Dr. Val Farmer
Rural Mental Health & Family Relationships

Why Are Rural Mental Health Problems Different?

February 4, 2002

What does it mean to be rural? The United States counts "rural" as people living in communities of 2,500 or less. That definition isn’t very useful when it describes commuters and suburbanites of larger communities. The definition of rurality is about to change to one of population density, a more descriptive indicator of what is truly rural. People of Canada, Great Britain, Australia and the United States who live in geographically isolated, low population areas where occupations are tied to natural resources have more in common with each other than they do with their fellow countryman in cities and towns of any size.

What makes rural mental health different? Small numbers create their own peculiar social dynamics. The values that underpin rural life are more family, social and community based. The social and relational parts of rural life are more powerful in terms of stress and in their psychological rewards. Rural people understand what it means to belong to a close knit community. They put stock in being a good neighbor. They have lifelong relationships with relatives close by and friends who seem like family.

Occupations and careers are important, but in a larger context of social obligations and constraints. People count. Community counts. The landscape is familiar and comforting. Family history and connection is meaningful. Local history is passed on as a part of heritage. Each person’s future and family well-being are tied in with place. Living somewhere else, doing something else, is hard to conceive.

Personal identity is drawn from the association and support of other people. Belonging and being in good standing with the group has deep meaning. Reliance on social identity is at once a strength and a weakness. The boundaries between oneself and others is more fluid and subject to pressures and threat.

What are some common dilemmas and problems facing people in rural communities?

- Dealing with powerful social expectations and pressures.

- Finding it difficult to say no.

- Not feeling reinforced for leisure or specialized interests unless community obligations are fulfilled.

- Being expected to participate in time-consuming social and community events.

- Being too successful in a community where others are easily threatened.

- Being judged by social comparisons to peers in the local community.

- Becoming easily upset or disturbed by adverse public opinion. Fault-finding and gossiping are tactics used to knock the competition in a community pecking order of public prestige.

- Maintaining appearances at a personal cost of being unauthentic. Not feeling emotional safety in expressing feelings, problems or divergent opinions - being criticized for being too open, spontaneous and honest.

- Serving in multiple roles and encountering others in different roles and settings means getting behind a mask. Social gain comes at the personal expense of stifling true opinions and feelings.

- Not being able to solve problems because conflict itself is viewed as harmful. It is easier to cover up a problem than to get people to try out poorly developed conflict-resolution skills.

- Being too different or out-of-step with strict community standards.

An urban person would say, "Who cares what other people think?" A rural person knows there is social accountability and obligation.

Rural drinking problems. The social acceptability of alcohol use in many rural social situations can add personal problems. While rural communities do not have a corner on alcohol problems, a lack of entertainment and recreation activities can lead to the use of alcohol to enliven social life. Some people are vulnerable to alcoholism and/or the social pressures that go with regular drinking. This can lead to marriage and family problems.

Financial pressures. Another common rural stressor is the increasingly marginal rural economy. Economic pressures mount in markets where population continues to decline. Wages are typically low.

Depression and anxiety are common problems when personal or business finances are precarious. Farming, ranching, fishing, mining and the timber industry - rural occupations that deal with raw commodities that are tied to geography - have tremendous economic pressures. Living constantly on the edge takes an emotional toll.

Some stressors are peculiar to farming and ranching. Management decisions are often reactions to weather conditions, which sometimes can be a disaster. Having little control over product market prices also makes financial risks and stress great. Too much farm and ranch debt puts the family livelihood, identity and way of life at risk and is probably the greatest source of stress.

Complex technology, expensive inputs, seasonal pressures, combining the work and home environments, labor shortages, supervisory responsibilities, and other on-farm enterprises and off/farm employment all test the compatibility and coping skills of farm families. Add in the mix the social obligations, leadership and volunteerism associated with responsible community life and you have a recipe for very busy, stressful lives.

Family business relationships. Another big source of stress is being in a family business. Many rural businesses are family businesses. There are boundary issues as family members work out common goals and share a common enterprise. These problems can build and create suffocating tensions and resentments while solutions are stymied by poor communication and problem-solving skills.

What is rural mental health? If you are from a rural community, you understand all these things. If not, they are just so many words.