Living with mental illness challenges people who have the strongest support systems and easy access to mental health professionals. Consider then the effects of living where there’s little to no professional mental health care. Rural areas throughout the nation lack psychiatrists, psychologists, and therapists. Even though about a third of Americans suffer from psychological disorders, there’s still a considerable stigma about it, and that stigma is much greater in rural America. Rural areas are accustomed to making due with what they have. It’s a set of social mores built on independence, yet independence in the face of crippling psychological problems morphs into isolation, which in turn cuts sufferers off from the very few social resources they might otherwise call on.
Yet depression and other psychological disorders remain at an all-time high. Suicide rates are high in the USA, especially when compared to other industrialized nations. Stigma about mental illness continues to be problematic in rural areas, even though the need for help keeps rising. A study from 2014 found that there is fractionally more mental illness in rural areas than urban locations. The study had been instigated to see whether or not there was more mental illness in urban areas, which was the expected outcome. Instead, it found a small but significant increase in mental illness in rural areas. People in rural areas are more vulnerable to the ravages of mental illness for a couple of significant reasons: a culture of independence internalized to the point where people feel they should be able to handle their problems completely on their own, and lack of resources to help. Rural Americans labor under a powerful local social injunction against discussing one’s personal troubles with a stranger. There’s also a mistrust of therapists and psychiatrists. As a result, people end up isolated with their problems, which makes mental illness far worse. Even if the societal taboo over opening up one’s personal affairs wasn’t there, around 65% of rural counties in the entire USA lack a psychiatrist.
Older Americans tend to suffer more from mental illness in non-urban areas. The self-imposed injunction against sharing very personal feelings with strangers is more powerful. Far fewer mental healthcare professionals are trained in the particulars of geriatric mental health. Fewer people coming to healthcare professionals ends up with fewer professionals moving into the area. The problems compound and are passed along.
Fixing these problems won’t be easy. Government cutbacks in public services have gutted community mental healthcare facilities across the country, and while more medical students are specializing in geriatric medicine, there’s been no appreciable rise in geropsychology practitioners.