Behavioral Health in Rural America: Understanding Citizen Perceptions and Willingness to Respond to Community Needs

Amid nationwide efforts to address behavioral health needs, rural communities often face unique challenges and a lack of resources. This study presents a bottom-up approach used by one rural community in the Midwest to respond to their needs regarding mental health and substance use. A survey instrument was developed from interviews with community stakeholders and disseminated in both online and paper formats. The survey sought to understand citizen perspectives regarding quality of life, barriers to treatment, and willingness to engage in efforts to address the community’s needs. Data from 1,303 respondents (71.5% women, 54.7% income <$42,000) were analyzed using descriptive statistics and chi-square analyses. Results indicate that cost of treatment, shame, and lack of privacy were a barrier for most citizens’ treatment-seeking behavior. In addition, many citizens were willing to engage in strategies to address the community’s needs, including increased county spending, forming a neighborhood watch, and donating money. Differences associated with gender and income emerged across perceptions and willingness to support efforts. Implications for community efforts are discussed