The Challenge of Delivering Mental Health Care in Rural Clinics
When Boundaries Blur
Maurice Sprenger, MD, Enrico Camara, MD, and Penny Jeffers, RN, MSN, CS, CNAA
Dr. Sprenger is the clinical manager of the VISN 7 mental health service line; a clinical associate professor of psychiatry and behavioral sciences at the department of psychiatry at Emory University School of Medicine, Atlanta, GA; and an associate clinical professor in the department of psychiatry at the University of Hawaii John A. Burns School of Medicine (UH JABSOM). Dr. Camara is the director of the Traditional, Alternative and Complementary Healing Program at the VA Pacific Islands Health Care System, Honolulu, HI and a clinical professor in the department of psychiatry at the UH JABSOM. Ms. Jeffers is the associate director for nursing services at the Tuscaloosa VA Medical Center, Tuscaloosa, AL; a nurse executive for the VISN 7 mental health service line; and an adjunt clinical professor in the Capstone College of Nursing at the University of Alabama, Tuscaloosa.
Clinicians practicing in rural community-based outpatient clinics may be at greater risk for violating provider-patient boundaries than their urban counterparts. Here's why—and what we can do to help them set appropriate limits.