Rural communities across New York State are experiencing urgent behavioral health challenges. The Statewide Aggregate Rural Health Needs Assessment: Mental Health and Wellbeing, developed by the New York State Association for Rural Health, compiles and analyzes findings from Community Health Assessments, Community Health Improvement Plans, and Local Services Plans across New York’s 44 rural counties. This report provides the first statewide synthesis of local planning documents to create a comprehensive picture of rural behavioral health needs. 

 

The report is organized in two parts. The first addresses mental health outcomes, including depression, suicide, substance use, and adverse childhood experiences. The second focuses on structural barriers to access, including workforce shortages, limited inpatient and crisis services, transportation challenges, and inadequate broadband. Accessibility is the thread that connects the themes in this report. A clinic may exist on a map, but residents still need to get an appointment, reach it, and stay connected to care. Poverty, disability, age, race and ethnicity, language, and gender identity all influence whether residents can access treatment. Conditions and barriers vary not only between counties but also within them, underscoring that rural communities are diverse rather than uniform. This assessment shows that the behavioral health crisis in rural New York is defined as much by the inaccessibility of care as by the prevalence of conditions themselves.