Rural disability, self-reliance, and the utilization of mental health services.

Background: The intersection of rurality, disability, self-reliance values, and utilization rates of mental health services (MHS) is under-researched.

Objective: To better understand the differences between unmet need and no perceived need for MHS between noncore, micropolitan, and metropolitan adults with disabilities.

Methods: We conducted logistic regression analyses of the 2022 National Survey on Health and Disability (NSHD) to identify associations between demographic characteristics and odds of reporting unmet need for MHS or no perceived need for MHS.

Results: Living in a noncore area, being male, lower educational attainment, older age, vision disability, and ambulatory disability were significantly associated with increased odds of reporting no perceived need for MHS. Being LGBTQIA+, poor transportation access, and cognitive disability were significantly associated with decreased odds of reporting no perceived need for MHS. Cognitive disability, cohabitation, and poor transportation access were significantly associated with increased odds of reporting unmet need for MHS. Conversely, being male, having some college and/or a two-year degree were significantly associated with decreased odds of reporting unmet need for MHS. There were not significant differences in unmet need for MHS across rural indicators.

Conclusion: No perceived need of MHS is an underexplored factor among rural and urban adults with disabilities. Solutions include policies to expand MHS access, tailored public health outreach, and provider communication training.