How to Serve the Underserved: Making the Case for Rural and Remote Mental Health Training for Psychiatry Residents
- PDF / 141,100 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 2 Downloads / 174 Views
LETTER TO THE EDITOR
How to Serve the Underserved: Making the Case for Rural and Remote Mental Health Training for Psychiatry Residents Marlon Danilewitz 1
&
Claire Docherty 1 & Anees Bahji 2
Received: 26 March 2020 / Accepted: 17 June 2020 # Academic Psychiatry 2020
To The Editor: While rural areas comprise nearly 75% of the USA by land mass, only about 20–23% of the population lives in these areas [1]. Individuals living in rural areas have reduced access to healthcare, with less than 10% of physicians and 2% of specialists practicing in rural areas [2]. Similarly, access to psychiatrists is greatly limited in remote areas in the USA [1]. In particular, for communities less than 20000, nearly 75% lacked a psychiatrist and 95% lacked a child psychiatrist [3]. To that end, ensuring adequate access to the same mental health services as those who live in more urban areas continues to be a significant challenge. As the demand for access to psychiatric care in rural areas rises, medical educators have worked to increase trainee interest and future commitment in rural practice by optimizing their exposure to these communities [2]. Accordingly, some psychiatry residency training programs across Canada and the USA have mandated training in rural and underserved communities, while others have incorporated formal telepsychiatry training [1, 4]. Across programs, requirements vary widely as do definitions of “rural and remote” [1, 3, 4]. Despite these challenges, the accrual of these skillsets, such as familiarity with complex cases, flexibility, and cultural sensitivity, is also essential attributes that could benefit all psychiatrists. Despite the potential benefits of increased access to rural psychiatry, there are several barriers to rural practice. These include a lack of education and training for rural practice, isolation, increased workload, decreased resources, cultural differences, and impact on spouses and families [3]. Trainee-
* Marlon Danilewitz [email protected] 1
University of British Columbia, Vancouver, British Columbia, Canada
2
Queen’s University, Kingston, Ontario, Canada
specific barriers involve isolation from peers, challenges accessing resources, and struggles fulfilling training requirements [1]. Fortunately, several studies have shown that when these barriers are addressed, trainees appear to be more inclined to pursue rural training and work long term in these communities. For example, while few postgraduate programs include rural training, rural training is a strong predictor of future rural practice [3, 4]. A review of existing rural training programs in North America found a “dose-related” trend where more training led to an increased likelihood of rural practice later, emphasizing the importance of including in vivo clinical experience in rural settings [4]. Similarly, the University of Toronto psychiatry pilot program demonstrated that residents who participated in outreach electives in rural or northern communities were ten times more likely to continue outreach as staff co
Data Loading...
