NEW YORK (Reuters Health) - Americans living in rural areas are ``dangerously'' undertreated for depression, according to mental health experts.

The danger of undertreated depression is highlighted by the fact that left untreated, 15% of depressed individuals commit suicide. And although 70% to 80% of the time clinical depression can be successfully treated with a combination of prescription medicines and therapy, only about 10% to 25% of patients are adequately treated.

``There is a critical shortage of qualified mental health professionals, particularly in regard to psychiatry and trained, licensed psychologists,'' said Dr. Katherine Nordal, chairperson of the Committee for Rural Health of the American Psychological Association. Nordal has been a practicing psychologist in Mississippi for more than 20 years.

At a recent presentation hosted by the National Rural Health Association (NRHA), Nordal and other experts spoke about the prevalence of depression in all settings and the risks associated with inadequate treatment for those in need of medical attention.

As a nonprofit association dedicated to improving healthcare for rural Americans, the NRHA speakers pointed to obstacles that many Americans living in rural areas face in getting depression treatment: an acute lack of awareness among patients and doctors as to the signs of depression; a lack of access to care due to the long distances between patients and doctors; and the financial hardship faced by those who lack adequate insurance coverage.

In an interview with Reuters Health, Nordal emphasized that there are a wide range of problems faced by Americans suffering from depression who live outside of urban centers that need to be understood and addressed.

``A lot of rural people have been through very hard times,'' she said. ``The farm crisis has been a tremendous pressure in rural communities, but rural folk often have a self-reliant backbone and maybe they're not so inclined to admit that they have an emotional or behavioral problem that they need to do something about.''

She added, ``This self-reliant, self-determination kind of value is sometimes a very good thing to have--but it can certainly be a hindrance if someone needs mental healthcare.''

Aside from this psychological and cultural roadblock, Nordal also pointed to the practical obstacles to getting depression treatment. ``Access to qualified care is a critical problem in rural areas,'' she said.

``There's not only a shortage of generic mental health providers, there's also a shortage of specialists, like pediatric psychologists.... Primary care physicians are often the default person because they are the ones who are there,'' Nordal explained. ``It can, however, be a first good place to (start) because of the stigma that's still attached to mental health issues. I think we've come a long way in that regard, but in rural areas--where there's not as much anonymity--the stigma becomes an impediment in and of itself.''

Nordal suggested that there are steps that can be taken to ease this problem. ``A solution would be to incorporate psychologists as part of the treatment team in rural health clinics, where it becomes a one-stop shop where someone could go in and see their physician and it wouldn't be advertised that they're going to see the psychologist. You can make it easy that way, you make it accessible that way--and folks don't have to travel some distance to see somebody.''