Mental Health Access a Challenge in Rural Pennsylvania

Possible solutions discussed in hearing

April 10, 2025

Rural Pennsylvanians are faced with many challenges when it comes to mental health care, including access, stigma, economic barriers, poor internet service for telehealth visits, and a shortage of mental health professionals.

This week, a panel of experts testified before the Center for Rural Pennsylvania Board of Directors about advancing rural mental health awareness and support. The hearing featured insights from the health care and law enforcement communities.

“We are working with PA school nurses to increase their confidence in screening for suicide risk in youth,” said Jamie Zelazny, assistant professor of nursing and psychiatry at the University of Pittsburgh in testimony. “This is especially important in rural areas, where there are fewer resources available. This is just one small step that could improve identification of youth at risk. Nurses at all levels of practice can play a role in suicide prevention.”

Here are five key takeaways:

Staffing gap contributes to the problem:  Difficulties continue with efforts to recruit and retain health care professionals to rural areas.

Insurance payments can be an obstacle for rural providers:  Insurance payments vary widely by carrier and, without regular increases, can quickly become cost prohibitive for small practices to accept some insurances, which limits access.

No easy answer:  Nurse practitioners are an underutilized profession that can meet many of the behavioral health needs of Pennsylvanians; however, they are required to maintain a collaborative agreement with two physicians. Collaborative agreements can be costly to maintain and are often thought of as “business agreements.”

Rural youth continue to struggle to access mental health care:  Low mental health care practitioner availability is associated with higher suicide rates and youth in rural counties have access to fewer mental health services than those in urban and suburban areas.

Tioga County District Court Judge Tiffany L. Cummings told the story of a resident trapped in a cycle of incarceration and release due to a lack of resources.

“I believe that our jail does a good job connecting inmates to the resources they need for both mental health and substance abuse treatment while they are incarcerated, but problems arise maintaining those connections upon release,” she said. “If someone is not already an established patient at an outpatient clinic, having them become a new patient can take months. During these months, those people often begin to deteriorate, and either don’t take prescribed medications, or use substances that they shouldn’t, which often leads to bad decisions including committing crimes.”

HAP and Pennsylvania hospitals are focused on efforts that support access to care and long-term recovery across the commonwealth. This includes ensuring investment in our behavioral health care system to meet the growing demand for this care.

This week’s hearing is available to watch online.