Rural Social Work: The Challenges and Impact

Yeshiva University Wurzweiler School of Social Work Professor Daniel Pollack, MSW, JD, and Wurzweiler graduate Marisa Markowitz, LMSW, CASAC-T, were published by the National Rural Health Association (NRHA) in Rural Health Voices. Their article, “Is there a shortage of rural social workers?” explores the lack of mental healthcare options in rural America.

Pollack and Markowitz note that 47 million adults and 13.4 million children live in rural areas, but that the majority of social workers live and work in urban areas. Those who live in cities and surrounding areas have access to 80 percent of social workers and 90 percent of working psychologists and psychiatrists, while 65 percent of the residents of rural areas receive mental health services from general practitioners. Due to lack of social workers, mental health professionals and health resources in these areas, rural Americans often find themselves struggling to find adequate mental health support.

While there is an obvious lack of social workers in rural areas, their services are without a doubt essential to the wellbeing of rural communities. Social workers address a variety of issues that folks in these communities face.

Pollack and Markowitz cite a statistic from the CDC that states injuries from drug overdoses, falls and even traffic accidents are 50 percent higher in rural areas. Social workers have the ability to make a difference when it comes to drug overdoses, seeing as the opioid epidemic has taken a strong hold in rural America. These areas are in need of social workers who specialize in addiction treatment, methadone treatment, medication assisted treatment and other mental health disorders.

Women living in rural areas often find it challenging to locate nearby clinics that offer reproductive services and the social workers that do the counseling. Pollack and Markowitz note that women in these areas may have to travel more than 180 miles to seek services, meaning they have to take time off of work and figure out transportation and childcare. They also highlight that a number of states, including Kentucky, West Virginia, Mississippi, North Dakota, South Dakota, and Wyoming, only have one abortion clinic, while many have long waiting periods. These challenges mean that counseling is essential to a woman’s wellbeing, but there are not enough social workers in these areas to help women work through the issues.

On top of reproductive issues, the increased poverty, lack of public transportation and shortage of childcare makes it challenging for women to leave abusive relationships. Rural social work is essential in creating safe spaces for women to work through dangerous relationships.

For LGBTQIA+ teens and adults, there is often a lack of community and support. Federally funded healthcare is also lacking. These folks typically do not have access to the same resources to assist with the physical and mental health needs that their urban counterparts do. Social workers here serve as a lifeline.

Pollack and Markowitz cite the National Center for State Courts, which notes that those who used to be incarcerated and return to rural areas have a harder time due to lack of jobs, places to live, public transportation and programs that assist with reentry. Regarding housing, public housing authorities in these areas are legally able to reject tenants with criminal records. In urban areas, there are federal, state, and city-funded programs where social workers serve as the go-between with courts, hospitals, nonprofits, vocational programs and more to support the formerly incarcerated. Due to a lack of research on programs in rural areas, it can be assumed that there is a gap in social services for the formerly incarcerated returning to these communities.

Social workers who do take on the challenges of rural environments state that they do enjoy the small town feel of the communities that they serve, due to the strong connections that they build. However, it is important to be realistic about the challenges. The article concludes that social workers in rural communities have to continually expand the scope of their services out of necessity.

Read the full article here.

Pollack is a professor for the Wurzweiler School of Social Work. He has been an expert witness for lawyers in more than 30 states. Since 1980, Pollack has held executive, management, and policy-making positions in social welfare agencies in Maryland and Ohio. Pollack's research interests include law, ethics, and liability; adoption, foster care, child abuse and neglect; wrongful death of children in foster care and residential care; risk management; record keeping; licensing and accreditation; domestic violence, and international social work.

Markowitz earned her MSW and CASAC-T at the Wurzweiler School of Social Work. She studies the relationship between technology and its adverse effects on mental health with a focus on vulnerable populations. She currently works as a clinical social worker at New York-Presbyterian Hospital.

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