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FACT SHEET
CHILD AND YOUTH MENTAL HEALTH
In a Rural Setting
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Children and their families in rural and northern areas may face more obstacles to obtaining health services and supports than those in urban areas (Cutrona, Halvorsen and Russell, 1996; Starr, Campbell and Herrick, 2002) |
Access to services
Often, in rural areas, there is no publicly funded transportation service. What this means is that families without vehicles will have to use taxis or rely on friends and relatives to access services. When a family’s needs are more specialized, families often have to access specialized resources such as residential services and hospitals in urban areas and a lack of transportation becomes a more significant barrier.
What this means for agencies providing services: Agencies have increased costs related to staff and volunteer travel. Also, agencies have increased costs as they open satellite offices in order to provide access and deliver services close to home.
Lack of Services
In rural areas, often a continuum of care does not exist. For example, in rural areas in the South East region, there are no residential services and limited or no free adult counselling services except for individuals that have a serious mental health problem. Similarly, for children, there are no Boys and Girls clubs and no YM/YWCA’s. The physician shortages are more acute; using Lanark County as an example, there is no pediatrician or psychiatrist in the county. Specialized services in general, including psychology, are limited, if available.
Some problems tend to be more rurally based; e.g. crystal meth, at least in the American experience, has been a predominantly rural issue; and yet, addiction resources in rural areas are extremely limited.
What this means for agencies providing services: Children’s mental health staff have to be “all things to all people” as there are few services to refer to.
Big City Problems are Less Visible
Risk indicators (crime rates, suicides and accidental deaths) are often above the provincial average in rural areas. A recent study indicated as well, that in general, people living in rural areas earn lower wages on average. Ironically, people move from urban areas, looking for an idealized rural life and do not understand the reality of living in rural poverty and the isolation that can bring. Very real problems are hidden. Youth homelessness for example, is a problem in rural areas but homeless youth are much harder to find than in an urban setting. As a result, often, funding for “big city” problems does not come to rural areas.
What this means for agencies providing services: There is a need for agencies to creatively deal with complex issues like youth homelessness without shelters and programs, creating pressure on scarce resources as youth are placed in inappropriate settings to keep them safe. Often the needs of rural areas are simply overlooked and underfunded.
Economic Issues
Due to small populations, the tax base in rural communities is quite small and typically, the tax base from business and corporations is extremely small.
What this means for agencies providing services: Agencies have limited opportunities for fund raising. Foundation and United Ways have little available financial support as their fundraising potential is limited.
Funding based on child population
Funding based on child population can be a positive approach as it encourages locally based services that are accessible to people living in rural areas. The 1996 restructuring of children’s mental health services in South Eastern Ontario is an example. However, child population based funding sometimes disadvantages rural areas by virtue of critical mass and absence of other services.
What this means for agencies providing services: Funding based on child population may mean that a rural area will not receive enough funding to create a viable program.
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