Skip to main content

Building Policy Support for School Mental Health in Rural Areas

  • Chapter
  • First Online:
Book cover Handbook of Rural School Mental Health

Abstract

School mental health (SMH) programs that include expanded prevention and intervention programs and services through collaboration between education, mental health, and other youth serving systems are developing progressively in the United States (see Weist, M. D., Evans, S. W., & Lever, N. A. (2003). Handbook of school mental health: Advancing practice and research. New York: Springer; Evans, S., Weist, M., & Serpell, Z. (2007). Advances in school-based mental health interventions. Kingston, NJ: Civic Research Institute; Weist, M. D., Lever, N. A., Bradshaw, C. P., Owen, J. S. (2014). Handbook of school mental health, New York: Springer) and in other countries (see Kutcher, S., Wei, Y., & Weist, M. D. (2015). School mental health: Global challenges and opportunities. Cambridge: Cambridge University Press). Per the emphasis of this book, there is a particular need for and unique issues being encountered in delivering SMH in rural environments. In this chapter, we describe policy foundations for SMH in a small, southeastern state and focus on our work in one region characterized by high rurality and generally high poverty. We provide background information on emotional/behavioral challenges experienced by children and youth in this rural impoverished area (and in this region), discuss system-level challenges and innovative programs that are beginning to address these challenges, and offer recommendations for further system enhancement and expansion and improvement of school behavioral health services.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abbeville County School District v. State of South Carolina (2014). WL 5839956 (S.C. 2014).

    Google Scholar 

  • Angold, A., Erkanli, A., Farmer, E. M., Fairbank, J. A., Burns, B. J., Keeler, G., & Costello, E. J. (2002). Psychiatric disorder, impairment, and service use in rural African American and white youth. Archives of General Psychiatry, 59(10), 893–901.

    Article  PubMed  Google Scholar 

  • Avenevoli, S., Swendsen, J., He, J.-P., Burstein, M., & Merikangas, K. R. (2015). Major depression in the national comorbidity survey–adolescent supplement: Prevalence, correlates, and treatment. Journal of the American Academy of Child & Adolescent Psychiatry, 54(1), 37–44. e32.

    Article  Google Scholar 

  • Barbopoulos, A., & Clark, J. M. (2003). Practising psychology in rural settings: Issues and guidelines. Canadian Psychology/Psychologie Canadienne, 44(4), 410.

    Article  Google Scholar 

  • Benavides-Vaello, S., Strode, A., & Sheeran, B. C. (2013). Using technology in the delivery of mental health and substance abuse treatment in rural communities: A review. The Journal of Behavioral Health Services & Research, 40(1), 111–120.

    Article  Google Scholar 

  • Brems, C., Johnson, M. E., Warner, T. D., & Roberts, L. W. (2006). Barriers to healthcare as reported by rural and urban interprofessional providers. Journal of Interprofessional Care, 20(2), 105–118.

    Article  PubMed  Google Scholar 

  • Breslau, J., Marshall, G. N., Pincus, H. A., & Brown, R. A. (2014). Are mental disorders more common in urban than rural areas of the United States? Journal of Psychiatric Research, 56, 50–55.

    Article  PubMed  Google Scholar 

  • Burns, B. J., Costello, E. J., Angold, A., Tweed, D., Stangl, D., Farmer, E., & Erkanli, A. (1995). Children’s mental health service use across service sectors. Health Affairs, 14(3), 147–159.

    Article  PubMed  Google Scholar 

  • Carter, A. S., Wagmiller, R. J., Gray, S. A., McCarthy, K. J., Horwitz, S. M., & Briggs-Gowan, M. J. (2010). Prevalence of DSM-IV disorder in a representative, healthy birth cohort at school entry: Sociodemographic risks and social adaptation. Journal of the American Academy of Child & Adolescent Psychiatry, 49(7), 686–698.

    Google Scholar 

  • U. S. Census Bureau (2014). QuickFacts. Retrieved from http://www.census.gov/quickfacts

  • Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614.

