Due to continuing challenges in access and usability, mental health care in rural farming communities is in a state of emergency. For example, due to the large distance between rural family farms and treatment centers, rural areas pose a major challenge for timely access to care. In addition, there is a shortage of clinicians across the country, especially in rural areas.
However, with the rise of telemedicine, the prospects are bright. Incorporating timely and early mental health care into the medical care delivery process through the telepsychiatry platform is an area of innovation that we must expand. Telepsychiatry has proven beneficial to our most underserved populations in acute situations and preventive care.
Telemedicine solves the accessibility and usability issues in these three ways:
First, we have learned from our experience and research that it is rare to see people seeking professional mental health care on the same day. Telemedicine has the potential to eliminate waiting time because it can directly connect professionals and patients in crisis more quickly and effectively. This is very beneficial for people who are suffering and cannot wait for weeks to make an appointment.
Second, establish telemedicine so that psychiatrists and therapists can work together to develop treatment plans for individuals. Research consistently tells us that the combination of psychopharmacology prescribed by psychiatrists and treatment provided by therapists provides the best opportunity for positive results for any type of behavioral health disorder, including addiction.
Third, telemedicine can fill the gap in mental health services caused by the closure of hospitals. Quarter Rural hospitals are at risk of closure-673 facilities will be lost in an environment where mental health support is already severely scarce. However, through telemedicine, clinicians living in Florida can treat people living in Missouri on the same day.
The struggle of rural communities
Although the healthcare system is facing difficulties across the country, the problem is particularly serious in rural areas where there is a shortage of doctors and some hospitals are permanently closed. In addition, many people living in rural communities do not have medical insurance to pay for treatment. Systematic complexity is further complicated because these populations are considered to be at risk. This is due to the unstable economic factors generated by the agriculture on which they rely heavily, meaning that the most cost-effective way to improve the health outcomes of these communities is to address Get care in a timely and smooth manner.
Due to the distance from the treatment center, it is difficult to take care of them in time. In an environment of 21.2% of adults in non-urban areas, this laid the foundation for less than ideal results. Suffer from mental illness 4.8% of adults had considered suicide before Covid-19.
Why farmers are at high risk
Although depression and isolation affect everyone, farmers are exposed to additional stress and pressure due to the unique challenges of managing farms. Farmers are highly dependent on factors beyond their control, such as weather, crop prices, and political decisions. They can do everything right in operating and managing the farm, but there may still not be a good harvest season.
Coupled with the lack of access to mental health care and the stigma of the need for mental health care, we are dealing with potential crisis situations. In recent years, agricultural communities have been in financial difficulties, leading to an increase in the suicide rate of farmers. In a 2017 study, researchers at the University of Iowa found that from 1992 to 2010, the suicide rate of farmers and other agricultural workers was the highest among all occupations, and was 3.5 times that of the general population on average.
Due to the limitations of the traditional medical model, agricultural workers are often unable to meet their psychological medical needs in time. Telepsychiatry has proven to be a platform for individuals in rural areas to provide effective access and promote positive health outcomes. As evidenced by the response to Covid-19, telepsychiatry is a viable solution and is becoming the standard of care in all regions.
Challenges surrounding telemedicine
Currently, there are some regulatory challenges. Clinician licensing is time-consuming and expensive, and it is state-by-state. If doctors want to prescribe medication, they need to have a DEA number, which can take several weeks to process. Billing vouchers are an additional requirement that can cause timely delays. These delays prevent individuals from getting timely care, even if there are clinicians who are properly trained, certified and ready.
Another challenge in providing care is the Ryan Haight Act — designed to regulate online Internet prescriptions — which requires practitioners to conduct face-to-face medical evaluations to prescribe Schedule 2 medications. The regulations of the bill were relaxed during Covid-19, and we have witnessed the effectiveness of telepsychiatry in this public health crisis. Since it is related to telepsychiatry, if we sit in the same room, our evaluation of patients through telemedicine is exactly the same as the evaluation in traditional models. Continuing to allow practitioners to prescribe medications without a face-to-face evaluation after Covid is essential to ensure the success of patients.
Expect good results in mental health care
Easily and quickly accessible assessment tools can measure depression and anxiety, which will greatly help us develop a treatment plan for timely care. As the treatment progresses, we expect and often see improvements in results. If not, then we have a measure to modify the plan. When patients can get effective treatment when they need it, we will achieve good results.
I am optimistic about the provision of mental health care, because now we are seeing a shift in people’s awareness and acceptance of this health crisis. More and more people are willing to speak out and seek help, and more and more people express sympathy and judgment for the negative factors that lead to poor mental health. I believe we are moving in the right direction together, and I look forward to positive changes in getting and providing mental health and addiction care in a timely manner.
