Educator and Caregiver Perspectives on Rural Youth Mental Health Access

Garbacz, S. A., Im, S., Young, K., Godfrey, E., Stelter, C., Twombly, T., Deng, X. F., & Albers, C. A. (2022). Promoting youth mental health in rural communities. School Mental Health, 14(4), 863–879. https://doi.org/10.1007/s12310-022-09526-1

Introduction

Youth in rural areas face disproportionately high rates of depression, suicide, and substance use, yet they often lack adequate access to mental and behavioral health (MBH) services. Schools are the most common point of care, but rural school systems encounter unique challenges such as staffing shortages, geographic isolation, and stigma. To address these gaps, Garbacz and colleagues (2022) examined how caregivers and educators perceive youth MBH needs, available services, barriers, and facilitators in rural school communities.

Methods

The study recruited 21 caregivers and 20 educators from three rural and one town school district in a Midwestern state. Participants joined nine focus groups (five caregiver, four educator), each lasting 90 minutes. Guided by the Quality Implementation Framework, researchers used thematic analysis to code transcripts and identify recurring themes. Caregivers also completed a standardized behavioral screening (BASC-3 BESS) for their children.

Results

Caregivers emphasized student-level needs such as ADHD, bullying, self-harm, and social-emotional struggles, as well as community stressors like drug abuse and family instability. Educators highlighted overlapping concerns but added trauma, poverty, and parental incarceration. Available services included community-based clinics, school psychologists, prevention programs, and tiered school supports, though access was uneven. Major barriers included limited school capacity, scarce providers, travel and cost burdens, stigma, and weak home–school communication. Facilitators included dedicated infrastructure (staff, funding, training), positive school climates, collaboration with community services, and strong staff and administrator buy-in.

Discussion

The findings underscore that MBH challenges in rural areas are both systemic and cultural, rooted in resource scarcity and community attitudes. However, opportunities exist in leveraging close-knit community relationships, normalizing mental health conversations, and strengthening coordination between schools, families, and community providers.

Implications for Mentoring Programs

Mentoring initiatives in rural settings should address mental health indirectly by building protective relationships, promoting social-emotional skills, and bridging communication gaps between families and schools. Mentors can normalize help-seeking, provide early identification of concerns, and connect youth with school or community resources. By training mentors in basic mental health literacy and embedding them into tiered support frameworks, programs can extend the reach of limited school-based professionals.

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