Behavioral Health Care Barriers in Rural New York

A recent study examined service providers’ views on behavioral health care delivery barriers in rural New York.

Researchers held focus groups with 206 professionals to explore their perspectives on facilitators and barriers to the delivery of behavioral health care services in 16 rural New York counties. Participants included health, behavioral health care, and social service providers; government officials; law enforcement; first responders; school staff; and clergy.

The study identified several government and regulatory policies that limited participants’ ability to provide effective behavioral health care in rural counties. These included funding algorithms based on population size instead of need as well as “one size fits all” policies that tend to favor urban, population-dense areas over rural, sparsely populated areas with greater need.

Participants also identified a gap in funding for upstream interventions. They reported that challenges in recruiting and retaining staff made it difficult to ensure continuity and quality of services. Participants said turnover rates among rural providers were linked to factors such as higher salaries in urban areas, large caseloads, and stress and burnout.

Despite these challenges, participants shared creative strategies for serving their communities. These included forming outreach teams, using non-traditional venues to meet with clients, and cross-agency collaboration. Participants said the close-knit structure of many rural communities made relationship building very important, especially in the context of behavioral health challenges and cultural beliefs passed down over generations.

This study has some limitations. Participants were recruited from rural New York counties, which may not be representative of rural areas in other parts of the country. Focus group participation was voluntary, so participants may represent the professionals who were most invested in providing behavioral health care services. The race and ethnicity of participants matched the demographics of the counties served (93% White), but the results may not reflect the experiences of other racial and ethnic groups.

Harris, B. R., & Gallant, K. C. (2023). In their own voice: Behavioral health care delivery barriers in rural New York. Journal of Rural Mental Health. Advance online publication. https://doi.org/10.1037/rmh0000237