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.

Ties that bind: Liberals, conservatives and mental health

It’s not much of an exaggeration to say that there are some…umm, slight…differences between liberals and conservatives in America today. I continue to believe – perhaps naively – that the things which unite us are bigger than the things that divide us.

One of those things, without a doubt, is mental health.

First, speaking in generalities: Liberals tend to want government to do more, conservatives tend to want governments to do less. This is a very broad statement and there is a lot of room for nuance within it, but I think that’s pretty accurate. Looking at that from a mental health perspective, that tends to translate into liberals wanting government to do more (even if it means raising tax rates), conservatives want them to do less.

I have a theory: That’s not completely accurate, because conservative areas need as much help as liberal areas when it comes to this.

Let me approach this from a different perspective: Urban vs. rural. Again, broadly speaking, but urban areas tend to be more liberal, rural ones more conservative. But – and this is important – rural areas really, really struggle when it comes to mental health. Suicide rates are higher in rural areas than urban areas. This is for any reasons, including an increased prevalence of firearms and a lack of access to health care practitioners.

At the same time, urban areas – which have high levels of poverty and minorities – also really struggle in these areas. Urban areas with high levels of poverty have significantly higher rates of mental illness. Unfortunately, poverty makes mental illness worse, and the mentally ill are more likely to be pushed into poverty and lose access to health insurance and care – thus creating a viscous cycle.

Here’s my theory: These can be united. While I represent an urban area, I don’t want anyone to suffer or struggle, no matter what they look like or where they live, and I am sure that the vast majority of conservatives feel the same. We all care about the people we represent, and I’m hoping that, over the next couple of years, I can find more people to work with in order to bridge the gap between liberals and conservatives/urban and rural areas. I’m hoping that we can use mental health to do that, and in so doing, help all of the people we represent.