Women living in rural communities are less likely than urban-dwelling women to receive sufficient mental health care, in large part due to limited access to services and societal stigma, according to medicine and public health researchers.

Some reports indicate that rural women are more likely than urban women to have depressive mood and anxiety symptoms. However rural women do not have adequate access to mental health care, compared with city women. Rural women who do seek mental health help are more likely to receive care from their primary physician than are urban women.

"We asked rural primary care physicians about how they care for women's mental health," said Jennifer S. McCall-Hosenfeld, primary care physician and assistant professor of medicine and public health sciences, Penn State College of Medicine. "Theirs is an important perspective because rural primary care physicians provide a substantial proportion of mental health services for their patients."

McCall-Hosenfeld and colleagues interviewed 19 primary care physicians who provide care to rural women in central Pennsylvania. The physicians answered questions that focused on screening and diagnosis of mental health conditions, barriers to treatment among rural women, management of mental illnesses in rural women and ideas to improve care for this population. The questions focused on practicing medicine in rural areas and specifically about providing care to rural women. The researchers report their findings in the current issue of Mental Health in Family Medicine.

As of 2005, only 7.4 percent of all U.S. psychiatrists practiced in a rural area. Primary care physicians in rural communities experience significant barriers in providing care to rural women with mental health problems. They commonly reported caring for mental health conditions that were often outside the scope of their training.

"I do a lot of psychiatry in my practice that I really wish I didn't have to do, but I do it because someone's got to do it," said one of the primary care physicians interviewed by the researchers.

Another problem, as several primary care physicians reported to the researchers, results from the stigma surrounding mental health.

"Rural women may not want to be seen walking into the office of a mental health care provider due to fear of judgment by family and friends," the researchers noted in the article.