The delivery of rural mental health services focuses on understanding and responding to emotional and behavioral needs of children in the 2,303 "rural" communities that, according to the United States Census Bureau, have fewer than 2,500 residents. The proportion of the rural population involved with farming has decreased markedly over the past fifty years, leading the young and better educated to migrate to urban settings. Also, more disabled persons tend to migrate to centers where more specialized services are available. As a result, the rural population is older, less educated, socially conservative, and living longer than its urban counterpart. Diagnostically, this trend appears linked to heightened levels of affective and alcohol-related disorders. Understaffed and geographically stretched providers of health services must overcome resistance to acknowledging emotional disorders, seeking treatment, and complying with interventions for children. Rural providers tend to be general practitioners who themselves experience isolation, as increasing demands for services and a constant need to overcome stigma are the norm. As a result, rural children may receive diagnoses and treatment only after emotional problems have become more advanced.
U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Center for Mental Health Services, National Institutes of Health, National Mental Health Institute, 1999.