Document Type

Policy Brief

Publication Date



Mental health, ACA, long-term care, LTC, quality improvement, reform, services, treatment, MRHRC, USM Aging Initiative, Health and Wellness, LTSS


To facilitate reform efforts, more research is needed on the current status of mental health services in rural long-term care. Also needed are new tools promoting the targeted use of provisions in the Affordable Care Act (ACA) to address the mental health needs of rural long-term care recipients. In this brief, we explore novel practices that hold promise for enhancing mental health services in rural long-term care, focusing primarily on the needs of rural elders who reside either in nursing facilities or in their own homes in the community. Key Findings: Despite high levels of need, individuals in long-term care often fail to receive appropriate mental health services, especially in rural areas. Efforts to promote better mental health treatment in rural long- term care face a broad array of challenges, including inadequate funding, workforce limitations, and physical access barriers. Strong pressures for health care delivery system innovation, supported by provisions in the Affordable Care Act (ACA), have created new opportunities for expanding access to appropriate mental health interventions for rural long-term care populations.

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