State mental health infrastructure, personality, and politics of shelter-in-place

Guided by the conservation of resources (COR) theory, this study investigated how regional variation in mental health needs and resources may have impacted early efforts to curb the spread of COVID-19. Publicly available data were analyzed to evaluate states' initial responses (i.e., February 2020-March 2020) to the COVID-19 pandemic. Each of the 50 U.S. states, as well as the District of Columbia, were included in the analyses, providing a total sample size of N = 51. U.S. states with greater mental health needs and barriers to treatment tended to: be slower to implement shelter-in-place orders;have residents who showed less increase in time at their residences in response to the crisis;be more rural, economically disadvantaged, and more conventional;and have less access to the internet. Considering this cultural context provides insight for tailoring and implementing interventions in a culturally competent manner. Furthermore, mental health resource sharing across states and regions may be needed to address future mental health care gaps resulting from the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement Rural and financially strained areas with fewer resources and greater mental health needs tended to spend less time under shelter-in-place orders and showed less increase in time spent at home during the early phase of the COVID-19 pandemic. Special attention is needed to strengthen community resources and health care infrastructure to support recovery from the pandemic. Access to finances and resources may facilitate more rapid and flexible change in routines required by future pandemics and large-scale threats. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

State mental health infrastructure, personality, and politics of shelter-in-place

Guided by the conservation of resources (COR) theory, this study investigated how regional variation in mental health needs and resources may have impacted early efforts to curb the spread of COVID-19. Publicly available data were analyzed to evaluate states' initial responses (i.e., February 2020-March 2020) to the COVID-19 pandemic. Each of the 50 U.S. states, as well as the District of Columbia, were included in the analyses, providing a total sample size of N = 51. U.S. states with greater mental health needs and barriers to treatment tended to: be slower to implement shelter-in-place orders;have residents who showed less increase in time at their residences in response to the crisis;be more rural, economically disadvantaged, and more conventional;and have less access to the internet. Considering this cultural context provides insight for tailoring and implementing interventions in a culturally competent manner. Furthermore, mental health resource sharing across states and regions may be needed to address future mental health care gaps resulting from the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement Rural and financially strained areas with fewer resources and greater mental health needs tended to spend less time under shelter-in-place orders and showed less increase in time spent at home during the early phase of the COVID-19 pandemic. Special attention is needed to strengthen community resources and health care infrastructure to support recovery from the pandemic. Access to finances and resources may facilitate more rapid and flexible change in routines required by future pandemics and large-scale threats. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Rural Psychology and the COVID-19 Pandemic: Highlighting Strengths and Future Directions

Public Significance Statement Rural mental health needs during the COVID-19 pandemic have not been widely discussed within the existing literature. Challenges and strengths specific to rural Canada are reviewed within the context of COVID-19 with recommendations for future directions provided to the reader. These recommendations are important for practitioners and policymakers to consider, as they provide future directions for policy development. Recommendations include ensuring mental health policies and practices implemented in rural and remote communities maintain a rural perspective. The Coronavirus disease (COVID-19) pandemic has dramatically impacted Canadians' mental health, including those who live in rural areas. Rural psychologists have long faced unique challenges associated with practice related to accessibility, isolation, and technology. They also have extensive experience in practicing with flexibility, creativity, and complex ethical considerations such as competency (generalist vs. specialist, cultural competence vs. content competence). Therefore, they may have adapted relatively rapidly to the dramatic changes that came along with the pandemic and be well positioned to lead their urban colleagues and organizations as we move forward. Whereas new and pre-existing challenges have been exacerbated by the pandemic, strengths of rural psychologists (e.g., managing geographical isolation, familiarity with telehealth) have emerged. This article looks at the strengths embedded in rural psychology that facilitated service provision during the pandemic. It also reviews future directions to build upon within the rural Canadian context.

Technology-Assisted, Group-Based CBT for Rural Adults' Depression: Open Pilot Trial Results.

Purpose: This pilot study assesses the association of Raising Our Spirits Together (ROST), a technology-assisted, group-based cognitive behavioral therapy for depression, with rural adults' depressive symptoms and anxiety. Method: Nine adults from rural Michigan participated in an open pilot of ROST. Clergy facilitated pilot groups. The pilot began in February 2020 in-person. Due to COVID-19, the pilot was completed virtually. Results: Mean depressive symptom scores, based on the PHQ-9, significantly decreased from pre-treatment (M = 14.4) to post-treatment (M = 6.33; t (8) = 6.79; P < .001). Symptom reduction was maintained at 3-month follow-up (M = 8.00), with a significant pattern of difference in depressive symptoms over time (F(2) = 17.7; P < .001; eta-squared = .689). Similar patterns occurred for anxiety based on the GAD-7. Participants attended an average of 7.33 of 8 sessions. Fidelity ratings were excellent. Discussion: ROST is a potentially feasible intervention for rural adults' depressive symptoms. ROST offers a promising model for increasing treatment access and building capacity in rural areas.

Remote mental health clients prefer face-to-face consultations to telehealth during and after the COVID-19 pandemic.

OBJECTIVE: To guide the efficient and effective provision of mental health services to clients in Central West and Far North Queensland, we surveyed preferences for face-to-face or in-person contact. METHODS: A clinician-designed survey of contact preferences was offered to 248 clients of mental health services in Far North and Central West Queensland in mid-2020. With the onset of COVID-19, the survey was modified to measure the impact of the pandemic. RESULTS: Just over half of the services' clients participated in the survey (50.4%), of whom more were female (63.2%). Of the participants, 46.3% in Far North and 8.6% in Central West Queensland identified as Indigenous. Strong resistance to telehealth before the pandemic across groups (76%) was moderated during COVID-19 (42.4%), an effect that appeared likely to continue past the pandemic for Central West clients (34.5%). Far North clients indicated their telehealth reluctance would return after the pandemic (77.6%). CONCLUSIONS: Our results suggest that remote Australians strongly prefer in-person mental health care to telehealth. Although the COVID-19 pandemic increased acceptance of telehealth across regions while social distancing continued, there was evidence that Indigenous Australians were more likely to prefer in-person contact after the pandemic.

What Is Rural Adversity, How Does It Affect Wellbeing and What Are the Implications for Action?

A growing body of literature recognises the profound impact of adversity on mental health outcomes for people living in rural and remote areas. With the cumulative effects of persistent drought, record-breaking bushfires, limited access to quality health services, the COVID-19 pandemic and ongoing economic and social challenges, there is much to understand about the impact of adversity on mental health and wellbeing in rural populations. In this conceptual paper, we aim to review and adapt our existing understanding of rural adversity. We undertook a wide-ranging review of the literature, sought insights from multiple disciplines and critically developed our findings with an expert disciplinary group from across Australia. We propose that rural adversity be understood using a rural ecosystem lens to develop greater clarity around the dimensions and experiences of adversity, and to help identify the opportunities for interventions. We put forward a dynamic conceptual model of the impact of rural adversity on mental health and wellbeing, and close with a discussion of the implications for policy and practice. Whilst this paper has been written from an Australian perspective, it has implications for rural communities internationally.