While many are working today to change the status quo, echoes of borderline mental health tragedies like those depicted in the film resonate in the rural West, where a doctor’s appointment of any kind can involve a journey. two hours one way. That is if you can find a provider, if you have transportation, and, as is often the case with mental health, if you can overcome the stigma surrounding your care.
Rural suicide rates it increased 48 percent between 2000 and 2018, according to the Centers for Disease Control and Prevention. Rural men are 40% more likely than urban men to end their lives. Women, universally less prone to suicide, are more like do so if they live with the specific challenges of rurality, including those cited above, and higher rates of poverty.
It turns out that the very elements we celebrate as rural Westerners — self-sufficiency, mental and physical strength, and being alone a lot — put our well-being at risk. According to the Centers for Disease Control and PreventionAlaska, Colorado, Idaho, Montana, New Mexico, Oklahoma and Wyoming have the seven highest suicide rates in the country.
In this part of Colorado, Joel Watts runs Integrated Insight Therapy, which employs about 40 therapists for clients in five counties, covering an area the size of New Jersey. (But imagine a early 19th century New Jersey, with less than 240,000 people). About 90 percent of their clients have Medicaid.
When Watts considers the challenges of providing mental health services, she cites lack of access and “resilient individuality” as important factors, along with some clients’ struggles with the boom and bust cycles of the oil, gas, and petroleum industries. mining.
“The mentality is the biggest obstacle. I can do it on my own. I do not need help. People see it as a sign of weakness to ask for help,” said Lee Halberg, until recently director of the Mancos Public Library in Mancos, Colo.
Last summer, he was in his office when 15-year-old Dustin Ford and a young woman walked past the small brick building and headed for the nearby Mancos River. Minutes later, a shot rang out. powder keg died, and the girl survived with injuries. Apparently they had planned to die together.
For the Mancos high school, which has about 40 students per grade, it was the second suicide in about a year.
Alanda Martin, a school counselor, is part of a team trying to help. Each year, they teach students about suicide prevention and distribute suicide screening forms. But 87 percent of kids don’t fill out the forms, she said.
“There is a lot of resistance here, from students and their parents. Accessing mental health services is not something they do,” she said.
Watts has a separate office in Delta, Colo., with a discreet alley entrance, he said, for “people who don’t want to be found” seeking treatment.
Retaining staff, most of whom come from elsewhere, is another ongoing challenge. Being a therapist here means confronting external bias (if you’re from the outside) or internal bias (if you grew up here and have some sort of history or connection to everyone). It’s no wonder customers are put off by churn.
Help for those most at risk is increasing. In Montezuma County, public and private agencies pooled resources to form the Community Intervention Program. Operating from a single unmarked van, two EMTs and a social worker responded to nearly 100 calls in CIP’s first two months. Most involve mental health issues, drug or alcohol addiction, homelessness or a personal crisis, according to Haley Leonard, a spokeswoman for the nonprofit Axis Health System, one of the groups involved.
When summer visitors come to this region, I wonder if they feel the quiet desolation that some of us who live here, no matter how fiercely we love it, must guard against.
In the middle of a snowstorm last winter, I thought of those women who had captured “prairie madness” in “The Homesman.” Squinting through the side snow, darkness falling, I struggled with the chores. The horses were hungry and skittish when I gave them hay, most of which was blown away by the wind. The hens hunched their shoulders and looked ahead as he locked them in their coop.
The temperature dropped below zero. My thoughts bounced between concerns about cattle, livelihood, loneliness. As the house rattled and creaked, I considered my voluntary isolation, with miles of national forest and only a handful of neighbors nearby. The dogs and I slept by the wood stove, as we would for weeks, to keep the fire going so my little house stayed above 50 degrees.
In the morning, the snow was blindingly bright in the high desert south of New Mexico and west of Utah. On my front porch was an ice-encrusted lasagna platter. I never found out who left it. He hadn’t asked for help, but someone thought he needed it.