Heart of Safety Coalition

Urban, suburban and rural perceptions of mental health care access for clinicians

2.18.2026

by Liz Boehm

Executive Strategist, Human-Centered Research

I recently took a deeper dive into the data from our 2025 report, Clinician perceptions of barriers to access mental health care, which I co-authored with Stefanie Simmons, MD, Chief Medical Officer, Dr. Lorna Breen Heroes’ Foundation, to better understand the differences between survey responses from clinicians living or working in urban, suburban and rural areas.

The report, which was informed by more than 2,000 nurse practitioners, physician associates, physicians and registered nurses identified three categories of barriers:

Structural barriers, including cost and schedule flexibility
Institutional barriers, including licensure and credentialing application questions
Cultural barriers, including privacy and internal and external bias, behaviors and attitudes

Issues such as institutional stigma and negative attitudes from peers and self-judgment were common across all geographies. Even structural barriers such as insurance coverage and challenges getting time off from work showed no clear pattern of difference across respondents from urban, suburban and rural locations.

However, rural clinicians were 27% more likely to disagree or strongly disagree with the statement “mental healthcare is accessible for healthcare workers” than urban and suburban clinicians. And they were more almost twice as likely to report a lack of available mental health clinicians as a prohibitive (13% versus 7%) or significant (43% versus 35%) barrier to accessing mental health care as compared with their urban and suburban counterparts.

When I looked at the open-ended responses, I uncovered some nuances that help explain these differences: privacy and proximity.

In a small town everyone knows your name

Rural clinicians called out the challenging reality of seeking mental health care in a small town. They expressed concern about maintaining privacy from people they know in the community and at work.

Behavioral health services can be far away

Taking time out of busy schedules to seek care was a common barrier across all geographies, but particularly pronounced among rural clinicians, who often must travel a considerable distance to find a qualified mental health provider. Even when there are local resources, they are scarce, according to survey respondents.

Ideas to break down barriers for rural clinicians

Clinicians in rural areas were in general agreement with colleagues in other regions that to remove stigmatizing language from licensure and credentialing processes would help reduce barriers to care. They also agreed that taking actions to reduce cost and stigma associated with clinicians’ access to mental health care would help. To address unique challenges that rural clinicians face, survey respondents provided suggestions. They called for organizations to find ways that enables clinicians to balance the time required to access care from a mental health provider located far away with their busy and sometimes unpredictable schedules. Some pointed to technology as a way to overcome these challenges and bridge distance and scheduling gaps.

If you have questions about this data or the broader report, reach out to me via email at HeartofSafetyCoalition@stryker.com. The Heart of Safety Coalition collaborates with the Dr. Lorna Breen Heroes’ Foundation and its ALL IN Coalition to help improve the safety and wellbeing of care team members regardless of where they live and work.

Read the full report

If you have any questions about this report, email Liz Boehm at HeartofSafetyCoalition@stryker.com.

Heart of Safety Coalition

Urban, suburban and rural perceptions of mental health care access for clinicians

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