Mental Health in Small Town, USA

“There is no standard normal. Normal is subjective. There are seven billion versions of normal on this planet.”

– Matt Haig

Just some brief thoughts:

I live in a small town. Like a really small town. It’s a very conservative, small town in a very conservative part of Illinois, which is most of the state (thank God for Chicago or we would be all Red). There aren’t a lot of resources in my area for people with any type of mental health or psychiatric problems. That seems to be the case for many rural areas across the U.S.

This isn’t news. A 2020 study found that “rural residents in the USA experience significant disparities in mental health outcomes even though the prevalence of mental illness in rural and metropolitan areas is similar.”

These issues may stem from a lack of funding or a lack of understanding of these types of problems. I haven’t even heard of any recognition that May is Mental Health Awareness Month on any type in any local media in my area – not that that is surprising. I have found most people have no idea this is Mental Health Awareness Month.

That’s part of the problem. No, not recognizing May as “ours”, but by not recognizing the issue at all. I had an appointment with my psych doctor yesterday, who practices more than an hour away now. Thank God (or whoever) for Telehealth or that monthly drive would be a killer.

A study by researchers at Wake Forest School of Medicine determined one of the main causes behind the lack of resources for mental health treatment in rural areas is the surrounding shame and stigma. The belief that “I should not need help.”

“We as a society have a hard time asking for help, so it’s hard enough to ask for help [without feeling] that everybody’s going to know it,” Dennis Mohatt, vice president of the behavioral mental health program at the Western Interstate Commission for Higher Education, said. “Your neighbors don’t have a clue in a city if you’re going to go get some help. But everybody [in a small town] will know if your pickup truck is parked outside of the mental health provider’s office.”

He’s right. Fortunately, I do not fall into that category. I’m not out picketing for change or acknowledgment, but I’m far from ashamed.

Other research suggests even suicide rates are affected by the regionality of mental health services.

“There is a higher suicide mortality rate among residents of rural and nonmetropolitan areas than those living in metropolitan areas,” Ty Borders, Ph.D., said. “The discrepancy has existed for decades, and the gap has widened in recent years,”

So, why is this? I’m sure there is more than one answer, but where I live it has a lot to do with what I hope is a lack of understanding (I have to believe that, at least). Funding, too, if that can be looped into it on some real substantive basis. However, I believe it stems from a lack of understanding.

It’s also because of a weakness that gets pinned on those who suffer from any type of mental health problem or crisis. There is very much a “Suck it up and get over it!” mentality among many throughout my community. The idea that mental illness didn’t exist fifty years ago is a very prevalent one.

Poverty plays a role in this dilemma, too. How can someone expect to pay for mental health services when they can’t afford their 10-year-old’s school physical? Especially if those types of appointments are an hour away and are only open certain hours or days of the week.

According to the Rural Health Information Hub, “18.7% of individuals in nonmetropolitan areas have a mental health condition, which is about 6.5 million people. Rural residents are also more likely than urban residents to experience a serious mental illness.”

One report suggests that for every 30,000 rural Americans there is one psychiatrist. This is interesting, and it would be interesting to know how many out of those 30,000 need psychiatric help. But we’ll never get any accurate information regarding that.

So, do we need more therapists? Or is it something more serious, a more systemic issue? I don’t think there is a black or white answer. I mean, I have no real ideas that would matter. I’m just like everyone else: pointing out the flaws in the system with no real alternative measure in mind.

3 thoughts on “Mental Health in Small Town, USA

  1. As someone who works in mental health, I can say with certainty that the stigma around mental health is a problem. I see that all the time with family or coworkers of those suffering mental health disorders. As you are probably aware, a person with Bipolar Disorder often suffers without treatment for nearly ten years before finally seeing a mental health professional…and I believe this has a lot to do with stigma. As to the rest… I have no idea what the answers are. I live in a very rural area as well, but things are different in CA. Here, there is quite a bit more funding than most places for mental health. Something that is happening though is that because there is funding for services, and the weather is fairly mild, we are experiencing a huge influx of homeless people coming here (obviously not all people with mental health issues are homeless, but many people who are homeless do suffer mental illness or addiction). Our small behavioral health clinic has been completely inundated and cannot keep up with all that need help and services. It is a serious problem and I don’t know what the outcome will be. Great job bringing attention to such a serious problem in our country, Josh! I wish politicians would focus on these sorts of issues, but no one seems to know what to do.

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