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Succeeding in Rural Mental Health Practice: Being Sensitive to Culture by Fitting in and Collaborating
Authors:Richard J. Bischoff  Allison M. J. Reisbig  Paul R. Springer  Sheena Schultz  W. David Robinson  Michael Olson
Affiliation:1. Child, Youth and Family Studies, University of Nebraska-Lincoln, PO Box 880236, Lincoln, NE, 68588-0236, USA
2. Marriage and Family Therapy Program, University of Nebraska-Lincoln, Lincoln, NE, USA
4. Marriage and Family Therapy Program, Utah State University, Logan, UT, USA
3. Department of Family Medicine, University of Texas Medical Branch, Galveston, TX, USA
Abstract:Sustainable solutions to the access to mental health care problems are complex and must address both the availability of mental health care resources and the acceptability of those resources to consumers. The purpose of this study was to determine how to address the acceptability problem by learning from medical and mental health care providers what mental health therapists need to know to be successful in providing care in rural communities. Using a qualitative design, focus groups were conducted in three rural communities (<2,500) with medical and mental health care providers practicing in these communities. Data were analyzed using inductive qualitative methods. Results indicate that in addition to sound clinical skill, mental health therapists should (A) be sensitive to the culture of the rural community in which they are working and (B) practice in a way that accommodates to the care culture of the community. The latter includes spending time with patients commensurate with what is expected by other providers, engaging in generalist practice, and collaborating with local providers in patient care. An important implication of these results is that mental health care must be acceptable to both the residents of the community and the gatekeepers to health care.
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