Thursday, February 06, 2014

Rural women often shy of seeking mental health care, so physicians must step into the breach

Penn State researchers' study of 19 rural primary-care physicians in central Pennsylvania found that "Women living in rural communities are less likely than urban-dwelling women to receive sufficient mental-health care, in large part due to limited access to services and societal stigma," Victoria Indivero reports for the university. Because of stigma, some rural primary-care physicians are being asked to treat conditions that a specialist would be better qualified to treat, she reports.

"Rural women may not want to be seen walking into the office of a mental health care provider due to fear of judgment by family and friends," said the researchers, who focused their study on screening and diagnosis of mental-health conditions, barriers to treatment among rural women, management of mental illnesses in rural women and ideas to improve care for this population. One physician told researchers, "I do a lot of psychiatry in my practice that I really wish I didn't have to do, but I do it because someone's got to do it."

That raises concerns. "About one-third of the physicians reported that they routinely screened for depression, while others stated that time constraints and competing priorities would not allow them to regularly screen patients," Indivero writes. "Identification of post-traumatic stress disorder among rural women may be particularly challenging because some of the rural doctors did not feel that PTSD was likely to affect rural women. Most of the physicians noted that many of their patients were underinsured and did not have mental health coverage."

"Despite the barriers to optimal healthcare, we found that many of the physicians are seeking creative solutions and developing informal networks with mental health care professionals for consultation," Jennifer S. McCall-Hosenfeld, one of the study's authors, told Indivero. "This study reinforced the fact that there are problems with access to health care in rural communities but also provided some examples of potential solutions to those access issues, such as formalizing and expanding existing consulting networks." (Read more) The study, which appears in Mental Health in Family Medicine, is behind a pay wall, and can be accessed by clicking here.

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