HJAR Jan/Feb 2021

56 JAN / FEB 2021 I  HEALTHCARE JOURNAL OF ARKANSAS RURAL HEALTH TO TRULY address rural health, you can’t just put your finger on a barrier or two; you have to take the community members by the hand and lead them out of poor health and personal crisis and into educational oppor- tunities and better training. We need to bring the talent and solutions to them, as well as from within them. In the end, it all comes down to doing what rural communities do best – collaboration. Poor mental and behavioral health have long been a major concern for communi- ties across the nation. Stigma surrounding mental health and the lack of understanding and/or misunderstanding related to preven- tion and treatment options often keeps indi- viduals from seeking needed interventions before symptoms accelerate into a mental health crisis or even death. In rural com- munities, these issues are exacerbated as prevention, early detection and treatment options related to mental health are limited. The number of mental health profession- als are often extremely limited in rural set- tings, leaving crisis management and treat- ment responsibilities to poorly equipped laypersons, first responders and healthcare COLUMN RURAL HEALTH workers who are overwhelmed and have limited training in mental and behavioral health. In a report released in April 2016 by the Arkansas Department of Health, suicide is the leading cause of injury-related deaths for Arkansans between the ages of 20 and 64 and the second leading cause of death among all other age groups (Suicide Statis- tics Among Arkansans from 2009 to 2014, Arkansas Department of Health, 2016). Suicide is a major public health concern across the U.S. According to Understand- ing the Impact of Suicide in Rural America, suicide continues to be higher in rural coun- ties, and the gap between rural and urban suicides has widened over time. While the prevalence of mental illness is similar between rural and urban residents, the services available are rather different. Mental healthcare needs are not met in many rural communities across the country, because adequate services are not present. As of Sept. 30, 2020, HRSA had designated 3,363 mental health professional shortage areas in rural areas. It is estimated that it would take 1,676 practitioners to remove BEHAVIORAL HEALTH : A RURAL CRISIS the designations. Rural communities face distinct chal- lenges in addressing mental and behavioral health concerns and their consequences. When Arkansas Rural Health Partnership surveyed its member hospitals in SouthAr- kansas in 2018, they recognized how many challenges were ahead of them if they were to address this issue that their communities so desperately needed. Challenges included: 1. Behavioral and mental health resourc- es and services were not as readily available and were often limited; 2. Limited number of mental health pro- fessionals, which increased barriers for individuals in need of specialized care; 3. Patients who required treatment for serious mental illness may need to travel long distances to access these services. This includes inpatient and outpatient treatment as well as hos- pitalization for psychiatric diagnoses. Transportation from the emergency department to treatment facilities is often limited to EMS. In some counties, one or two EMS trucks cover an entire county with a one-hour driving radius; Working together has never been more important.