Facets of a Crisis
Doctor with patient
Women's Health
Migrant Health
Mental Health
Mental Health
People throughout history have suffered from emotional problems like anxiety and depression. Whereas in urban areas it can be almost chic to speak casually of visiting one's therapist, the stigma of being weak or out of control can keep rural people away from the help they need.
Additionally, services can be few and far between. During the time period of 1999 to 2001, Baker County reported zero psychiatrists, zero psychologists, 1 licensed social worker, zero family counselors and zero drug/alcohol counselors. Baker currently ranks 33 of Oregon's 36 counties in median family income. The result can be devastating: Oregon's Office of Rural Health calculated a suicide rate from 1999 to 2001 of 53.2 per 100,000 people, almost quadruple the state average of 14.5.
A patient who has mental health issues that require medical intervention, like schizophrenia or a severe drug problem, more often than not is treated in the emergency room, where the on-call provider must handle a condition and potentially dangerous situation for which s/he may have little training or a lack of resources. Alternately, a patient may become involved with local law enforcement. Approximately 16 percent of all people in state prisons are identified as mentally ill; in Oregon, twice the national rate of prisoners take psychotropic medication.
There are some characteristics of rural communities that support those with mental health problems: closely knit networks of family, friends and neighbors and the rural tradition of helping one another in times of need can be sufficient buffer for a depressed or marginally ill person. An active rural lifestyle can provide diversion for depression and alternatives to recreational drug use.
Urban innovations like video conferencing are also promising to help: Rodeo Net in La Grande is a "behavioral health telecommunications service" that has been involved in the establishment of the Oregon Telecommunications Coordination Council and the Oregon Telehealth Alliance. Other individuals and organizations in Eastern Oregon have been working for fifteen years to secure high-bandwidth connection in the region, but Rodeo Net's main focus is to provide remote mental health care. Read more about this in the section, Finding Solutions With Technology.