Treating Mental Health in Rural Areas

Physician assistants can be key in providing mental health treatment options for rural populations.

two health care professionals talking on a bench with "the future of health" written on the wall behind them

PAs can fill a valuable need in mental health care

A 2020 paper published in the Journal of Clinical and Translational Science estimates that approximately one fifth of the U.S. population lives in rural areas. Of those, about one fifth, or 6.5 million individuals, have a mental illness.

While the prevalence of mental illness and psychiatric disorders is similar between rural and urban areas, the issue is about access to mental healthcare. People in rural areas have fewer options when it comes to seeking treatment.

We sat down with Sarah Stringer, DMSc, PA-C, CAQ-Psych., Assistant Professor in the TTUHSC School of Health ProfessionsMaster of Physician Assistant Studies, to learn about the role that physician assistants can play in bringing mental health treatment to rural populations.

Access to Mental Illness Treatment in Rural Areas

Sarah Stringer, DMSc, PA-C, CAQ-Psych.

Sarah Stringer, DMSc, PA-C, CAQ-Psych.

“We know that mental illness prevalence will be the same in urban versus rural areas, but rural areas have less access to services,” Stringer begins. “In rural areas, if there are not many mental health resources available, patients might have to travel far for care or wait on very long wait lists to get help.”

Stringer adds that living in a less-populated area where everyone seems to know each other can create a resistance to seeking care due to the stigma that still surrounds mental illness.

It’s estimated that as many as 65 percent of non-metropolitan counties in the U.S. do not have psychiatrists available. The scarcity of mental health services in rural areas contributes to the disparity in care when compared to urban areas.  

This is where physician assistants (PAs) can fill a valuable need.

How Can Physician Assistants Help Fill the Need for Mental Health Care?

“PAs are qualified to practice psychiatry upon graduation without any further credentialing or education,” Stringer says. “There’s a national shortage of practitioners in mental health, with the greatest need in rural areas.”

While psychologists and therapists typically treat patients using psychotherapy or talk therapy, a PA will use a more pharmacological approach, much like a psychiatrist.

“PAs can practice psychiatry in collaboration with supervising physicians,” Stringer adds. “And a psychiatrist is a physician.”

The TTUHSC Master of Physician Assistant Studies Program

Physician assistants are part of one of the fastest-growing and most-rewarding healthcare fields. PAs are trained to provide care to patients in a variety of medical settings, and they are certified to practice medicine as part of the healthcare team. This includes psychiatry.

“Psychiatry is fascinating,” Stringer says. “We try to keep it exciting for students and light the fire that makes them want to serve the rural population.”

After practicing general medicine, Stringer finds working in psychiatry as a PA to be incredibly rewarding.

“It’s rewarding to see them grow and their lives change,” she says. “The family dynamic improves.

“I get the honor of being trusted with the deepest parts of a patient’s life,” she continues, “Their spirituality, struggles and triumphs.”

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