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ORCID
https://orcid.org/ 0009-0003-9698-9609
Date of Graduation
5-14-2026
Semester of Graduation
Spring
Degree Name
Educational Specialist (EdS)
Department
Department of Graduate Psychology
First Advisor
Renee Staton
Second Advisor
Robin Anderson
Third Advisor
Michele Kielty
Abstract
Despite disproportionately higher suicide mortality rates and comparable prevalence of mental illness across urban and rural communities in the United States, rural populations across the nation experience significantly lower access to and utilization of mental health services, naturally leading to worse comprehensive outcomes. This literature review examines multifaceted factors shaping mental health service use in rural America, taking note of both barrier and enabling factors that impede or enable these unique populations’ willingness and ability to access and use mental health services. Ten articles published prior to September 9, 2025, were selected from the James Madison University Libraries’ Psychology and Behavioral Sciences Collection. Findings indicate that barriers to care cluster into seven primary categories: workforce shortages and system capacity; accessibility and structural barriers; communication and coordination gaps; cultural and community context; service delivery and systemic fit; implementation, adaptation, and sustainability challenges; and systemic inequity. Conversely, five categories of enablers emerged as promising mechanisms for improving access and engagement: collaborative and integrated care models, training paraprofessionals, school-based mental health services, the utilization of technology, and strong patient-provider relationships. This essay highlights the importance of mental health service providers and programs incorporating this knowledge to best serve and support rural communities. In doing so, providers will be much better equipped to help ameliorate the nation’s mental health crisis and rampant disparities in mental health care.
Included in
Clinical Psychology Commons, Community Health Commons, Multicultural Psychology Commons, Other Languages, Societies, and Cultures Commons, Other Mental and Social Health Commons, Other Psychology Commons, Place and Environment Commons, Rural Sociology Commons, Social Justice Commons
