1 The Professional Counselor™ Volume 14, Issue 1, Pages 1–14 http://tpcjournal.nbcc.org © 2024 NBCC, Inc. and Affiliates doi: 10.15241/kfj.14.1.1 Career Counselors Addressing Social Determinants of Mental Health in Rural Communities Career counselors practicing in rural communities must understand and address social determinants of mental health (SDOMH). This conceptual article details the relationships between SDOMH domains and employment and provides evidence-based recommendations for integrating SDOMH into practice through a rural community health and well-being framework. Description of the adaptation of the framework for career counselors in rural communities, SDOMH assessment strategies and tools, and workflow adjustments are included. Conclusions suggest next steps for practice and research. Keywords: social determinants of mental health, career counselors, rural communities, health and well-being framework, assessment Career counselors in rural communities address standard employment needs of the population, but they also must be aware of the socioeconomic circumstances that impact their community’s mental health and, in return, employment. Such socioeconomic factors are termed the social determinants of mental health (SDOMH). SDOMH are nonclinical psychosocial and socioeconomic circumstances that contribute to mental health outcomes (Office of Disease Prevention and Health Promotion [ODPHP], n.d.). Healthy People 2030, a government initiative to promote health and wellbeing, describes a five-domain framework of SDOMH which includes: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context (ODPHP, n.d.). Collectively, SDOMH can disrupt overall well-being and have a cyclical relationship with employment. For example, in rural communities, minimal access to public transportation may make sustaining employment difficult, which can then impact health insurance. Without insurance, a person loses access to health care; with unmet health care needs, a person who is unwell and without access to treatment has less opportunity for employment. Thus, understanding and addressing SDOMH is critically important for career counselors working in rural and other underserved communities (Pope, 2011). This conceptual paper will define SDOMH, introduce a theoretical framework for addressing SDOMH, provide evidence-based recommendations for assessment and treatment, and conclude with national resources to support career counselors in rural communities as they incorporate addressing SDOMH into their work. Rural Communities, Employment, and Career Counselors The U.S. Census Bureau considers rural communities as a group of people, counties, and housing outside of an urban area. More specifically, the Office of Management and Budget defines rural as Kaprea F. Johnson, Alexandra Gantt-Howrey, Bisola E. Duyile, Lauren B. Robins, Natese Dockery Kaprea F. Johnson, PhD, LPC, is a professor and Associate Vice Provost for Faculty Development & Recognition at The Ohio State University. Alexandra Gantt-Howrey, PhD, LPC (ID), is an assistant professor at Idaho State University. Bisola E. Duyile, PhD, LPC, CRC, is an assistant professor at Montclair State University. Lauren B. Robins, PhD, is a clinical assistant professor and distance learning coordinator at Old Dominion University. Natese Dockery, MS, NCC, LPC, CSAM, is a licensed professional counselor and doctoral student. Correspondence may be addressed to Kaprea F. Johnson, The Ohio State University, 1945 N. High Street, Columbus, OH 43210, johnson.9545@osu.edu.
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