An Exploration of Rural School Mental Health Professionals' Workforce Needs Post COVID-19

Background and Purpose: Rural school mental health (SMH) providers are crucial in addressing youth mental health (MH) needs but face a myriad of complex, interrelated challenges such as workforce shortages, funding/resource limitations, and high levels of burnout (Bain et al., 2011). Rural youth encounter barriers to care like geographic isolation, transportation issues, and stigma (Ferris‐Day et al., 2021), making schools vital settings for service delivery. The COVID-19 pandemic only worsened these challenges and amplified demands on rural SMH providers. This study sought to inform policy and practice reforms to support SMH professionals by exploring their post-COVID 19 experiences in one southeastern state. Research questions included: 1) How does working in a rural location impact the practice of rural SMH professionals? and 2) What types of challenges do rural SMH professionals encounter and what supports do they perceive help mitigate these challenges?

Methods: Interviews were conducted on Zoom with 15 rural SMH professionals from one southeastern state during Spring 2024. Most participants self-identified as female (87%), and White (53%) or Black/African American (33%). Participants had an average of 8.9 years of experience. Qualitative data were analyzed in MaxQDA using inductive analysis. The first author conducted initial coding. The second author reviewed coding and identified discrepancies, which were resolved via consensus discussions. A member check was conducted.

Results: Participants described the impact of working in a rural location on their practice across four areas: resource availability, transportation challenges, the unique needs of families and students, and the intergenerational and close-knit community dynamics. Participants’ challenges, needs, and supports were linked to three stakeholder groups: parents and families, school staff and other SMH professionals, and community partners. Regarding parents and families, engagement, stigma/buy-in, and knowledge/education were identified as significant and interrelated challenges and needs. With regard to school staff/other SMH professionals, participants emphasized the need for school staff support of MH programing, greater MH education, cooperative relationships between school staff and SMH professionals, more frequent inclusion in administrative meetings, and a strong network of SMH providers for moral and practical support. Community partnerships were described as both a challenge and support, particularly around referrals to services. Participants highlighted their own mindset and telehealth services as additional supports.

Conclusions and Implications: Despite study limitations, findings highlight the pervasive challenges in rural school contexts and how multiple stakeholder groups influence the practice of rural SMH providers in this state. Findings also underscore the need for additional support to meet the growing MH service demands. Implications for research and policy/practice initiatives addressing rural SMH professionals’ needs will be discussed.

References:

Bain, S. F., Rueda, B., Mata-Villarreal, J., & Mundy, M. A. (2011). Assessing mental health needs of rural schools in south Texas: Counselors’ perspectives. Research in Higher Education Journal, 14, 1–11.

Ferris‐Day, P., Hoare, K., Wilson, R. L., Minton, C., & Donaldson, A. (2021). An integrated review of the barriers and facilitators for accessing and engaging with mental health in a rural setting. International Journal of Mental Health Nursing, 30(6), 1525-1538.