Rural Canadians face mental health concerns to the same degree as their urban counterparts, but rural communities have less access to psychologists, and that access may be eroding. Psychologists can be found in the public system , but increasingly are choosing to work in private practice, in fee-for-service clinics.
In rural settings, specialized mental health services are often not locally accessible, particularly in terms of early screening, treatment, tertiary care, teletherapy, integrated health services and community approaches. All these approaches have been suggested by policymakers to improve mental health service access in rural spaces.
This leads us to ask: is mental health a responsibility of publicly funded health care, like a broken leg or cancer? Or has it fallen into a category of services that are necessary yet have limited coverage, such as dental care? The lines delineating what constitutes health seem arbitrary. What is a psychologist? Psychologists are experts in mental health and provide essential services in identifying and treating behavioural disorders and difficulties. In collaboration with physicians and nurse practitioners, both of whom can prescribe pharmacological therapies, best outcomes for mental illness treatment are observed when medications are paired with evidence-based psychological interventions.
Rural psychologists also need to work collaboratively with other health-care providers and mental health practitioners including counsellors, social workers and physicians. Noting of course, that these professions are also disproportionately allocated to urban settings. Ultimately, this movement means that experts in mental health are accessible only to those who can afford them. Further, the private system tends to provide service in an out-patient setting to clients who are generally functioning in their day-to-day lives, whereas the public system serves a wider range including inpatient and high-needs care.
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