Those who go without: an ethnographic analysis of the lived experiences of rural mental health and healthcare infrastructure

Abstract

The impact of navigating one's mental health in a rural community is a unique lived experience because of the many barriers associated with seeking and receiving mental health services. Using arts-based visual ethnography and an analysis of 47 semi-structured interviews, we examine the lived experiences of navigating mental health struggles and healthcare infrastructure in a rural community in the western United States. To do so, we leverage the tenets ‘social exclusion’ in tandem with an ‘availability, accessibility, acceptability, and appropriateness’ framework to situate our analysis centered around three key, intertwined themes: the internalized shame and stigmatization experienced by rural people with mental health struggles, exclusionary communal attitudes and practices that exacerbate rural individuals' experiences, and an unreliable, fragmented rural mental healthcare infrastructure that further aggravates the individual and community-level experiences of stigmatization and mental health struggles. Our paper concludes with participant-driven solutions for future policy- and community-level improvements to better address rural mental health.