The Impact of Substance Abuse on Mental Health in Rural America

Though rural areas may provide a serene atmosphere and less traffic, they often lack the resources necessary to treat addiction or mental health issues. Accessing healthcare can be difficult in these regions, making it much harder for people to receive help for substance abuse or mental illness than those living in urban America. To gain an understanding of why this is so, it’s important to acknowledge the disparities between rural health and that of urban communities.


Healthcare In Rural America

It is well-known that people in rural America face strenuous roadblocks to receiving quality healthcare services. This could explain why they are more susceptible to chronic conditions such as diabetes, heart issues, and cancer. There exists a multilayered combination of factors behind this troublesome reality, including:

  • a shortage of healthcare institutions and mental health providers
  • deteriorating quality of available healthcare systems
  • transportation issues with healthcare accessibility
  • lack of financial resources for primary care services
  • social dynamics like stigmatization
  • invasive communities and lack of privacy


Access To Behavioral Health

Residing in rural America presents an extra burden to those struggling with addiction or mental health concerns. As revealed by reports from the Substance Abuse and Mental Health Services Administration (SAMHSA), these rural patients often require even more of such services than their urban counterparts; however, they are more deprived of behavioral healthcare than city dwellers. Three key factors contribute to the issue at hand:



For individuals to seek treatment, it must be perceived as relevant, beneficial, and worth the effort. In certain communities, a normalization of mental health issues such as depression or substance abuse can present an additional challenge for those seeking help. Privacy concerns and cultural appropriateness also have significant impacts on if someone is willing to get assistance or not.



Too often, hospitals and clinics overlook specialized services, leaving a lack of practitioners who are able to competently employ evidence-based practices.



The travel requirements are too extreme, the transportation is sparse, and poverty has blocked access to necessary services in rural settings. This risky situation creates a dangerous environment for rural Americans who desperately need behavioral health services but cannot obtain them due to external factors.

Recent data gathered by the University of Southern California’s online MSW program has revealed an alarming trend in suicides across America:

  • Suicide is tragically now one of the top 10 causes of death in America.
  • In comparison to urban areas, rural populations experience significantly higher rates of suicide.
  • As opposed to metropolitan areas, rural regions are seeing a more rapid rise in suicide rates.


Impact Of The Opioid Epidemic

The Opioid crisis is having an immense effect on Americans, particularly in rural areas. Due to the labor-intensive nature of jobs such as agriculture and mining in these communities, work-related injuries are more widespread. As a result, these small towns often lack access to therapies like physical therapy, leaving providers no choice but to rely heavily on opioids for pain management.

However, if a client starts to abuse these substances, due in part to the social networks present in smaller communities, there is little access to treatment. This has perpetuated a cycle of addiction with far-reaching consequences that must be addressed urgently if we want any hope of mitigating this devastating epidemic.


The Role Of Telehealth

Thankfully, technology has opened the door to improved care in rural communities. Telehealth usage is soaring in these areas, particularly for substance abuse and mental health treatment which were previously difficult or impossible to access. This increased availability of healthcare gives people hope that they can get the help they need no matter where they live.

Leveraging information and communications technologies, such as videoconferencing, emailing, and texting, telehealth is helping to bridge the gaps in acceptability, availability, and accessibility that rural Americans encounter. This cutting-edge technology has proven invaluable for better delivering healthcare services to those living in remote or rural areas of our country.


Addressing Acceptability Barriers

Telehealth has the potential to offer a groundbreaking solution for those living in rural areas. For example, it can be used to give confidential therapies and treatments through emails that contain advice and self-help strategies, preventing subthreshold depression from becoming clinical. By delivering these services online, individuals don’t have to reveal their condition or risk disclosure within their communities.

With telehealth technology, individuals can receive assessments or treatment for mental health and substance use disorders without others knowing their purpose of visit. They may access these sophisticated systems from hospitals, clinics, educational institutions, professional offices, and various other settings that provide privacy. For example, someone could easily go to a primary care provider’s office or a community clinic and access this type of confidential service.

Telehealth applications can provide a useful platform for educating healthcare personnel about behavioral health issues. Moreover, it is an incredibly convenient tool to educate and train behavioral health professionals on technical, ethical, cultural, and professional competencies they will need when working with people in rural areas.


Addressing Availability Barriers

Telehealth is a powerful tool that has the potential to tighten the rural-urban treatment gap. It can connect people in remote locations with high-quality behavioral health services and providers from more populated areas. Of all of the technologies available, video telehealth seems to be the closest replica of office-based therapy, and studies have revealed that satisfaction levels and outcomes for video telehealth users are comparable to those receiving face-to-face treatments!

The unbelievable potential of telehealth can be leveraged to benefit patient care by providing access and opportunity for collaboration. In rural areas especially, this technology could offer a solution to practitioner isolation while ensuring all individuals have equitable healthcare options.


Addressing Accessibility Barriers

Telehealth has revolutionized the way providers, and their clients can access services, creating a more convenient solution that negates the need for excessive travel time or expense. Not only do families benefit from having less of an interruption in their daily lives, but institutions also reap the rewards through reduced expenditure associated with practitioners’ distant site visits. Telehealth’s effectiveness even facilitates approaches that would not have been possible before its innovation.


Bridging the Gap in Mental Health Services Between Urban and Rural Communities

To bridge the rural-urban divide in behavioral health services, we must attack a variety of intricate roadblocks and devise innovative solutions to complex difficulties that are often exclusive to more rural areas. Yet, neither clients nor service providers from these regions have to fight this battle on their own. Professional resources are available.

The Journal of Rural Mental Health, as well as professional organizations such as the National Association for Rural Mental Health, are devoted to the progress and replication of successful rural behavioral health programs. Telehealth has become a notable way to improve access to quality mental healthcare in remote areas. This is sure to increase an individual’s chances of connecting with necessary services no matter where they live or work.

Moreover, telehealth is ready for tremendous expansion. Not only is technology rapidly advancing, but healthcare laws are also being modified to extend coverage for telehealth services and make them available to more people than ever before.


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The Union Workforce Initiative is for educational, training, and awareness purposes only. This is not an Employee Assistance Program. We help build awareness within the workforces of employer/employee assistance professionals, substance abuse professionals, nurses, doctors, and other educational professionals.