By Marnie Werner, Vice President of Research & Operations
Mental health has become an increasingly urgent topic across Minnesota, but for those living in rural communities, the challenges are often more complex and harder to solve. Whether it’s limited access to care, persistent stigma, or barriers to students entering the mental health field, the story of rural mental health is one of both common struggles and unique experiences. But as one of our favorite sayings states, rural is not a monolith. There are so many subgroups of rural, defined by place or race or income or what have you. Our research is always showing that while rural communities share many similarities, there’s also no one-size-fits-all solution to whatever the problem of the day happens to be.
This is just as true for access to mental health services as anything else. As my co-author Mitra Melani Engan and I worked on our latest report, “Barriers & Bridges: Access to Mental Healthcare for Rural Minnesota’s Communities of Color,” a few things became very apparent, beginning with this:
We’re More Alike Than Different
When it comes to access, most rural Minnesotans face similar obstacles. The farther you live from an urban center, the fewer mental health professionals there are nearby—and the farther you’ll have to drive to reach one. In many ways, Figure 1 from the report tells a familiar story: the more rural the area, the more difficult it becomes to find help. This shortage of providers results in long wait times for diagnoses, then treatment. And then there is the ever-present stigma and fear that still surround talking openly about mental health.
But We’re Not All the Same
While the challenges may be shared, the experiences are not identical. This is especially true when talking about rural Minnesota’s people of color accessing mental health care services. Talking about something as personal as mental health often depends on trust—and people feel more comfortable talking to someone they can believe understands what they’re going through. This is why the Minnesota Department of Agriculture and U of M Extension started the Minnesota Farm Stress Helpline for farmers. They experience specific stresses that non-farmers don’t and won’t understand.
For people of color living in rural Minnesota, a lack of mental health service providers—counselors, therapists, psychiatrists—who look like them is a serious roadblock. Past experiences and trauma, whether their own or their ancestors’, also shape how they perceive and approach mental health care. Language barriers and cultural differences that insist “Oh, we don’t get mental illnesses” also add layers of difficulty. A therapist who looks like them, speaks their language, and/or understands their lived experience can go a long way toward making a person feel comfortable talking about their troubles.
Removing Roadblocks to Growing the Workforce
The need for mental health professionals in rural Minnesota is clear—but getting more warm bodies into the field isn’t all that simple, especially for people of color. The system is full of bottlenecks: high education costs, low-paying supervised hours that can stretch for a year or more, and licensing exams that seem to work in favor of certain demographics, particularly white women, over men and people of color.
These barriers help explain a troubling statistic: only about half of those who earn a degree that could lead to licensure actually become licensed providers. The good news is that Minnesota and several other states are working to change this. New approaches and alternative pathways to licensure are being developed to remove unnecessary barriers and make it easier for qualified individuals to enter the field.
What We Can Do Now?
But while these changes to how people qualify to treat mental health issues are underway, it will take time—years, in fact. In the meantime, though, there’s a lot that we as friends, neighbors, and family members can do right now. The report looked at several things going on at the community level, from reshaping government programs to align with their culture’s and community’s needs to simply helping people get comfortable with talking to each other about their mental health.
Small actions matter. Checking in on someone, offering support, and making it safe to talk about mental health can make a difference. We can encourage those who are struggling to seek professional help, but we can also play an important role in preventing isolation and loneliness—two of the biggest enemies of good mental health.
Improving mental health in rural Minnesota will take a combination of policy change, workforce development, and good old-fashioned looking after our neighbors. While access to services is crucial, so is compassion, understanding, and connection. We can’t afford to wait for someone else to fix it. The solutions start with all of us—talking openly, supporting one another, and making sure everyone in rural Minnesota knows they’re not alone.