Rural Mental Health: Understanding Mental Health Care & Stigma In Rural Areas

Mental health looks different for everyone. Where someone lives, how they were raised, the culture(s) they belong to, and the values they hold can all shape a person’s mental health and affect how they view mental well-being in general.

In some rural communities, the idea of seeking mental health care can feel distant or uncomfortable. However, this doesn’t mean that people in these areas don’t need this type of support. More often, it’s that stigma, limited resources, or deep-seated cultural norms create invisible walls around those who may be in need of care. 

Below, we’ll explore what the mental health landscape looks like in the rural United States today. We’ll look at how stigma can function in small communities, what the research suggests, and how approaches like online therapy might help support positive change.

Understanding mental health care in rural areas

For example, in a small farming town, the nearest licensed mental healthcare provider may be over an hour’s drive away, with no public transportation available. In other rural areas, mental health clinics might serve five or six counties, stretching resources thin and leaving many waiting weeks or months for an appointment.

Additionally, these regions often face shortages of mental health professionals and financial barriers to individuals receiving care. In fact, research suggests that the gap between mental health needs and the ability to receive mental health care in these areas is significant.

Statistics about mental health care in rural areas

To better understand the scope of these rural health challenges, it can be helpful to review the statistics from recent studies:

• Over 60% of rural residents live in areas with a shortage of mental healthcare providers.
• Suicide rates in rural America are consistently higher than in urban areas.
• Rural youth are less likely to receive mental health services, despite rising rates of anxiety and depression among young people.
• Fewer than half of rural primary care practices offer any behavioral health support on site.
• Telehealth uptake remains lower in rural communities, despite its potential to bridge gaps in care.

Examining rural mental health research

A growing body of research on rural mental health challenges suggests that rural populations face higher risks for mental illness, yet are often the last to receive timely or appropriate care. In fact, several studies highlight how mental health services administration and delivery systems typically are simply not structured to fit the realities of rural life. 

Whether it's the long distance to the nearest clinic, the lack of providers, or the absence of integrated care, the barriers are numerous. In addition, cultural attitudes in rural settings often make it harder to talk about or seek help for mental health symptoms.

Other key research findings on rural mental health

How stigma can impact rural mental health care

Stigma can play a powerful role in shaping how people in rural areas approach mental health, but it isn’t always overt. Sometimes, it’s a quiet discomfort, judgment, or a heavy silence that surrounds emotional difficulties. Still, its effects can be profound, often leading people to hide symptoms, delay care, or feel ashamed for even considering therapy. Below are a few examples of the most common forms of stigma people living in rural areas may face related to mental health. 

Stigma #1: The stigma of receiving mental health care

In small towns, the thought of simply walking into a mental health clinic might be enough to trigger concerns about being seen and judged. Some people worry that even the mental health providers themselves might know their family. One study suggests that rural residents often hold more negative views of those seeking help, and this social stigma directly contributes to avoiding care in many cases.

Stigma #2: Religious or moral judgment

In many rural communities, faith plays a central role in daily life and culture. While spirituality can offer comfort, it also has the potential to create barriers—such as when mental illness is framed as a lack of belief or moral weakness. Thoughts and prayers may be offered instead of genuine support, potentially discouraging people from seeking mental health services.

Stigma #3: A culture of self-reliance and rigid gender norms

Self-reliance is often valued in rural cultures, and many people are taught to avoid asking for help or “burdening others.” This mindset can be especially tough on men, who may feel pressure to be unemotional and avoid showing any vulnerability. Other outdated gender stereotypes and expectations can also silence those who need help—not to mention making life especially difficult for LGBTQ+ people, who may not feel safe coming out or seeking affirming care.

Stigma #4: Stigma by association

In some rural communities, stigma doesn’t stop with the individual. If one person seeks care, others might make assumptions about their whole family. In some places, mental health conditions are still associated with dangerous behavior or institutionalization. Just talking to a therapist might cause someone to be labeled as unstable, even if their challenges are very common.

Other barriers to receiving rural mental health care

Along with stigma, logistical and structural barriers form a combination of unique challenges that can prevent people in rural areas from receiving mental health care.

When care is unavailable or avoided, a domino effect may occur, such as:

• Reduced service utilization leaves those with mental health needs unsupported.
• Worse outcomes, like increased medical complications and emotional distress, become more likely.
• Barriers to early intervention prevent people from getting support before things escalate for them.

Approaches to reaching underserved communities

Reaching people in underserved rural communities and addressing the dynamics that shape mental health in these places can offer a source of relief for individuals. Public education and awareness campaigns, especially when rooted in local stories and cultures, may help shift how communities view care. Additionally, offering mental health services within primary care settings and schools can normalize care and increase availability of professional support. 

How therapy can help those living in rural areas

Therapy can offer a safe space for a person—including those in rural communities—to explore their emotional world. Approaches like cognitive behavioral therapy (CBT) can be particularly helpful, as it helps people learn how to identify thought patterns that may be contributing to distress and develop healthier ways of coping with difficult feelings. Particularly for someone who was raised to suppress emotions or “tough it out,” learning that thoughts and feelings can be flexible may be transformative.

The potential benefits of online therapy

For those in rural and remote locations, online therapy can help bridge the gap between mental health needs and mental health care, often making therapy feel more available and less intimidating.

Online therapy has the potential to benefit rural communities in a number of ways, such as by offering: 

• Comfort. People wary of judgement or stigma can receive support from the comfort of their home or anywhere they have an internet connection.
• Availability of providers. Telehealth services connect clients with a wider pool of mental health providers than what may be available locally, including specialists in trauma, grief, or adolescent care.
• Affordability. Online therapy tends to be more affordable than in-person sessions without insurance, which can be helpful to those facing financial barriers.
• Research-backed effectiveness. Many studies suggest that for treating conditions like depression, anxiety, and post-traumatic stress disorder (PTSD), online therapy can often be just as effective as in-person sessions.