Rurality as Concordance: Mental Health Service Delivery for Rural Survivors of Intimate Partner Violence

This manuscript examines how a shared sociospatial or "rural" identity may uniquely facilitate mental health care delivery. In particular, we consider the significant but largely unexplored role that domestic violence center staff, whom we term "Reputational Provider-Experts" or RPEs, play in addressing the mental health needs of rural women who have experienced intimate partner violence. Using data collected through semi-structured individual and focus group interviews with RPEs across 12 counties and four tribal reservations in northern Wisconsin (N = 15), we detail the sociospatial commonalities that enable RPEs to provide trusted, sustained mental health support to rural women. Because these advocates are rural community members whose approach implicitly appeals to local norms and values, we argue that they represent rurally concordant providers. In this way, rurality emerges as a meaningful and novel form of patient-provider concordance, one with critical relevance to addressing the rural mental health crisis in the United States.