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Friday, August 12, 2022
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Social worker Lucas Moore discussed the disparities and obstacles related to mental health access in rural Wisconsin, and how the pandemic has affected services. 

Rural mental health services will see boost from new state program

The Farm Center at the state Department of Agriculture, Trade and Consumer Protection joined a multi-state effort on Friday aimed at strengthening farmers’ mental wellness. 

The center, which provides resources and services to agricultural communities throughout the state, will work with the UW-Madison Division of Extension to develop farmer focus groups and mental health provider trainings. Over several years, Wisconsin will receive more than $400,000 to provide support to farmers, agriculture-related businesses and mental health providers. 

“As stress among farmers continues to run high, we are excited to work with the Wisconsin Farm Center to help farmers and their families overcome mental health-related challenges," Joy Kirkpatrick, an outreach specialist at the UW Center for Dairy Profitability, said in the Farm Center’s announcement. “Low prices and uncertainty for many primary farm and food products over the last five years have created hardship and stress for many in rural communities, and the 2020 COVID-19 pandemic has only compounded those stress levels."

This joint effort will attempt to reduce the disparities in mental health services between rural and urban populations in the 12 states involved. This is an especially important effort in Wisconsin due to the large rural population — approximately 25 percent — the state holds.

These disparities were most recently reported in the 2019 Wisconsin Mental Health and Substance Use Assessment, which showed rural counties have higher rates of adults who have not been given sufficient mental health treatment. These rates are consistent with the report’s data on the number of psychiatrists needed to reduce a significant shortage of mental health treatment in each county.

According to Lucas Moore, a UW-Madison professor and licensed clinical social worker, there are no real differences in mental health reporting for urban and rural communities. The reporting differences arise mostly due to differences in social constructs.

“You might see more people seeking services in more urban areas, but that kind of turns into a chicken or the egg. Is that because there are more services available so people seek it out? Or is there a culture that’s more accepting to actually talking about it?” said Moore. “People in rural communities definitely have the need, it’s just how is it being talked about or not.”

There are also quality disparities in mental health services between rural and urban communities. A portion of these differences is due to mental health professionals being paid more in urban areas, which leads to fewer practitioners in rural settings.

The issue of infrastructure also exists in these same areas. Many rural communities do not have the volume of services that cities do, which leads to an exclusion when it comes to government grants. 

As the former Adolescent Substance Abuse Coordinator for the state, Moore accepted grant proposals to fund mental health services. For many of the proposals to pass, communities needed to already have specific services in place. If they did not already have these services, they could not be funded by the grants.

“Sometimes when you don’t have things, then you don’t have the things that are needed to get more money to have more things and it tends to be this weird feedback loop,” Moore explained.

Discussing limited services, Moore also explained, “It’s not that [rural mental health services are] poor quality or good quality, sometimes it’s just the thing that they have and it’s not best for what the individual needs, which then makes the service lower quality.”

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While the COVID-19 pandemic has increased the disparities between many populations, it has actually allowed more people from rural communities to access mental health services.

Before the pandemic began, there were rules regarding where practitioners could operate based on their and the patient’s locations. These rules were temporarily lifted to allow further access to health care and resulted in greater numbers of rural residents seeking this type of care.

To further decrease the differences in mental health care throughout Wisconsin, Moore believes the state needs to provide outreach to counties that have increased need.

“Basically doing equitable analyses of who needs what, and if places like Dane County or Milwaukee County already have stuff, then it’s good to do that kind of outreach for more rural communities too,” Moore said.

Many policy decisions in Wisconsin are made at the county level. Counties can participate in a practice called Comprehensive Community Services, which groups counties with different health capabilities together to create an entity that will support all aspects of healthcare in rural communities. The state Department of Health Services offers technical assistance and support to CCS providers.

Along with CCS, Moore believes in the importance of supporting grassroots organizations to try to overcome much of the bureaucratic delay that comes with working through the state.

To effect change on a personal level when it comes to mental health, Madison is home to meetings of the State Council on Alcohol and Other Drug Abuse and the Wisconsin Council on Mental Health. These organizations inform state legislation on mental health and substance abuse disorders and the meetings are open to the public.

“If you want to get involved as a citizen, you can have your voice heard. Go be a part of this stuff,” urges Moore. The meeting schedules and minutes for both of these organizations can be found on their websites, linked above. 

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Emma Grenzebach

state news writer


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