PABI Plan - The Sarah Jane Brain Project

of affairs. The rural mental health community has not developed or sufficiently advocated
for innovative and replicable evidenced-based solutions tailored specifically to the needs
of rural citizens to serve as alternatives to the existing urban-based models.
Fortunately, there are effective mental and behavioral health advocates in many local,
State, and Federal agencies and organizations that understand and have embraced the
issues of rural communities. By virtue of their willingness to “go the extra mile,” these
key individuals and agencies have begun to move the field toward a better awareness of
the mental and behavioral health needs of rural Americans and the challenges of serving
them. Our challenge is to build on their efforts and maintain the momentum that they
have created. In order to do this, we must address and move beyond the problems briefly
addressed by the Surgeon General and the President’s New Freedom Commission. This
will require State and Federal policymakers, providers, consumers, and mental and
behavioral health advocates working together to forge an ongoing national rural mental
and behavioral health agenda that enables these services to operate in the health care
mainstream by:
• Incorporating policies specifically tailored to the needs of rural communities,
providers, and consumers;
• Providing the resources and tools needed to appropriately deliver services in rural
areas in a culturally sensitive and competent manner; and
• Developing evidenced-based models of care that are both replicable and transferable
across a range of rural communities.”
Rural / Telehealth and childhood injury prevention
As it relates to motor vehicle (MV) collisions, one of the leading causes of PA/TBI in
children/young adults, the strategies adopted from the Prevention Category of Care must take
into strong consideration the rural regions of the country, where over one-third of motor vehicle
collisions occur and two-thirds of the deaths attributed to these collisions occur. The people who
reside in these locations, as well as the private and commercial traffic that travels through these
regions, have the same emergency health care needs as their counterparts living in urban and
suburban areas. The day-to-day realities of EMS systems in rural and frontier environments are
vastly different when contrasted with their urban and suburban counterparts. Anywhere from 57
to 90 percent of first responders in rural areas are volunteers. MV collisions resulting in death or
serious injury are the cause of 60 percent of total rural injuries, versus only 48 percent of urban
injuries. Poorly defined geographical boundaries, low population density and call volumes,
elongated response and transport times (national average response times in rural areas was 18
minutes, which is eight minutes longer than in urban areas), the need for more well-established
communication infrastructure over remote areas, and the lack of acute or specialty care facilities
are all factors that impact operations. These facets can also widen the disparity between the
services delivered and the public’s expectations.
In addition, rural residents are nearly twice as likely to die from unintentional injuries other than
MV collisions as are their urban counterparts. Rural residents are also at a significantly higher
risk of death and brain injury by gunshot than urban residents. Additional causes of PA/TBI
such as alcohol poisoning have a higher risk factor in rural America since the rate of DUI arrests
is greater among rural youth than their urban counterparts. Forty percent (40%) of rural 12 th
graders reported using alcohol while driving compared to 25% of urban high school seniors.
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