How can I get mental health help in a small town?

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Your mental health is just as important as your physical health, but getting treatment in a small town can be really hard. Small towns typically have fewer mental health care providers, and you may not be able to find a therapist near you. Additionally, since everyone in your small town likely knows each other, you may feel uncomfortable opening up to a therapist you’ll run into at the grocery store. Despite these obstacles, you can get the care you need and have other options for supporting your mental health.

Finding a Therapist

  1. Talk to your primary care physician (PCP) about your mental health. Your PCP can give you a lot of guidance about what type of treatment you need. They can refer you to a therapist and may prescribe you medication to treat your symptoms. Make an appointment with your doctor to discuss your symptoms and ask for help.[1]

    • It’s best to set up an appointment specifically for your mental health so you'll have more time for an in-depth discussion about your mental health. However, you can bring it up during an appointment for a physical medical condition if that’s more comfortable for you.

    Tip: When you live in a small town, you might feel nervous about opening up to your doctor because they might be a friend or neighbor. However, your doctor is trained to separate what you tell them as a professional from what they know about you as a friend. Don’t let your personal relationship prevent you from getting the help you need.[2]

  2. Ask your PCP if you might benefit from medication. Fortunately, your PCP can legally prescribe you medication for a mental health condition even if you’re struggling to find a therapist. Tell your PCP about your symptoms and what you’re hoping to get out of treatment. Then, ask if they’ll offer you medication.[3]

    • For instance, your doctor might prescribe medication to help treat symptoms of depression, anxiety, ADHD, or PTSD. However, they may ask you to see a therapist while they’re treating you.
  3. Get a referral from your PCP to see a nearby therapist. Your PCP can likely help you find the therapist who is closest to your small town. You may be lucky enough to find a therapist in your town. However, your PCP may recommend a therapist outside your area. Talk to your doctor to get a referral for treatment.[4]

    • Referring you to a specialist is part of your doctor’s job, so they’ll be happy to help you get treatment. Don’t worry that you’re putting them on the spot by asking.
  4. Search online for the closest therapist as another option. If you don’t feel comfortable talking to your PCP, you may be able to find a therapist online. Do a general search using your favorite search engine or use a website like Psychology Today, which has a list of psychologists for each region.[5]

    • You might type in the search term, “Therapist in Orange, TX.”

    Tip: Your insurance company’s website may help you find a provider in your area that takes your insurance. Visit their website or call the number on the back of your insurance card to ask about the therapists in their provider directory.

  5. Ask if you can get transportation if you don’t have a ride. You may have to travel outside your town to find a therapist. If you don’t have reliable transportation, this can be a big barrier to you getting treatment. Some clinics offer transportation services, so ask if you can get a ride. Otherwise, see if a friend or neighbor could take you.[6]

    • It can be nerve-wracking to ask someone to drive you to your therapy appointment, but you need and deserve care. Reach out to someone you trust and say, “I know it’s a big favor to ask, but I really need a ride to a doctor’s appointment. The only doctor I could find is an hour away. Could you please help me get there?”
  6. Check if your area is served by a home-based counseling program. Since many small towns and rural areas lack mental health services, there are home-based counseling programs that send a therapist to you. Talk to your doctor to find out if this type of service is available in your area. They may be able to help you sign up for the service.[7]

    • Your PCP can refer you to the program for treatment if this type of service is available in your area.

Getting Therapy Online

  1. Find a place where you have access to broadband internet. Online therapy is called telehealth counseling, and it requires broadband internet so you can make video calls. Depending on your area, you may have broadband internet at home. However, some small towns get spotty coverage, so you may have to find a hotspot. Look for a place where you can log on to the internet.[8]

    • For instance, you may be able to use the wifi in a coffee shop or the library.
  2. Enroll in a telehealth counseling service so you can get treatment. If you have insurance, call your insurance company or go to their website to find their telehealth provider. As another option, do an online search for telehealth providers that operate in your area. If this doesn’t work, sign up for a counseling app, like BetterHelp or Talkspace. Provide your personal information to create an account.[9]

    • For instance, anyone can sign up for a service like BetterHelp or Talkspace, though they can be costly. Additionally, your insurance may offer other telehealth services that are low-cost, so check your benefits.
  3. Schedule video appointments with your therapist. The website or app will offer you times when your therapist is available. Choose an available time that fits your schedule and set up an appointment. Make sure you are logged in when your appointment time arrives so you don’t miss it.[10]

    • If you miss a video appointment, you may not be able to schedule another one.

    Variation: Counseling apps often allow you to send your therapist questions or messages between appointments, and they will reply back to you. If this service is available to you, use it to get additional care when you need it.

  4. Ask if you need to attend in-person sessions as part of your therapy. While many telehealth services are designed to be completely online, your doctor may require you to occasionally attend in-person sessions. For instance, you may have to go to a monthly in-office session. Talk to your doctor to find out if this is a requirement for treatment before you get started.[11]

    • Your doctor may want to meet in person so they can get to know you better and can better evaluate your nonverbal communication. This will help them give you better treatment.

