Mental health services in rural areas : a multicomponent examination / John Paul Jameson.

Format:

Book

Manuscript

Thesis/Dissertation

Author/Creator:

Jameson, John Paul.

Contributor:

Chambless, Dianne L., 1948- advisor.

University of Pennsylvania.

Language:

English

Subjects (All):

Penn dissertations--Psychology.

Psychology--Penn dissertations.

Local Subjects:

Penn dissertations--Psychology.

Psychology--Penn dissertations.

Physical Description:

vii, 71 pages : illustrations ; 29 cm

Production:

2009.

Summary:

Three studies were conducted to examine issues in the rural mental health service system. In Study 1, a nationally representative dataset was used to examine the diagnosis and treatment of anxiety and depression in rural compared to nonrural primary care settings. Results suggest that anxiety and depressive disorders are underdiagnosed in both rural and nonrural primary care. Further, approximately one-third of patients diagnosed with depression and two-thirds of patients diagnosed with an anxiety disorder did not receive quality care according to treatment guidelines. Though few rural/nonrural differences emerged in diagnostic and treatment practices, the findings are discussed specifically in terms of improving detection and treatment of depression and anxiety in rural primary care settings. In Study 2, treatment practices in rural and nonrural community mental health centers (CMHCs) were examined with a focus on the utilization of empirically supported treatments (ESTs) for depression and anxiety. Clinical directors in rural and nonrural CMHCs responded to a mailed survey. Contrary to a priori hypotheses, rural respondents were as likely as nonrural respondents to report EST use in their clinic for anxiety disorders and major depressive disorder. However, ESTs represent a relatively small proportion of the treatments reported for depression and anxiety disorders. Results indicate that continuing efforts to disseminate these treatments in both urban and rural CMHCs is warranted. Study 3 concerned the shortage of psychologists in rural areas. The hypothesis that this shortage can be attributed to negative attitudes among prospective clinicians regarding rural practice was examined by surveying attitudes of current doctoral students in clinical psychology. Eight hundred eighty-four students responded to an online survey. Contrary to prediction, results indicate that attitudes toward rural practice were not overwhelmingly negative. A follow-up study revealed that few rural jobs were advertised in sources likely to be used by psychologists to find work, suggesting weak demand for psychologists in rural areas. Thus, the shortage of rural psychologists may be an issue of demand rather than supply. In sum, although rural mental health services seemed no worse than urban services in these studies, results suggested that patient care in both settings needs improvement.

Notes:

Adviser: Dianne L. Chambless.

Thesis (Ph.D. in Psychology) -- University of Pennsylvania, 2009.

Includes bibliographical references.