Mental Health Outcomes Worse in Counties Lacking Psychiatrists, Broadband

Nearly 1 in 5 US counties do not have psychiatrists or broadband internet service, severely hindering access to mental health services for the mostly rural counties’ 10.5 million residents, according to research released on Friday by the RAND Corporation and Harvard Medical School.

Findings, based on a variety of sources that identified 596 counties without psychiatrists or broadband availability in 2020, were published in JAMA Network Open. Based on regression results, the identified counties were:

• More likely to be rural;
• Have higher rates of unemployed and uninsured individuals; and
• Have lower proportions of residents with bachelor’s degrees and Hispanic individuals, but were not associated with the Health Resources and Services Administration mental health professional shortage area (MPHSA) designation.

An MPHSA designation, the researchers noted, can bring funding to underserved counties that helps to recruit clinicians.

Compared to national averages, counties without psychiatrists and broadband were found to have higher rates of adult depression, frequent mental distress, drug overdose mortality, and suicide.

“Our finding suggests that lacking access to virtual and in-person psychiatric care continues to be a key factor associated with adverse outcomes after controlling for county-level sociodemographic status,” the researchers wrote. “Future research should examine whether recent legislation, including the Consolidated Appropriations Act of 2021 and American Rescue Plan, which expanded psychiatry residency slots and broadband infrastructure, reduces these dynamics.”

Reference

Ramesh T, McBain RK, Cantor JH, Stein BD, Yu H. Mental health outcomes among patients living in US counties lacking broadband access and psychiatrists. JAMA Network Open. 2023;6(9). doi:10.1001/jamanetworkopen.2023.33781