Using Non-Traditional Mental Health Supports

  1. Research your mental health symptoms so you can support your treatment. While reading about a condition, such as depression or anxiety, isn’t a replacement for a therapist, it can help you learn tools to help you manage your mental health needs. Read about your symptoms and how you can take care of yourself. Additionally, share the resources you find with the important people in your life so they better understand what you’re going through.[12]

    • You may be able to find mental health exercises and tracking tools that will help you better manage your mental health. However, keep in mind that it’s always best to do these activities under the care of a licensed therapist.
  2. Have an honest talk about your mental health with a trusted friend or relative. Talking about your mental health can be really hard, especially if you’re worried people will judge you. However, your mental health is just as important as your physical health, and you deserve to get the care you need. Discuss your symptoms and how they’re affecting you with someone you trust. Ask them to support you and be there for you when you need to talk.[13]

    • You might say something like this: “Lately I’ve been feeling sad, lethargic, and empty. I think I’m depressed, and I need support right now. Can I talk to you about what I’m feeling?”
  3. Talk to your religious leader if you have one. Your religious leader can listen to you, offer you support, and suggest coping strategies that are based on your faith. While they likely won’t be a replacement for a licensed therapist, they can be a great resource if you’re having trouble finding a doctor. Ask your religious leader if you can meet with them for a one-on-one session. Then, share what you’ve been going through.[14]

    • Some religious leaders are also trained counselors, so ask yours if they have any training.

    Tip: You might feel embarrassed about talking to your religious leader because you’re worried that they might judge you or share your business with everyone. However, they are generally committed to withhold judgement and keeping information told to them in confidence secret.

  4. Use a mental health app for free or low-cost guidance and tools. While most mental health apps don’t offer counseling, they provide tools that can help you manage your symptoms. These can include mood trackers, advice for improving your mood or controlling anxiety, and relaxation tips. Try different apps to find the one you like best. Then, use it to support your recovery.[15]

    • Some apps are free but may have in-app purchases. Options include apps like What’s Up, HealthyMinds, MoodKit, Mood Path, Pacifica, and MindShift.
    • While these apps can be helpful, they aren’t a replacement for a licensed therapist.
  5. Look for a support group that meets in your area. A support group gives you a place to share your struggles, get advice, and make connections with others. In some cases, the group may even be run by a licensed therapist who will offer their professional guidance. Ask your PCP or local therapist if there is a group in your area. Alternatively, check with your local religious communities or search for a support group online. Attend the group to see if it feels right to you.[16]

    • You may feel nervous about opening up to a group of your peers, especially since you’ll likely know everyone in the support group. Try to remember that you’re all there for the same reason. You might also talk to the group’s leader beforehand to ask if you can listen for awhile before you talk. This way you can see that the other group members are struggling just like you.
  6. Join an online support group if there's not one in your area. You might struggle to find a group that meets in your area, but that doesn't mean you can't get the support you need. Visit websites dedicated to mental health and join the forums. Then, post on the forum to find people you can talk to about your symptoms or struggles.[17]

    • For instance, you might use Mental Health America's Inspire forum for support. You can find it here: https://www.inspire.com/groups/mental-health-america/
    • You might also join a community platform like Reddit. However, pick a moderated forum so you know the content is reviewed and look for supporting evidence for advice you receive.
    • You may be able to find support on social media using mental health hashtags, such as #addiction, #anxiety, #depression, or #mentalhealth.[18]

References

  1.  https://journalofethics.ama-assn.org/article/patient-privacy-and-mental-health-care-rural-setting/2011-05
  2.  https://www.chausa.org/publications/health-progress/article/september-october-2010/when-there's-no-place-to-turn
  3.  https://journalofethics.ama-assn.org/article/patient-privacy-and-mental-health-care-rural-setting/2011-05
  4.  https://journalofethics.ama-assn.org/article/patient-privacy-and-mental-health-care-rural-setting/2011-05
  5.  https://naminc.org/stigma-mental-illness-small-towns/
  6.  https://www.chausa.org/publications/health-progress/article/september-october-2010/when-there's-no-place-to-turn
  7.  https://www.chausa.org/publications/health-progress/article/september-october-2010/when-there's-no-place-to-turn
  8.  https://www.chausa.org/publications/health-progress/article/september-october-2010/when-there's-no-place-to-turn
  9.  https://health.usnews.com/health-care/patient-advice/articles/2018-04-20/how-much-of-a-struggle-is-it-to-get-mental-health-care-in-rural-areas
  10.  https://naminc.org/stigma-mental-illness-small-towns/
  11.  https://www.chausa.org/publications/health-progress/article/september-october-2010/when-there's-no-place-to-turn
  12.  https://www.huffingtonpost.ca/entry/mental-health-rural-towns_ca_5cd55e01e4b07bc7297772d7
  13.  https://www.cnn.com/2018/06/20/health/mental-health-rural-areas-issues-trnd/index.html
  14.  https://www.cnn.com/2018/06/20/health/mental-health-rural-areas-issues-trnd/index.html
  15.  https://www.huffingtonpost.ca/entry/mental-health-rural-towns_ca_5cd55e01e4b07bc7297772d7
  16.  https://www.huffingtonpost.ca/entry/mental-health-rural-towns_ca_5cd55e01e4b07bc7297772d7
  17.  https://www.huffingtonpost.ca/entry/mental-health-rural-towns_ca_5cd55e01e4b07bc7297772d7
  18.  https://psychcentral.com/blog/mental-health-hashtag-list/
  19.  https://health.usnews.com/health-care/patient-advice/articles/2018-04-20/how-much-of-a-struggle-is-it-to-get-mental-health-care-in-rural-areas

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