| PCPs identify mental illnesses through several mechanisms including routine screening, indicator-based assessment, and self-identification by the patient. |
Screening for mood or anxiety disorders is one of several strategies used by PCPs to identify these disorders among rural women. Routine screening for all women may not be feasible due to time constraints and competing priorities Most PCPs somatic complaints are a common presentation of mental illnesses among rural women Assessment for adverse mental health conditions did not generally use a validated instrument. Post-traumatic stress disorder (PTSD) was not recognized as a woman’s health problem or a rural health problem.
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| Rural culture and social ecology are significant barriers to women in need of mental healthcare. |
Low socioeconomic status exacerbates and complicates treatment of mental health problems in rural women. Stigma around mental health issues in rural communities prevents women from seeking care. Patients often prefer to be seen locally, or by a known provider for mental health conditions. Rural culture of self-reliance and independence prevents help-seeking for mental illnesses.
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| Mental healthcare resource limitations in rural communities lead PCPs to seek creative solutions to care for rural women with mental illnesses. |
PCPs reported a shortage of mental health professionals in their area Many rural PCPs created informal networks of specialists to improve the quality of mental health care delivered to their patients. Rural PCPs practice mental healthcare outside their scope of comfort and training.
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| To improve mental healthcare in rural communities, both social norms and resource limitations must be addressed |
PCPs perceived community and provider education to be a key to improve mental healthcare for rural women Increasing access to subspecialty mental health care will improve mental healthcare for rural women.
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