    Article  PubMed  Google Scholar 

  • Costello, E. J., Angold, A., Burns, B. J., Stangl, D. K., Tweed, D. L., Erkanli, A., & Worthman, C. M. (1996). The Great Smoky Mountains Study of Youth: Goals, design, methods, and the prevalence of DSM-III-R disorders. Archives of General Psychiatry, 53(12), 1129–1136.

    Article  PubMed  Google Scholar 

  • Costello, E. J., Erkanli, A., Fairbank, J. A., & Angold, A. (2002). The prevalence of potentially traumatic events in childhood and adolescence. Journal of Traumatic Stress, 15(2), 99–112.

    Article  PubMed  Google Scholar 

  • Costello, E. J., He, J. P., Sampson, N. A., Kessler, R. C., & Merikangas, K. R. (2014). Services for adolescents with psychiatric disorders: 12-month data from the National Comorbidity Survey–Adolescent. Psychiatric Services, 65(3), 359–366.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cummings, J. R., Wen, H., & Druss, B. G. (2013). Improving access to mental health services for youth in the United States. JAMA, 309(6), 553–554.

    Article  PubMed  PubMed Central  Google Scholar 

  • DeLeon, P. H., Wakefield, M., Schultz, A. J., Williams, J., & VandenBos, G. R. (1989). Rural America: Unique opportunities for health care delivery and health services research. American Psychologist, 44(10), 1298.

    Article  PubMed  Google Scholar 

  • Ellis, A. R., Konrad, T. R., Thomas, K. C., & Morrissey, J. P. (2009). County-level estimates of mental health professional supply in the United States. Psychiatric Services, 60(10), 1315–1322.

    Article  PubMed  Google Scholar 

  • Evans, S., Weist, M., & Serpell, Z. (2007). Advances in school-based mental health interventions. Kingston, NJ: Civic Research Institute.

    Google Scholar 

  • Fagan, T. K., & Hughes, J. (1985). Rural school psychology: Perspectives on lessons learned and future directions. School Psychology Review, 14, 444–451.

    Google Scholar 

  • Fontanella, C. A., Hiance-Steelesmith, D. L., Phillips, G. S., Bridge, J. A., Lester, N., Sweeney, H. A., & Campo, J. V. (2015). Widening rural-urban disparities in youth suicides, United States, 1996–2010. JAMA Pediatrics, 169(5), 466–473.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fox, J. C., Blank, M., Rovnyak, V. G., & Barnett, R. Y. (2001). Barriers to help seeking for mental disorders in a rural impoverished population. Community Mental Health Journal, 37(5), 421–436.

    Article  PubMed  Google Scholar 

  • Gamm, L., Stone, S., & Pittman, S. (2010). Mental health and mental disorders—A rural challenge: A literature review. Rural Healthy People, 2, 97–113.

    Google Scholar 

  • Girio-Herrera, E., Owens, J. S., & Langberg, J. M. (2013). Perceived barriers to help-seeking among parents of at-risk kindergarteners in rural communities. Journal of Clinical Child & Adolescent Psychology, 42(1), 68–77.

    Article  Google Scholar 

  • Glueck, D. (2013). Establishing therapeutic rapport in telemental health. In K. Myers & C. Turvey (Eds.), Telemental health (pp. 29–46). London: Elsevier.

    Chapter  Google Scholar 

  • Godoy, L., Carter, A. S., Silver, R. B., Dickstein, S., & Seifer, R. (2014). Infants and toddlers left behind: Mental health screening and consultation in primary care. Journal of Developmental & Behavioral Pediatrics, 35(5), 334–343.

    Article  Google Scholar 

  • Goldstein, F., & Glueck, D. (2016). Developing rapport and therapeutic alliance during telemental health sessions with children and adolescents. Journal of Child and Adolescent Psychopharmacology, 26(3), 204–211.

