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behavioral health, emergency department


People living in rural communities face unique challenges when seeking effective treatment for serious mental health conditions. Multiple barriers may exist when individuals are experiencing behavioral health challenges. Care may be delayed because of several factors including: stigma of needing mental health care, privacy/confidentiality in the rural setting, shortage of professional mental health providers, a lack of culturally-competent care, affordability of care and transportation to a mental health provider. These challenges create delays in receiving vital mental health services. When care is postponed, rural individuals may experience an emergent health crisis resulting in emergency department visits for immediate intervention. Utilization of the emergency department may not be the appropriate intervention depending on the care required. Many deep rural healthcare organizations rely on family practice physicians and advanced practice providers to meet community health needs. These providers may lack the resources necessary to adequately prevent mental health emergencies. According to a recent report by Merritt Hawkins, a physician search and consulting firm, 77 percent of U.S. counties face a serious shortage of psychiatrists, and the AAMC projects that there will be a shortage of as many as 3,400 psychiatrists by 2032. What’s more, ED visits related to mental health is on the rise with mental health ED visits seeing a 44 percent increase between 2006 and 2014. Our research will examine the impact behavioral health services have on emergency departments and determine what improvements can be made to ensure appropriate use of emergency services while simultaneously providing prompt, quality behavioral health services.

First Advisor

Jewel Shepherd

Research Area

Health Services Administration