Virtual school-based progam to reduce suicide and improve the mental health of young people in rural America

**The Problem**

Rural youth in America are experiencing a mental health crisis. **Over[ 2 million](https://achi.net/newsroom/survey-1-in-5-us-adolescents-had-a-diagnosed-mental-health-condition-in-2023/) children and teens in rural areas** struggle with treatable mental health conditions, yet[ ](https://www.aacap.org/aacap/zLatest_News/Severe_Shortage_Child_Adolescent_Psychiatrists_Illustrated_AACAP_Workforce_Maps.aspx)[fewer than half](https://www.aacap.org/aacap/zLatest_News/Severe_Shortage_Child_Adolescent_Psychiatrists_Illustrated_AACAP_Workforce_Maps.aspx) receive the care they need. **Suicide, the second leading cause of death for rural youth**, occurs at a rate[ ](https://wisqars.cdc.gov/reports/?o=MORT&y1=2021&y2=2023&t=0&i=2&m=20810&g=00&me=0&s=0&r=0&ry=2&e=0&yp=65&a=custom&g1=0&g2=199&a1=11&a2=18&r1=UR2013&r2=NONE&r3=NONE&r4=NONE)[61% higher](https://wisqars.cdc.gov/reports/?o=MORT&y1=2021&y2=2023&t=0&i=2&m=20810&g=00&me=0&s=0&r=0&ry=2&e=0&yp=65&a=custom&g1=0&g2=199&a1=11&a2=18&r1=UR2013&r2=NONE&r3=NONE&r4=NONE) than their urban peers. In states like Montana, where youth suicide rates are more than[ ](https://wisqars.cdc.gov/reports/?o=MORT&y1=2021&y2=2023&t=0&i=2&m=20810&g=00&me=0&s=0&r=0&ry=2&e=0&yp=65&a=custom&g1=0&g2=199&a1=11&a2=18&r1=NONE&r2=NONE&r3=NONE&r4=NONE)[triple](https://wisqars.cdc.gov/reports/?o=MORT&y1=2021&y2=2023&t=0&i=2&m=20810&g=00&me=0&s=0&r=0&ry=2&e=0&yp=65&a=custom&g1=0&g2=199&a1=11&a2=18&r1=NONE&r2=NONE&r3=NONE&r4=NONE) the national average, severe provider shortages and long travel distances leave families without support. This is not just a crisis of access—it's a matter of lives lost and impaired life trajectories. Millions of rural children are being left behind.

**The Solution**

RBHI offers a simple, yet transformative, solution to the rural youth mental health crisis that addresses the critical gaps in care delivery and workforce shortages. RBHI’s fully virtual Screening Linked to Care (SLTC) program, tailored for rural communities, brings bi-annual universal mental health screenings, same-day care for high-risk students, care navigation support, and short-term clinical services right to students **at their schools**. Through RBHI’s creation of strong community partnerships that break through care silos and development of a novel care model that uses nurses to deliver psychiatric care, with psychiatrists ensuring care quality via supervision, RBHI has begun to solve the major mental health workforce shortage across rural America.

RBHI’s comprehensive approach ensures **equitable access to mental health support** **for rural youth** regardless of the availability of local resources**.** Thanks to SLTC, no children or adolescents will have to suffer the dire consequences of untreated mental health conditions because of geography. 

RBHI is on track to transform rural health care delivery for youth via their multidisciplinary partnerships with schools, communities, other service providers, clinicians, technology companies, and state agencies. Since piloting in one Montana school in spring of 2021, RBHI has rapidly scaled to 120+ schools in 70% of Montana’s counties, serving over 18,000 students in 2024-2025. RBHI is piloting similar programs in Illinois, Georgia, and Oregon and working to expand to rural regions of Colorado, Wyoming, and Kansas. By combining an innovative care delivery model with a growing nurse workforce, RBHI is poised to change the landscape of mental health care for rural youth and screen over 160,000 students annually by 2028.

**Impact**

●      In 4 years, RBHI scaled SLTC delivery from 41 to \~21,000 students in rural Montana, Georgia, Illinois, and Oregon schools.

●      Same-day care provided to more than 3,400 students with elevated suicide risk.

●      Among repeat SLTC student participants, new suicidality rates have decreased more than three-fold annually.

●      Severe depression and anxiety symptoms, risk factors for suicide, have dropped over 30% year-over-year.

Rural Behavioral Health Institute

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