Rural America and Mental Health

This is something I’d been working on in the real job, and it occurred to me that it might be an interesting topic to explore here.

So, my legislative district is urban and suburban. This comes with the usual struggles: Poverty, educational access, economic attainment, health care access, and more. To be clear, the challenges facing urban America are massive and monstrous. I deal with them every day, and that unquestionably applies to the area of mental health, where the impacts of poverty, crime, trauma, and addiction are deleritous towards the impacts of the lives of urban residents.

That being said, I don’t think we do a good enough job of flipping this topic and talking about the challenges that rural America faces when it comes to mental health. I’ve written about this topic before, but with a specific focus on suicide. I want to broaden that a bit.

First, let’s be clear: In a lot of ways, the challenges facing rural America from a mental health perspective are worse than that of their urban counterparts. This is for many reasons, including:

• More depressed economies: In total, urban and suburban areas are growing, while rural areas are stagnating or shrinking. Economics do not necessarily predict mental health, but they can predict access to health care. Furthermore, negative changes in economic status are a predictive factor of people developing mental health issues.
• Less access to health care: Rural America is more likely to have health care access challenges than their urban or suburban counterparts. There are fewer hospitals, and doctors/other health care professionals are less likely to go to rural areas. As a result, a rural resident may miss that they have a mental health challenge, and even if they are aware of their problems, they may not be able to find a doctor they can easily get to – particularly given the transportation problems in rural America and the lack of access to mass transit. Telehealth can help address some of these issues, but again, much of rural America doesn’t have the broadband access they need to make this work.
• Higher rates of addiction: Rural America tends to have higher levels of addiction than their urban or suburban counterparts.
• Higher rates of firearms ownership: Unfortunately, this pertains directly to suicide – more guns means more suicide. This is why there are more suicides per capita in rural America than elsewhere.

So, what’s the answer? Okay. Some of these are above my paygrade. I am not capable of reviving the economy of rural America. I cannot relieve their economic pressures, though I will say that I do believe that the progressive policies I support can help address these issues.

That being said, yes. Progressive policies, in my opinion, can help. Dealing with health care access, a lack of broadband internet, rates of addiction…guys, this requires investing money. Increased reimbursement rates for physicians, psychiatrists, and psychologists to encourage more people to enroll in mental health specialties. Grants for construction and increased funding for operations for hospitals. Increased investment to open drug treatment centers. A minimum wage that isn’t a catastrophe. Targeted tax incentives to alleviate the pain faced by rural farmers. It’s funny because typically, rural Americans vote for more conservative politicians and policy outcomes. I would argue they are voting against their own interests here.

That being said, an honest answer acknowledges that this is more than just politics or policy. Rural America faces unique challenges that cannot be solved with the drop of a hat or the wave of the magic money wand, and these challenges require long-term investment, comprehensive solutions, and answers more than whatever I have thought of.

Still, as a long-time elected official for a depressed urban area, I have nothing but sympathy for my rural friends. They deserve real answers and real investment. I hope we can figure out comprehensive solutions to their problems and pain.