Trends in mental health care utilization in rural and nonrural areas, 2019-2023

The recent increase in mental health care providers offering telehealth may improve access by reducing travel costs, particularly for those in rural areas. This paper seeks to understand how mental health care utilization changed from 2019 to 2023 for rural and nonrural areas.

This study uses data from the National Health Interview Survey for 2019 and 2021-2023 (n = 118,652). To adjust the utilization rates for sociodemographic factors, a probit model with survey weights is used. For each year, the adjusted percentage of rural and nonrural populations receiving any mental health care in the past year is reported. Changes in demographic characteristics of those receiving care are also discussed.

This study finds that both rural and nonrural populations experienced large increases in adjusted mental health care utilization rates from 2019 to 2023. Utilization rates in rural areas grew 3.72 percentage points, from 9.35% (95% CI: 8.85-9.84) in 2019 to 13.07% (95% CI: 12.86-13.28) in 2023. For nonrural areas, utilization rates increased 4.40 percentage points, from 12.06% (95% CI: 11.79-12.74) in 2019 to 16.46% (95% CI: 15.82-17.11) in 2023.

Rural populations utilize less mental health care than nonrural populations, but both saw a substantial increase from 2019 to 2023. While telehealth may particularly benefit rural areas, these data suggest a larger increase in utilization for nonrural respondents. Future work is needed to better understand remote mental health care and rural populations.