There is a severe shortage of mental health workers across the U.S., but the problem is most pronounced in rural areas. There isn’t a single psychiatrist in 65 percent of nonmetropolitan counties, and almost half of those counties don’t have a psychologist, according to a report from the American Journal of Preventive Medicine released this month.

But even when a rural area does have some mental health workers, they alone usually can’t address the entire population’s needs. Many residents are uninsured or underinsured, and can’t afford regular treatment. Residents may have to travel dozens of miles to get to the nearest town where a therapist works, and may not have access to transportation. Some therapists have irregular office hours and may only visit town a few days a month. The inconsistency can be a deterrent to patients.

Rural areas have the highest suicide rates, according to the Centers for Disease Control and Prevention, as well as a high concentration of veterans, who experience higher rates of suicide than nonveterans. Rates of drug overdoses in rural areas have surpassed those in metropolitan areas. There are also more elderly people, who are often socially isolated and at risk for depression, said Ron Manderscheid, executive director of the National Association for Rural Mental Health.

Manderscheid said improving telehealth programs, which allow patients to call or video chat with therapists in cities, is one potential solution. Encouraging young people from rural areas to go into the mental health field could also help.

“We need to start recruiting some of our providers from these rural areas, and work with people in high schools and colleges,” he said. “They are most likely to go back. They have an appreciation for rurality and living in rural communities.”

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