Article Highlights Needs of Rural Children, Families with Mental, Behavioral and Developmental Disorders

March 16, 2017

In the latest of a series of reports on child mental health, the Center for Disease Control and Prevention documents that rural children from small communities have more mental, behavioral and developmental disorders (MBDDs) than those living in cities and suburbs. A Perspective article, published today in the New England Journal of Medicine, outlines the disparities and how they could potentially be addressed.
The authors cite poverty, perinatal or early-childhood teratogen exposure from extraction and processing industries, and a lack of evidence-based, early intervention programs compared to urban areas as possible contributing factors to the burden of MBDDs among rural children. They call for further research about why this disparity exists and outline how to potentially help families affected in the meantime.
“We believe that rural communities should partner with agencies that operate in alternative settings, use telehealth services, and employ primary care and alternative providers to coordinate care and deliver low-intensity interventions,” write co-authors from Nationwide Children’s Hospital and the Centre for Child Mental Health Services and Policy Research, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
“It’s possible to expand care by delivering behavioral and developmental health care in settings other than medical offices, but there are financial and regulatory issues to consider so we wanted to address those,” said co-author Kelly Kelleher, MD, MPH, director of the Center for Innovation in Pediatric Practice and vice president of Health Services Research at The Research Institute at Nationwide Children’s.
“We are using videoconferencing to help train primary care physicians to deliver complex mental care to kids in isolated rural areas in Canada,” said co-author William Gardner, PhD, who is director of the Centre for Child Mental Health Services and Policy Research, Children’s Hospital of Eastern Ontario Research Institute.
“Our goal in writing this, especially now that the future of American health care reform is uncertain, is to draw the attention of the medical community to a rural need that is too often out of sight and out of mind,” said Dr. Kelleher, who is also a faculty member at The Ohio State University College of Medicine.”

About Nationwide Children's Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report’s 2019-20 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit freestanding pediatric health care systems providing wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children and adolescents, as well as adult patients with congenital disease. Nationwide Children’s has a staff of more than 13,000 providing state-of-the-art pediatric care during more than 1.5 million patient visits annually. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Abigail Wexner Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded freestanding pediatric research facilities. More information is available at