Researcher Releases Detailed Look at Rural Mental Health

By TED MEBUST

What are the unique aspects of rural communities and culture that may contribute to mental health concerns and increased risk of suicide in rural New York? What factors contribute to positive mental health and well-being?  How do community members seek help for behavioral health concerns, and what factors influence these help-seeking preferences? How can rural communities—individually and as a whole—improve availability, awareness, access, and utilization of mental health services, resources, and support?

These were the questions Dr. Brett Harris sought to answer as she embarked on an 18-month rural listening tour, the first of its kind in New York State, from March 2020 to September 2021. Dr. Harris, a senior research scientist at NORC, an independent research institution at the University of Chicago, and a professor of public health at the University at Albany, heard from almost 300 residents and healthcare professionals across 16 rural counties to produce a report detailing possible strategies to “improve mental health in rural areas in New York and beyond.”

The report quickly identified a major gap in suicide rates between New York State residents in rural areas, now at 15.2 per 100,000, and those in urban areas, at 7.5 per 100,000. Rural suicide rates rose 83.1 percent between 2004 and 2020, compared to a 27.9 percent urban increase over the same time. Dr. Harris stated that although the New York State Suicide Prevention Task Force released recommendations for addressing mental health and suicide in 2019, rural areas—home to nearly 20 percent of New Yorkers—were underrepresented and “more work was needed to capture the voices of rural communities and inform these efforts.”

Listening sessions were divided into two groups: county residents 18 years of age and older, and “professionals who play a role in the mental health of the community (e.g., health and behavioral health directors and providers, law enforcement, first responders, clergy, school personnel, local government staff and officials, and suicide prevention coalition members).” Participants most commonly raised topics such as “social isolation, the impact of close-knit communities on mental health, deep-rooted issues that impact mental health, service access and delivery barriers, lack of knowledge and understanding of available mental health services, and rural culture including self-determination and the high prevalence of guns in the home,” each of which Dr. Harris elaborated on at length.

Recommendations produced from the study included increasing opportunities for non-clinical peer support, awareness of available mental health resources and community connectedness, expanding access to the Internet, and strengthening the capacity of crisis centers to link to appropriate local resources. State and county efforts to aid the mental health crisis were also encouraged, including conducting periodic listening sessions, investing in grant writing support and “allocating funding for prevention to address issues upstream and reduce burden on resource-limited treatment services.”

Dr. Harris recognized the “limited generalizability” of the study due to several factors, including its emphasis on qualitative over quantitative data, lack of participant diversity and the use of Zoom for some but not all sessions due to the pandemic. Despite these limitations, the study proved an important medium for thoughtful conversation.
“The rural listening tour is a first step in recognizing the unique aspects of rural New York communities that serve as both risk and protective factors for suicide… ultimately, these efforts will help reduce suicide and promote mental well-being in rural communities,” Dr. Harris concluded.