    Article  PubMed  Google Scholar 

  • Gould, S. R., Beals-Erickson, S. E., & Roberts, M. C. (2012). Gaps and barriers in services for children in state mental health plans. Journal of Child and Family Studies, 21(5), 767–774.

    Article  Google Scholar 

  • Grob, G. N. (2005). Public policy and mental illnesses: Jimmy Carter’s presidential commission on mental health. Milbank Quarterly, 83(3), 425–456.

    Article  PubMed  PubMed Central  Google Scholar 

  • Heflinger, C. A., Shaw, V., Higa-McMillan, C., Lunn, L., & Brannan, A. M. (2015). Patterns of child mental health service delivery in a public system: Rural children and the role of rural residence. Journal of Behavioral Health Services & Research, 42(3), 292–309.

    Article  Google Scholar 

  • Hirsch, J. K. (2006). A review of the literature on rural suicide. Crisis, 27(4), 189–199.

    Article  PubMed  Google Scholar 

  • Human, J., & Wasem, C. (1991). Rural mental health in America. American Psychologist, 46(3), 232.

    Article  PubMed  Google Scholar 

  • Jameson, J. P., & Blank, M. B. (2007). The role of clinical psychology in rural mental health services: Defining problems and developing solutions. Clinical Psychology: Science and Practice, 14(3), 283–298.

    Google Scholar 

  • Kee, J. A., Johnson, D., & Hunt, P. (2002). Burnout and social support in rural mental health counselors. Journal of Rural Community Psychology, 5(1). Retrieved from http://www.marshall.edu/jrcp/sp2002/Kee.htm.

  • Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., … Petukhova, M. (2012a). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372–380.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Avenevoli, S., Costello, J., Green, J. G., Gruber, M. J., McLaughlin, K. A., … Merikangas, K. R. (2012b). Severity of 12-month DSM-IV disorders in the national comorbidity survey replication adolescent supplement. Archives of General Psychiatry, 69(4), 381–389.

    Article  PubMed  PubMed Central  Google Scholar 

  • Komiti, A., Judd, F., & Jackson, H. (2006). The influence of stigma and attitudes on seeking help from a GP for mental health problems. Social Psychiatry and Psychiatric Epidemiology, 41(9), 738–745.

    Article  PubMed  Google Scholar 

  • Koppelman, J. (2004, October). The provider system for children’s mental health: Workforce capacity and effective treatment. Washington, DC: National Health Policy Forum.

    Google Scholar 

  • Kramer, G. M., Kinn, J. T., & Mishkind, M. C. (2015). Legal, regulatory, and risk management issues in the use of technology to deliver mental health care. Cognitive and Behavioral Practice, 22(3), 258–268.

    Article  Google Scholar 

  • Kutcher, S., Wei, Y., & Weist, M. D. (2015). Global school mental health: Considerations and future directions. In S. Kutcher, Y. Wei, & M. D. Weist (Eds.), School mental health: Global challenges and opportunities (pp. 299–310). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • Lambert, D., Gale, J. A., & Hartley, D. (2008). Substance abuse by youth and young adults in rural America. The Journal of Rural Health, 24(3), 221–228.

    Article  PubMed  Google Scholar 

  • Lavigne, J. V., Binns, H. J., Christoffel, K. K., Rosenbaum, D., Arend, R., Smith, K., … MCGuire, P. A. (1993). Behavioral and emotional problems among preschool children in pediatric primary care: Prevalence and pediatricians’ recognition. Pediatrics, 91(3), 649–655.

    PubMed  Google Scholar 

  • Mackie, P. F. E. (2015). Technology in rural behavioral health care practice: Policy concerns and solution suggestions. Journal of Rural Mental Health, 39(1), 5.

    Article  Google Scholar 

  • McGinty, K. L., Saeed, S. A., Simmons, S. C., & Yildirim, Y. (2006). Telepsychiatry and e-mental health services: Potential for improving access to mental health care. Psychiatry Quarterly, 77, 335–342.

