Rural Behavioral Health: A SWOT Analysis from the Special Interest Group

Approximately 46 million people live in rural America, making up 14% of the U.S population in 2023. Both unique strengths and considerable challenges characterize rural communities. For example, rural Appalachian Kentucky is known for its resilience and tight-knit community bonds, a trait many small towns share. The expansion of broadband internet has increased economic opportunities and access to healthcare in these areas. However, rural communities continue to face significant hurdles, such as limited resources, smaller workforces, and geographic isolation from urban centers.

Behavioral health continues to be an issue in rural America, where nearly 23% of adults report experiencing mental illness, and substance use is markedly high. Poverty further compounds the issues of behavioral health making access to healthcare difficult for the 13.6% of the rural population living below the poverty line. Rural communities are plagued by behavioral health provision challenges related to accessibility, affordability, availability, and acceptability.

Population migration during the COVID-19 pandemic and an aging rural population have created new challenges in rural areas, including a population gap among working-aged people 16-64. The aging baby boomer population has led to a growing elderly demographic in rural regions, yet the eldercare sector has struggled to meet these needs. Meanwhile, access to childcare services has diminished in smaller cities and rural communities.

Given these complexities, there remains an urgent need to advance research in rural social work and promote social justice and health equity for rural populations.

Methods:
In January, 2025, a group of 12 rural social work researchers and practitioners came together during a special interest group to discuss the strengths, weaknesses, opportunities, and threats (SWOT) of rural social work research. Our primary objective was to have a broader understanding of the challenges faced by researchers working conducting rural research and to identify opportunities to advance rural research in social work. Participants were divided into two groups based on topical interest and experience in rural research. Each group inventoried individual aspects of the SWOT analysis based on their experiences. Results from both groups were combined.

Results:
The findings highlighted several strengths within rural communities, including deep cultural connections, resilience, and a strong sense of interconnectedness. Additionally, the increasing interest and funding opportunities for rural research present significant opportunities for growth. However, weaknesses were identified in the form of academic constraints, including the rigidity of research expectations in universities and challenges in working with small, often hard-to-reach populations. Political and logistical barriers were also identified as major threats.

Conclusions and Implications:
The results of this SWOT analysis underscore the importance of adapting academic research practices to better meet the needs of rural communities, particularly by fostering community-based participatory research. Our poster will detail the components of the SWOT and implications for social work researchers.