the rural United States. Rural Healthy People 2010 recognized substance use as one of the ten top priorities for rural America. 

 

The rates of drug and alcohol use in South Carolina are similar or slightly lower than the national rates of use, however, the use of opioids is on the rise—especially in rural South Carolina. Over the past five years there has been a thirty-two percent increase in inpatient services and emergency room visits related to substance use in South Carolina. The highest rates of substance use disorders in South Carolina are found in women, people age 25-44 and people with low income from rural areas. 

Unique Considerations for Rural Communities

In addition to the limited availability of substance abuse treatment and recovery services in rural communities, there are other unique considerations for clients seeking behavioral care services. These include:

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  • Difficulty accessing supplementary or support services (e.g. AA, NA, shelters)

  • Greater geographic distances & limited access to transportation

  • Lower utilization & treatment completion rates

  • Higher financial burden of services

  • Increased stigma & privacy concerns for rural residents

  • Technological challenges for provider training, intra-agency communication, or telehealth services

Implications for Rural Practice

Behavioral care services can be vital to promoting the health and wellness of rural residents. Those who are interested in entering rural behavioral care practice should consider the following practice tips:

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  • Assess community needs while understanding that not all rural areas are the same

  • Encourage integration of behavioral health within primary care & mental health settings

  • Promote flexible service delivery including day, night, and walk-in opportunities

  • Assure spiritual & religious diversity in treatment services

  • Identify options for accessing transportation, childcare, & other barriers

  • Promote low-cost, evidence-based interventions

  • Encourage partnerships and collaboration with other service providers—including partnerships to provide technical assistance and evaluation

This work was supported by contract number 201712381A proviso 33.22(E)(4) which is a legislative grant funded by a rural health proviso with the South Carolina Department of Health and Human Services (SCDHHS). The work was approved by and developed in conjunction with DHHS and the USC school of Medicine. The points of view or opinions in this project are those of the authors and do not necessarily represent the official position or policies of the SCDHHS.

Copyright © 2018. All Rights Reserved.

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