The challenge of providing quality psychiatric services in a rural setting.

The development of a system of services that addresses the medical, psychiatric, and social needs of mentally ill persons may be particularly difficult in rural health areas because of environmental, sociocultural, and program issues different from those in urban settings. The quality of rural mental health care must be evaluated in light of these unique needs and resources. This article identifies and discusses problems in delivery of services, including environment, denial, confidentiality, costs, and human resources, and outlines responses to these problems seen as challenges rather than as barriers.