    Article  Google Scholar 

  • Merikangas, K. R., He, J. P., Brody, D., Fisher, P. W., Bourdon, K., & Koretz, D. S. (2010a). Prevalence and treatment of mental disorders among US children in the 2001–2004 NHANES. Pediatrics, 125(1), 75–81.

    Article  PubMed  Google Scholar 

  • Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., … Swendsen, J. (2010b). Lifetime prevalence of mental disorders in US adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989.

    Article  Google Scholar 

  • Merikangas, K. R., He, J. P., Burstein, M., Swendsen, J., Avenevoli, S., Case, B., … Olfson, M. (2011). Service utilization for lifetime mental disorders in US adolescents: Results of the National Comorbidity Survey–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 50(1), 32–45.

    Article  Google Scholar 

  • Monk, D. H. (2007). Recruiting and retaining high-quality teachers in rural areas. The Future of Children, 17(1), 155–174.

    Article  PubMed  Google Scholar 

  • National Center for Health Statistics, Centers for Disease Control and Prevention. (2014). Multiple cause of death, all county data 1996–2010. Hyattsville, MD: National Center for Health Statistics.

    Google Scholar 

  • Nelson, E. L., & Patton, S. (2016). Using videoconferencing to deliver individual therapy and pediatric psychology interventions with children and adolescents. Journal of Child and Adolescent Psychopharmacology, 26(3), 212–220.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nock, M. K., Green, J. G., Hwang, I., McLaughlin, K. A., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: Results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry, 70(3), 300–310.

    Article  PubMed  Google Scholar 

  • Polaha, J., Dalton, W. T., & Allen, S. (2011). The prevalence of emotional and behavior problems in pediatric primary care serving rural children. Journal of Pediatric Psychology, 36(6), 652–660.

    Article  PubMed  Google Scholar 

  • President’s Commission on Mental Health. (1978). Report to the president from the President’s Commission on Mental Health (vol. 4). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • President’s New Freedom Commission on Mental Health (2003). Achieving the promise: Transforming mental health care in America. Retrieved from http://govinfo.library.unt.edu/mentalhealthcommission/reports/FinalReport/downloads/FinalReport.pdf.

  • Pullmann, M. D., VanHooser, S., Hoffman, C., & Heflinger, C. A. (2010). Barriers to and supports of family participation in a rural system of care for children with serious emotional problems. Community Mental Health Journal, (3), 46, 211–220.

    Google Scholar 

  • Ramsey, A. T., & Montgomery, K. (2014). Technology-based interventions in social work practice: A systematic review of mental health interventions. Social Work in Health Care, 53(9), 883–899.

    Article  PubMed  PubMed Central  Google Scholar 

  • Reinherz, H. Z., Giaconia, R. M., Lefkowitz, E. S., Pakiz, B., & Frost, A. K. (1993). Prevalence of psychiatric disorders in a community population of older adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 32(2), 369–377.

    Article  Google Scholar 

  • Report of the School Safety Taskforce (2015). Retrieved from http://www.scstatehouse.gov/CommitteeInfo/SchoolSafetyTaskForce/SCHOOL%20SAFETY%20TASK%20FORCE-FINAL%20REPORT%202014%2012%2031_112818.pdf.

  • Roberts, R. E., Roberts, C. R., & Xing, Y. (2007). Rates of DSM-IV psychiatric disorders among adolescents in a large metropolitan area. Journal of Psychiatric Research, 41(11), 959–967.

    Article  PubMed  Google Scholar 

  • Robinson, W. D., Springer, P. R., Bischoff, R., Geske, J., Backer, E., Olson, M., … Swinton, J. (2012). Rural experiences with mental illness: Through the eyes of patients and their families. Families Systems, & Health, 30(4), 308.

