Rural Communities

Rural environments provide many challenges and opportunities to psychiatrists and their patients. Although telemedicine is a growing option in some communities, access to mental health care remains difficult, compounded by transportation and other resource limitations. Although many technical aspects of community psychiatry are universal, particular attention must be paid to the special characteristics of rural settings, including boundary issues in close-knit communities, each of which may have a unique culture that a psychiatrist may need to learn to understand. Managing risks associated with substance use, particularly opioid dependence, and suicide risk can be more challenging in rural practice. Poverty and homelessness are also common problems. This chapter provides expertise on best practices to address these challenges, encouraging psychiatrists to consider the potential rewards of rural practice.