Poverty is an intersectional issue, as children; women; men; people of color; people who identify as lesbian, gay, or transgender; and immigrant groups are all prone to experience the multifaceted impact of poverty. People who live in rural poverty are likely to experience more severe and persistent mental health disorders. This chapter provides an overview of how rural poverty impacts the mental health and wellbeing of diverse children and families. The authors discuss issues faced by residents living in rural poverty and provide multiple strength-based strategies that behavioral service providers can use to provide culturally relevant mental healthcare in impoverished rural communities. Lastly, the authors offer suggestions for future research.
TopIntroduction
“I don't see class.” This claim echoes the more popular statement “I don't see color,” which is a faulty claim made by individuals who want to ignore issues of structural power, privilege, and other topics related to race (Burke, 2019). Like the phenomenon of colorblindness, being class-blind dismisses the reality of social class differences and lessens one's ability to recognize and discern how to provide equitable resources and services to those who experience poverty. Over 40 million Americans live in poverty, with the most concentrated areas of poverty in non-metro, rural locales (United States Department of Agriculture [USDA] Economic Research Service, 2019). While poverty is commonly considered to be an urban issue, persons in rural areas experience poverty in higher rates (USDA Economic Research Service, 2019), with 16.4% living in rural areas versus 12.9% in metropolitan areas. The physical and psychosocial stressors attributed to poverty, such as malnutrition, increased morbidity, and homelessness are detrimental to the wellbeing of children and families (Zalaquett & Chambers, 2017). Therefore, scholars, policymakers, and the public must acknowledge the chronic life stressors that adversely impact the mental health and wellbeing of individuals living in rural poverty as well as identify protective factors that promote their healthy development and resilience.
In order to address the mental health-related concerns of children and families living in rural poverty, it is vital that professionals recognize the challenges residents face while simultaneously noting the strengths present in these communities. Individuals living in rural poverty possess remarkable assets that help them to overcome environmental and personal stressors (Williams, Bryan, Morrison, & Scott, 2017). However, in order to recognize the capacities (i.e., potential to withstand adversity) of individuals living in rural poverty, scholars from multiple disciplines (mental health, education, and allied professionals) suggest a need to shift from a deficit-oriented ideology to a culturally responsive, strength-based framework when providing services in these communities (Crumb, Haskins, & Brown, 2019; Harms Smith, 2017). Strengths based frameworks focus on the empowerment of people living in poverty and the acknowledgement of their capabilities (Harms Smith, 2017).
The objective of this chapter is to help readers develop an understanding of the mental health needs of children and families living in economically disadvantaged, rural communities. The authors provide strategies that providers of rural mental and behavioral healthcare services can use to address the concerns extant in impoverished communities using strength-based approaches. The authors outline ways that providers can alter services to address the unique mental health concerns of residents living in rural poverty and methods providers can use to engage in individual and systems-level advocacy interventions to promote equity and positive systemic changes in rural communities. The chapter concludes with recommendations for how mental healthcare providers can collaborate with schools, local organizations, and faith communities to improve mental healthcare for residents living in rural poverty.