Rural Mental Health – Models and Innovations

Evidence-Based Examples

Mental Health First Aid

Updated/reviewed July 2023

• Need: Rural areas face challenges in access to mental health services, including shortages of mental health providers.
• Intervention: This 8-hour course trains rural community members to recognize mental health and substance use issues and learn how to help someone who is developing a mental health concern or experiencing a mental health crisis.
• Results: Numerous studies of this method have found that course participants are better able and more likely to help others regarding mental health issues.

Effective Examples

STAIR (Skills Training in Affective and Interpersonal Regulation)

Updated/reviewed March 2024

• Need: To increase access to telemental health services for rural veterans, especially women, with a history of trauma.
• Intervention: STAIR (Skills Training in Affective and Interpersonal Regulation) is a 10-week program designed to reduce PTSD and depression symptoms and increase emotional regulation and social functioning in clients.
• Results: Therapists reported that clients attended more sessions when offered via teleconferencing, and clients reported satisfaction with the program.

I Got You: Healthy Life Choices for Teens (IGU)

Updated/reviewed February 2024

• Need: To improve awareness of behavioral and mental health issues by students in rural, east central Mississippi.
• Intervention: An intensive community mental health outreach program was implemented for students in rural Mississippi.
• Results: As of 2018 and on a yearly basis, 6,000 7th and 8th grade students receive mental health education on a variety of topics which improves their ability to recognize mental health issues, high risk behaviors, and manage their own choices.

University of Vermont Medical Center's Nursing Home Telepsychiatry Service

Updated/reviewed December 2023

• Need: To improve the health status and access for rural nursing home patients in need of mental health services.
• Intervention: The University of Vermont Medical Center provides telepsychiatry care and education to nursing homes in communities that face shortages of mental health professionals.
• Results: These telepsychiatry consultations have eased the burden on nursing home residents by saving travel time, distance, and money it takes to travel to the nearest tertiary facility.

Strong African American Families-Teen Program

Updated/reviewed May 2023

• Need: There is a lack of interventions that addresses teenager behavioral problems, particularly for rural African American adolescents.
• Intervention: Rural, locally trained leaders administered five 2-hour meetings for teenagers and their primary caregivers. Trainings focused on reducing risks that prevent positive development, specifically sexual risk-taking that can lead to HIV and other STIs.
• Results: Teens reported reduced conduct problems, depressive symptoms, and substance abuse. Families were strengthened, and SAAF-T reduced unprotected intercourse and increased condom efficacy.

Promising Examples

Cross-Walk: Integrating Behavioral Health and Primary Care

Updated/reviewed May 2024

• Need: To address and treat substance use disorder (SUD) and depression in the Upper Great Lakes region.
• Intervention: Cross-Walk, a program that integrates behavioral healthcare into primary care services, was developed in Michigan's Marquette County.
• Results: The collaborative efforts strengthened care management services in local healthcare facilities as primary care patients were referred to a behavioral health specialist.

Schools That Care

Updated/reviewed August 2022

• Need: To provide mental health services to rural Kansas students and their families.
• Intervention: The Schools That Care project provides mental health treatment and case management as well as community education events.
• Results: From 2018 to 2021, 3,456 individuals participated in health education and counseling activities offered to the public, and 964 individuals and 303 families received direct services through the Family Advocate.

Other Project Examples

FirstLink Care and Support Program

Updated/reviewed July 2024

• Need: To reduce suicide and substance-related deaths in North Dakota and Minnesota.
• Intervention: The Care and Support program provides support through phone calls, cards, and texting to those who have called suicide helplines or were referred by a healthcare provider.
• Results: In 2023, FirstLink made 10,709 calls and sent 913 cards to program participants.

Florissa

Updated/reviewed June 2024

• Need: To address the developmental, behavioral, and social/emotional needs of rural children ages 0-22 in northwest Illinois.
• Intervention: Local partners teamed up to create a centralized service facility for children and families facing developmental, behavioral, and social/emotional issues. Florissa provides evaluations, diagnosis, and treatment to local children using a multidisciplinary, evidence-based approach.
• Results: In 2023, Florissa provided a direct clinical service to over 337 children, in addition to many trainings and supportive programs. It also is co-located with the KSB Hospital pediatric department, a certified pediatric patient-centered medical home (PCMH).

Hope Squad

Updated/reviewed June 2024

• Need: To reduce youth suicide rates.
• Intervention: First begun in Utah, Hope Squad is a nationwide program that trains youth to look after their classmates and refer those with suicidal thoughts or other mental health concerns to adult advisors.
• Results: Studies suggest that Hope Squad schools' students with suicidal thoughts are more likely than non-Hope Squad schools' students to solicit help. In addition, stigma surrounding mental illness is decreasing.

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