Marnie Werner
Vice President of Research & Operations
My dad once told me his boss had a sign on his door that read: “Are you part of the problem or part of the solution?”
When I first started at the Center in 2000, I think rural Minnesota was at a crossroads of sorts. The population was shrinking, big businesses were pulling out or closing down, economic developers were poaching companies from each other in the hope of bringing more jobs to town, which would hopefully bring more people to town and boost the tax base. And there was this hot new thing called the Internet that everyone seemed to have everywhere, except in small towns. Rural communities seemed like they were just waiting to die. The optimistic ones were waiting for someone to rescue them.
Fast-forward twenty-three years, and from out here, rural looks like a different world. Gradually over the years, the feeling has gone from a woe-is-me attitude to a we-can-do-it vibe. People are starting small businesses, bigger businesses are doing well, and population decline has reversed in many rural counties or at least slowed down. There are still problems: we have genuine housing and childcare shortages, and the worker shortage is something that will take a lot of adjusting to. But overall, rural is back on its feet, and much of that, most of that is thanks to … rural. Rural folks got up out of their chairs and said we can do this. We can make our home a better place for us. We can be part of the solution. That’s the power of community.
So now we’re facing another challenge, a big one. Mental health issues and suicide rates are growing everywhere, but especially in rural areas. Part of the reason could be attributed to a lack of access to mental healthcare services, and especially with suicide, easier access to guns. Stigma around mental health and plain old loneliness are also big factors.
We definitely have a shortage of formal mental healthcare in Greater Minnesota. Our 2023 report on the mental health workforce demonstrated that. But as we talked to a number of mental healthcare providers in rural areas for our latest report on mental health, one particular theme kept coming up: friends and family, community, informal care vs formal care. It’s not a big new discovery, but it’s maybe something we’ve forgotten about or forgot we could do: we can harness the power of community to help each other with our mental health.
There may not be a lot of formal mental healthcare in rural areas, but there could be an abundance of informal care. In the report, we called them “anchor members of the community,” but they’re really the friends and family people turn to first when they’re stressed and troubled. Like in any tight-knit community, people living in small towns are more likely to say something to friends or neighbors first when trouble comes knocking at their door, rather than seek outside help.
That’s especially true with mental health. People don’t know what they don’t know. They may not realize anything’s wrong. They just know they haven’t felt right for a while. But because of the stigma and taboo status around mental health, especially suicide, they can’t bring themselves to open up to people about it, especially a stranger. The idea of seeking out a professional to talk to is intimidating. What will that doctor think of them? Will the therapist expect them to lie on a sofa and spill all the dirt on their family, their life, everything? What will people in town think? They’d be forever labeled “the crazy guy” who went to that clinic. We know what we see on TV.
For most people, though, life isn’t a TV show, and mental health symptoms don’t have to be out of control before someone goes looking for help. Many people’s symptoms are mild and temporary. Talking through things with a professional, learning new ways to deal with life may be what most people need. The key, though, is to get that help early, because mental health issues have a way of not going away on their own. So the sooner they’re addressed, the sooner they’re nipped in the bud.
But people in the middle of crisis or even just going through a bad time might not recognize that that’s what’s going on. Depression can be a big heavy blanket, smothering a person and distorting their view of the world, if they can see the world around them at all. That’s where family and friends, those anchor members, come in. They can lift the corner of that blanket, let in a little light, and say, “Hey, how are you doing?”
You protest, though: “I need proper training” or “I wouldn’t know what to say” or “What if I say the wrong thing?”
And that’s normal. But it’s important to keep in mind that because of the shortage of mental healthcare providers in rural areas, you—as a friend, a family member, even someone who sees a person regularly and can tell something is wrong—may be in the best position to help a person when they need help.
You don’t need the perfect thing to say, although the number of trainings to help you know what to say is growing all the time. But you can listen, and you can use your common sense to help smooth the way for your struggling friend or family member to take that next step toward getting help.
As much as we need more mental healthcare providers in rural areas, there are a lot of barriers between now and that goal line. In the meantime, we don’t have to sit around and wait for someone to rescue us while people suffer. We can look out for each other. Be willing to talk, and more importantly, be willing to listen. We maybe can’t solve the mental healthcare worker shortage or stop the suicide crisis, but we can all help move toward the solution.
If you or someone you know is troubled, please call or text 988 or chat at 988lifeline.org. They will listen, and they can help.