The Family Counseling Center of Fulton County, along with health providers across the country, are recognizing National Rural Health Day (NRHD) on Thursday, November 16, 2023. NRHD highlights rural communities as wonderful places to live and work, increases awareness of rural health-related issues, and promotes efforts to address these issues.
Nationally, approximately one-fifth of the population deals with mental health issues. Mental health includes social, emotional, and psychological well-being and affects nearly all aspects of daily life including physical health. While statistically the occurrence of mental health illness is consistent regardless of location, incidents of depression and suicide are twice as high in rural communities as in more urban settings.
Experts have identified three major barriers to mental health care in rural settings: availability, access, and acceptability. These factors, coupled with the cultural norms of rural communities including self-reliance, independent spirit, and the stigma of depression or anxiety as weakness, can keep rural residents from seeking help from family, friends, or professionals.
Availability
There is a national mental health care provider shortage and rural areas are especially hit hard. More than 90% of psychologists and psychiatrists work exclusively in metropolitan areas, creating a severe lack of mental health professionals in rural communities.
Statistically, rural residents are more likely to be uninsured or underinsured, therefore they receive Medicaid, adding complexity to reimbursement for services – a complexity that limits the number of providers who will accept clients with Medicaid.
The Family Counseling Center is a designated National Health Services Corps site, meaning that it serves all patients – regardless of their ability to pay. This designation, the agency’s ability to accept Medicaid, Medicare, and managed care coverage, and a sliding fee scale for clients who pay out-of-pocket means that an individual’s access to care increases.
Access
Due to the nature of rural communities, the distance individuals need to travel for services is significantly farther than their urban counterparts. In addition, lack of public transportation and low rates of car ownership create barriers to accessing healthcare services. Limited broadband access and cell phone dead zones also limit access to telehealth options.
Acceptability
Small communities can mean a lack of anonymity when accessing mental health care, creating a reluctance to seek treatment. In addition, cultural acceptability of seeking mental health services in rural communities can also add a significant stigma to getting care.
The Family Counseling Center has over 47 years of experience in the treatment of clients from rural and semi-rural communities. The agency’s Fort Plain office is located in a facility that includes a dentist and podiatrist – allowing for co-located services and a level of anonymity for clients who are seeking our services. The organization’s Gloversville headquarters includes a pharmacy that is open to general public use and other services. Access to crisis counselors is available weekdays Monday to Thursday, 8 a.m. to 6 p.m. and Fridays 8 a.m. to 5 p.m. at the agency’s Gloversville office.
Farmer-Focused Care
Fulton and Montgomery counties are proud farming communities with many residents connected to agriculture in one form or another. Farming is a physically and emotionally demanding profession that can take a toll on overall mental health. Studies, including those from the Centers for Disease Control (CDC), have shown a higher rate of anxiety and depression in farmers and farmworkers than the general population. In addition, farming and ranching has one of the highest suicide rates of all occupations, with farmers being twice as likely as other professionals to die by suicide.
There are avenues that farmers can use to seek help for the stress they feel. In addition to The Family Counseling Center, local, state, and national resources including hotlines, crisis assistance are available.
State-wide Services
NY FarmNet is a statewide program that works with farmers to deal with stress – both financial and emotional. A treatment team of financial advisor and mental health worker come directly to a farm to discuss the causes of strain and create a plan of action. In addition, the organization provides a crisis hotline at 800.547.3276.
National Services
FarmAid provides resources for farmers in crisis or someone who is worried about a farmer. Their national hotline speaks from a place of understanding, farmers talking to farmers about the stressors, concerns, and anxiety associated with the profession. The hotline (800.327.6243) is manned Monday through Friday from 9 a.m. to 5 p.m.
AgriStress Helpline provides free and confidential crisis support by phone or text 24/7. Callers speak to individuals who understand the unique stressors, culture, values, and lived experiences of agriculture. The hotline can be reached via phone or text at 833.897.2474.
If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org.