The 2010 implementation of the Affordable Care Act ensured that mental and behavioral health treatment would be an essential benefit covered by all health insurance policies sold on the federal health exchange.

While this measure has greatly expanded access to mental health treatment for a number of Americans, people all over the country still struggle to access mental health treatment for a variety of reasons. Some are dissuaded by a lingering stigma that surrounds mental illness, but for many others, mental health treatment simply isn’t available in their communities.

“Right to care does not mean access to treatment,” Columbia University Psychologist Paul Appelbaum tells The Guardian. “Tens of millions of people who did not have insurance coverage may now be prompted to seek mental health treatment. And the capacity just isn’t there to treat them.”

These sentiments have long been voiced by counselors, social workers, and health care professionals for years now, who have especially noted that people in rural areas are in dire need of mental health care.

Goutham Menon, who directs the Social Work program at University of Nevada, Reno attributes this problem to what he describes as a “Brain Drain,” which occurs when students from rural communities attend college and don’t return to the towns they grew up in, which leaves a dearth of college educated professionals in rural areas.

Perhaps the most shocking lack of mental health professionals might be in rural Texas, where 185 out of 254 counties have no psychiatrist, meaning that 3.2 million people don’t have access to psychological care.

This is a troubling trend for a number of reasons. There is a strong correlation between mental and physical health, meaning these individuals are actually becoming more ill as their conditions are left untreated. Those who struggle with their mental health disorders are also at a high risk of becoming a part of the criminal justice system.

“Where we don’t have those services for mental health patients, they wind up cycling back through our jails and our emergency rooms,” Texas state Senator Charles Schwertner tells NPR.

Solving this crisis is harder than it may seem, however. Psychiatry faces a supply issue in the medical field. Still, many governments have begun putting forth measures that they hope will put a damper on the crisis before it gets worse.

For some states, solutions come in the form of loan repayment programs, which help medical health professionals pay off their loans if they choose to serve in rural and underprivileged areas.

Others think it’s important to build up those who are already invested in the community, and to combine pre-existing resources in order to better serve the needs of the population.

“The most successful strategies are to find young people within the rural community, Sita Diehl of the National Alliance on Mental Illness tells NPR. “They know the community, they have an investment in the community.”

It’s this kind of investment, she argues that will keep mental health professionals from leaving after their loans are paid off.

It’s clear that the lack of mental health care professionals available in rural areas is a disturbing trend that needs to he addressed. While many are starting to realize just how crucial it is to address mental health concerns in their communities, large scale reform will likely be needed in order for those most marginalized and vulnerable to receive adequate mental health treatment.

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