Palomin Amanda, Takishima-Lacasa Julie, Selby-Nelson Emily, Mercado Alfonso
Department of Psychological Science, University of Texas Rio Grande Valley, 1201 W. University Dr, Edinburg, TX, 78539, USA.
Manakai O Malama, Hawaii, USA.
Community Ment Health J. 2023 Nov;59(8):1442-1451. doi: 10.1007/s10597-023-01151-9. Epub 2023 Jun 14.
This manuscript reviews the unique challenges, barriers, and ethical implications of providing mental health services in rural and underserved areas. Community mental health centers in rural areas are often underserved due to shortages of mental health providers and limited resources. Individuals living in rural areas are at increased risk of developing mental health condition with limited access to mental health clinicians and healthcare facilities. These access to care issues are often exacerbated by geographical barriers as well as social, cultural, and economic challenges. A rural mental health professional may encounter several barriers to providing adequate care to individuals living in rural areas. For example, limited services and resources, geographic barriers, conflict between professional guidelines and community values, managing dual relationships, and challenges pertaining to confidentiality and privacy are several barriers to providing adequate care in rural areas. We will briefly summarize the primary ethical domains that are especially influenced by rural culture and the complex responsibilities of mental health providers in rural areas including barriers to care, crisis intervention, confidentiality, multiple relationships/dual roles, limits of competency, and rural mental healthcare practice implications.
本文回顾了在农村和服务不足地区提供心理健康服务所面临的独特挑战、障碍及伦理问题。由于心理健康服务提供者短缺和资源有限，农村地区的社区心理健康中心往往得不到充分服务。生活在农村地区的个人患心理健康疾病的风险增加，因为他们获得心理健康临床医生和医疗设施的机会有限。地理障碍以及社会、文化和经济挑战往往会加剧这些获得医疗服务的问题。农村心理健康专业人员在为农村地区居民提供充分护理时可能会遇到几个障碍。例如，服务和资源有限、地理障碍、专业准则与社区价值观之间的冲突、处理双重关系以及与保密和隐私相关的挑战，都是在农村地区提供充分护理的障碍。我们将简要总结受农村文化特别影响的主要伦理领域，以及农村地区心理健康服务提供者的复杂责任，包括护理障碍、危机干预、保密、多重关系/双重角色、能力限制以及农村心理健康护理实践的影响。
