Lauren Broffman1,2, Margaret Spurlock3,4, Kristen Dulacki1, Amy Campbell1, Fanny Rodriguez1, Bill Wright1, K John McConnell3,4,5, Donald Warne6, Melinda M Davis3,7. 1. Center for Outcomes Research and Education, Providence Health & Services, Portland, Oregon. 2. Robert F. Wagner School of Public Service, New York University, New York, New York. 3. Oregon Rural Practice-Based Research Network, Oregon Health & Science University, Portland, Oregon. 4. Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, Oregon. 5. Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon. 6. Master of Public Health Program, North Dakota State University, Fargo, North Dakota. 7. Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.
Abstract
PURPOSE: More than 25% of US adults experience mental health or substance use conditions annually, yet less than half receive treatment. This study explored how rural participants with behavioral health conditions pursue and receive care, and it examined how these factors differed across American Indian (AI) and geographic subpopulations. METHODS: We undertook a qualitative follow-up study from a statewide survey of unmet mental health and substance use needs in South Dakota. We conducted semistructured phone interviews with a purposive sample of key informants with varying perceptions of need for mental health and substance use treatment. RESULTS: We interviewed 33 participants with mental health (n = 18), substance use (n = 9), and co-occurring disorders (n = 6). Twenty participants (61.0%) lived in rural communities that did not overlap with AI tribal land. Twelve participants (34.3%) were AI, 8 of whom lived on a reservation (24.2%). The discrepancy between actual and perceived treatment need was related to how participants defined mental health, alcohol, and drug use "problems." Mental health disorders and excessive alcohol consumption were seen as a normal part of life in rural and reservation communities; seeking mental health care or maintaining sobriety was viewed as the result of an individual's willpower and frequently related to a substantial life event (eg, childbirth). Participants recommended treatment gaps be addressed through multicomponent community-level interventions. DISCUSSION: This study describes how rural populations view mental health, alcohol, and drug use. Enhancing access to care, addressing discordant perceptions, and improving community-based interventions may increase treatment uptake.
PURPOSE: More than 25% of US adults experience mental health or substance use conditions annually, yet less than half receive treatment. This study explored how rural participants with behavioral health conditions pursue and receive care, and it examined how these factors differed across American Indian (AI) and geographic subpopulations. METHODS: We undertook a qualitative follow-up study from a statewide survey of unmet mental health and substance use needs in South Dakota. We conducted semistructured phone interviews with a purposive sample of key informants with varying perceptions of need for mental health and substance use treatment. RESULTS: We interviewed 33 participants with mental health (n = 18), substance use (n = 9), and co-occurring disorders (n = 6). Twenty participants (61.0%) lived in rural communities that did not overlap with AI tribal land. Twelve participants (34.3%) were AI, 8 of whom lived on a reservation (24.2%). The discrepancy between actual and perceived treatment need was related to how participants defined mental health, alcohol, and drug use "problems." Mental health disorders and excessive alcohol consumption were seen as a normal part of life in rural and reservation communities; seeking mental health care or maintaining sobriety was viewed as the result of an individual's willpower and frequently related to a substantial life event (eg, childbirth). Participants recommended treatment gaps be addressed through multicomponent community-level interventions. DISCUSSION: This study describes how rural populations view mental health, alcohol, and drug use. Enhancing access to care, addressing discordant perceptions, and improving community-based interventions may increase treatment uptake.
Authors: Daniel P Chapman; Charles L Whitfield; Vincent J Felitti; Shanta R Dube; Valerie J Edwards; Robert F Anda Journal: J Affect Disord Date: 2004-10-15 Impact factor: 4.839
Authors: Melinda M Davis; Margaret Spurlock; Kristen Dulacki; Thomas Meath; Hsin-Fang Grace Li; Dennis McCarty; Donald Warne; Bill Wright; K John McConnell Journal: J Rural Health Date: 2015-10-30 Impact factor: 4.333
Authors: Elizabeth H Golembiewski; Derek L Gravholt; Victor D Torres Roldan; Eddy P Lincango Naranjo; Sebastian Vallejo; Andrea Garcia Bautista; Christina M LaVecchia; Christi A Patten; Summer V Allen; Soumya Jaladi; Kasey R Boehmer Journal: Ann Fam Med Date: 2022 May-Jun Impact factor: 5.707
Authors: Teresa N Brockie; Jacquelyn C Campbell; Gail Dana-Sacco; Jason Farley; Harolyn M E Belcher; Joan Kub; Katie E Nelson; Jerreed D Ivanich; Li Yang; Gwenyth Wallen; Lawrence Wetsit; Holly C Wilcox Journal: Prev Sci Date: 2022-06-01