Journal of Rural Mental Health, Vol 47(4), Oct 2023, 221-231; doi:10.1037/rmh0000237
Rural areas are disproportionately impacted by mental health and substance use disorders, drug overdose, and suicide. Several environmental and service access barriers are linked to these disparities, yet little is known about facilitators and barriers to care delivery that may impact client outcomes. Our study sought to explore these facilitators and barriers from the perspective of service providers. We conducted a qualitative focus group study with 206 professionals with a vested interest in behavioral health in 16 rural counties across New York State between March 2020 and September 2021. We started focus groups in person and then transitioned to Zoom during the pandemic. We audio-recorded, transcribed, and analyzed focus groups for themes. Multiple themes related to the delivery of behavioral health services emerged including invested and collaborative provider networks as facilitators and limited workforce capacity, state policy and regulatory issues, and scarce funding as barriers. Specifically, participants described how the way funding is allocated puts rural areas at a disadvantage and does not provide them with the flexibility or resources necessary to address the unique and extensive needs of their communities. They also explained how strict service quotas contribute to stress, burnout, and turnover among service providers. Despite these challenges, they described significant investment, collaboration, and determination that helped them provide high-quality services with limited resources. Together, our findings uncovered new regulatory and policy-related contributors to behavioral health care disparities in rural areas and suggested developing and implementing community-specific, needs-based approaches that leverage community strengths and assets. (PsycInfo Database Record (c) 2023 APA, all rights reserved)