Understanding Treatment Gaps for Mental Health, Alcohol, and Drug Use in South Dakota

A Qualitative Study of Rural Perspectives

Lauren Broffman, Margaret Spurlock, Kristen Dulacki, Amy Campbell, Fanny Rodriguez, Bill Wright, Kenneth (John) McConnell, Don Warne, Melinda Davis

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: More than 25% of US adults experience mental health or substance use conditions annually, yet less than half receive treatment. This study explored how rural participants with behavioral health conditions pursue and receive care, and it examined how these factors differed across American Indian (AI) and geographic subpopulations. Methods: We undertook a qualitative follow-up study from a statewide survey of unmet mental health and substance use needs in South Dakota. We conducted semistructured phone interviews with a purposive sample of key informants with varying perceptions of need for mental health and substance use treatment. Results: We interviewed 33 participants with mental health (n = 18), substance use (n = 9), and co-occurring disorders (n = 6). Twenty participants (61.0%) lived in rural communities that did not overlap with AI tribal land. Twelve participants (34.3%) were AI, 8 of whom lived on a reservation (24.2%). The discrepancy between actual and perceived treatment need was related to how participants defined mental health, alcohol, and drug use "problems." Mental health disorders and excessive alcohol consumption were seen as a normal part of life in rural and reservation communities; seeking mental health care or maintaining sobriety was viewed as the result of an individual's willpower and frequently related to a substantial life event (eg, childbirth). Participants recommended treatment gaps be addressed through multicomponent community-level interventions. Discussion: This study describes how rural populations view mental health, alcohol, and drug use. Enhancing access to care, addressing discordant perceptions, and improving community-based interventions may increase treatment uptake.

Original languageEnglish (US)
JournalJournal of Rural Health
DOIs
StateAccepted/In press - 2015

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Mental Health
Alcohols
Pharmaceutical Preparations
North American Indians
Rural Population
Therapeutics
Mental Disorders
Alcohol Drinking
Parturition
Interviews
Delivery of Health Care
Health

Keywords

  • Alcohol abuse
  • Drug abuse
  • Mental health
  • Policy
  • Qualitative research

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Understanding Treatment Gaps for Mental Health, Alcohol, and Drug Use in South Dakota : A Qualitative Study of Rural Perspectives. / Broffman, Lauren; Spurlock, Margaret; Dulacki, Kristen; Campbell, Amy; Rodriguez, Fanny; Wright, Bill; McConnell, Kenneth (John); Warne, Don; Davis, Melinda.

In: Journal of Rural Health, 2015.

Research output: Contribution to journalArticle

Broffman, Lauren ; Spurlock, Margaret ; Dulacki, Kristen ; Campbell, Amy ; Rodriguez, Fanny ; Wright, Bill ; McConnell, Kenneth (John) ; Warne, Don ; Davis, Melinda. / Understanding Treatment Gaps for Mental Health, Alcohol, and Drug Use in South Dakota : A Qualitative Study of Rural Perspectives. In: Journal of Rural Health. 2015.
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