    Article  Google Scholar 

  • Rural School and Community Trust (2007). Poorest rural districts poorer than most cities. Retrieved from http://www.ruraledu.org/articles.php?id=2274

  • Schank, J. A., & Skovholt, T. M. (2006). Rural practice: Illuminating dilemmas in one kind of small community. In J. M. Schank & T. M. Skovholt (Auths.). Ethical practice in small communities: Challenges and rewards for psychologists (pp. 75–115). Washington, DC: American Psychological Association

    Google Scholar 

  • Searles, V. B., Valley, M. A., Hedegaard, H., & Betz, M. E. (2015). Suicides in urban and rural counties in the United States, 2006–2008. Crisis, 34, 18–26.

    Google Scholar 

  • Singh, G. K., & Siahpush, M. (2002). Increasing rural-urban gradients in US suicide mortality, 1970–1997. American Journal of Public Health, 92(7), 1161–1167.

    Article  PubMed  PubMed Central  Google Scholar 

  • Slade, E., Mills, C., Cunningham, D., Hobbs, N., Andrews, C., & Weist, M. D. (2009). Non-public special education programs: Evaluating the costs of within school alternatives for students with emotional disturbance. Advances in School Mental Health Promotion, 2(3), 30–37.

    Article  Google Scholar 

  • South Carolina Department of Mental Health (1996). A history of the South Carolina Department of Mental Health. Retrieved from http://www.state.sc.us/dmh/history.htm.

  • Stamm, B. (2003). Rural behavioral health care: An interdisciplinary guide. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  • Starr, S., Campbell, L. R., & Herrick, C. A. (2002). Factors affecting use of the mental health system by rural children. Issues in Mental Health Nursing, 23(3), 291–304.

    Article  PubMed  Google Scholar 

  • Thomas, C. R., & Holzer, C. E. (2006). The continuing shortage of child and adolescent psychiatrists. Journal of the American Academy of Child & Adolescent Psychiatry, 45(9), 1023–1031.

    Article  Google Scholar 

  • Thomas, K. C., Ellis, A. R., Konrad, T. R., Holzer, C. E., & Morrissey, J. P. (2009). County-level estimates of mental health professional shortage in the United States. Psychiatric Services, 60(10), 1323–1328.

    Article  PubMed  Google Scholar 

  • Torio, C. M., Encinosa, W., Berdahl, T., McCormick, M. C., & Simpson, L. A. (2015). Annual report on health care for children and youth in the United States: National estimates of cost, utilization and expenditures for children with mental health conditions. Academic Pediatrics, 15(1), 19–35.

    Article  PubMed  Google Scholar 

  • U.S. Public Health Service (1999). Mental health: A report of the surgeon general. Retrieved from http://www.surgeongeneral.gov/library/reports/

  • US Department of Health and Human Services (2000). Report of the surgeon general's conference on children's mental health: A National Action Agenda. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK44233/

  • Wagenfeld, M. O. (2003). A snapshot of rural and frontier America. In B. H. Stamm (Ed.), Rural behavioral health care: An interdisciplinary guide (pp. 33–40). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Weist, M. D., Evans, S. W., & Lever, N. A. (2003). Introduction. In Handbook of school mental health advancing practice and research (pp. 1–7). New York: Springer.

    Google Scholar 

  • Weist, M. D., Lever, N. A., Bradshaw, C. P., & Owens, J. S. (2014). Further advancing the field of school mental health. In Handbook of school mental health (pp. 1–14). New York: Springer.

    Chapter  Google Scholar 

  • Williams, S. L., & Polaha, J. (2014). Rural parents’ perceived stigma of seeking mental health services for their children: Development and evaluation of a new instrument. Psychological Assessment, 26(3), 763.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E. Rebekah Siceloff .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Siceloff, E.R., Barnes-Young, C., Massey, C., Yell, M., Weist, M.D. (2017). Building Policy Support for School Mental Health in Rural Areas. In: Michael, K., Jameson, J. (eds) Handbook of Rural School Mental Health. Springer, Cham. https://doi.org/10.1007/978-3-319-64735-7_2

Download citation

Publish with us

Policies and ethics