Nationally, rural American communities have some of the largest need for behavioral health care providers and yet the lowest availability. This is reflected in the fact that more than 60% of rural Americans live in a mental Health Professional Shortage Area, and more than 90% of psychologists and psychiatrists and 80% of social workers practice exclusively in metropolitan areas. The lack of providers is thought to be caused by providers seeking:

  • A living wage with health care benefits
  • Opportunities to grow and advance
  • Clarity in a job role
  • Some autonomy and input into decisions
  • Manageable workloads
  • Administrative support without crushing administrative burden
  • Basic orientation and training for assigned responsibilities
  • A decent and safe physical work environment
  • A competent and cohesive team of coworkers
  • The support of a supervisor, and rewards for exceptional performance

Loan repayment services, such as the National Health Service Corps (NHSC), has been promoted as a successful strategy for attracting behavioral health providers, especially psychiatric prescribers, into rural practice. The recent federal spending bill expanded NHSC eligibility to include Substance Use Disorder Counselors. Also, some states have additional policies that increase the recruitment of providers in rural areas.

The focus of this project is a multi-case comparison study to describe state incentives for behavioral health provider recruitment, particularly into rural areas. This case comparison study aims to work with state rural health and health workforce offices to determine current recruitment practices to both build the provider pipeline in a given state and incentivize practice in areas suffering from maldistribution of workers.


Nancy Baum, PhD, MHS
Jaque King, MPP

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