About 1 in 5 Americans live in a rural area where they are just as likely to have mental health challenges as those living in or near cities. Unfortunately, rural Americans may not have access to the same mental health resources as others. In fact, about 60% of people in rural or remote areas live where there is a shortage of mental health services.
And there are other barriers to treatment in these areas. Travel can be an issue. Even if you can find a provider, you may have to travel a very long way to reach them, says psychologist Iva GreyWolf, PhD, who is based in Roseburg, OR, and works with remote Indigenous communities throughout Alaska.
“In Alaska, there is no connecting road system,” she says. “In many villages, you only have the option of flying in or out, or if it’s coastal, traveling by boat.”
Or you may have trouble finding a therapist who understands your problems. If you’re a farmer, for example, you’ll want to speak with someone who knows something about that life.
“It’s important to understand the culture of people involved in agriculture,” says Michael Rosmann, PhD, a psychologist and farmer based in western Iowa.
Rosmann recommends that you start with your primary care provider. Often, he says, such health care providers, whether doctors or nurse practitioners, are well-connected to the local community and understand the types of stresses common in the area.
“You can turn to them for medications and referrals,” says Rosmann.
You can also check with local pastors or other religious leaders. They often have experience helping people in mental health crises. Even if they’re unable to provide counseling, they can typically point you to other local resources.
This is often the more common path in smaller communities, says GreyWolf. “When people are stressed in small communities, they typically aren’t going to go to a psychologist,” she says.
“They are going to go to someone that they trust, like a relative or a member of the clergy. That’s how you get that referral line going.”
You can also reach out directly to your local community mental health provider. Check your county government’s website to learn how to get in touch.
“Call up and ask for a contact for someone who can help with the particular problem you’re having,” says Rosmann. “In rural areas, they serve more than the Medicaid population.”
If you’re in a very remote area, you may need to reach out to state professional psychology organizations, like the California Psychological Association or the Alabama Psychological Association. The American Psychological Association’s website provides links that will take you to the psychological association in your state.
“They have services to help find a therapist near you,” says Rossman. “For example, you can ask the organization to refer you to a therapist who understands agriculture in your area.”
Keep in mind that you don’t have to see a therapist in person or even in your state. Telehealth, in which you see a therapist via video on your phone, tablet, or computer, is a growing option, says Rosmann.
“COVID really sped up the development of telehealth counseling,” he says. “And you can often more easily find a person who is competent in understanding agriculture in telehealth than in a face-to-face basis.”
But there’s a drawback. Telehealth requires a high-speed internet connection, and that’s not always available or reliable in rural or remote areas.
“Telehealth has its glitches, particularly in remote areas,” says GreyWolf. “The system can go down.”
Check your health insurance company’s website for listings of providers that are covered under your plan. Rosmann also recommends Psychology Today’s provider directory. You can use it to narrow your search to find therapists that meet your needs.
988 Suicide & Crisis Lifeline: If you are having an emotional crisis or you are feeling suicidal, or if you are concerned about someone in that situation, contact the 988 Suicide & Crisis Lifeline: Call or text 988, or chat online at 988Lifeline.org/chat/ any time, 24-7.
Your call or text will be routed to the crisis center nearest to you based on your area code. A trained counselor will provide support and can point you to other resources, like therapists.
Though the on-duty therapists may not be attuned to the particular problems of your particular area, these types of hotlines can be very useful, especially in a crisis situation, says GreyWolf.
SAMHSA: It’s short for Substance Abuse and Mental Health Services Administration. SAMHSA provides 24/7 treatment referrals for those with substance abuse and/or mental health disorders. Call them at 800-662-HELP (800-662-4357). TTY: 800-487-4889. You also can access their directory through their website or via text, by texting your ZIP code to 435748.
Local helplines: There also may be helplines specific to your area. Check your local Farm Service Agency or your county government’s website for phone numbers and other ways to contact.
Rural Minds: Provides phone numbers and links to mental health resources for people in rural areas. Find them on their website at ruralminds.org. Or you can call 800-226-8113 or email them at [email protected].
Farm Aid: They help farmers and their families with all kinds of problems, including mental health assistance. Check them out online. You can also call their hotline at 800-327-6243 or email them at [email protected].