What are the differences between looking for counseling in a rural community compared to looking for counseling in an urban one?

Someone in an urban area is going to have access to a lot more resources. Here in Reno, there's tons of agencies as well as a lot of private practices. In a rural community, depending on the size of the town, there may only be one counselor in that community or one mental health professional. If someone needs psychiatric medication, they may need to go to a primary care doctor.

What are some of the mental health challenges facing those in rural Nevada during the pandemic?

Some of the issues we are seeing with our clients from rural Nevada are universal to what everyone is experiencing during the pandemic - loneliness, depressive symptoms, anxiety, family/ relationship conflict. 

There seems to be a stigma around receiving mental health support in rural areas. Why is this and what should an individual do to break the stigma? 

The stigma seems to be from a lack of understanding of mental health and viewing it as a foreign concept instead of normalizing it to being similar to our physical health. We will quickly go see a medical doctor if something doesn't seem right for us physically and we need to work to transition that mindset into our mental health as well. I think the best way to break the stigma is normalizing mental health and the best people to do that are those who have received their own mental health services. For example, a male who has gone to counseling then opening up to other males about how he went to counseling to take care of his mental wellbeing changes the conversation and makes mental health services seem less intimidating when we know someone who has been through the process. 

Is it harder to get access to counseling during the COVID-19 pandemic?

Now is a prime time to get into mental health services if someone in a rural community has been thinking about it. The pandemic has forced all mental health services and a lot of medical services to provide telehealth. If you live two hours away from Reno, you can still get connected with a mental health professional here in Reno. You can still be scheduled for services instead of having to wait three months for a waitlist in your community or having to do a long commute to come to a counseling session.

What can a rural community do to help reduce the barriers to receiving mental health care in their communities?

It would be wonderful if rural communities were able to put technology for telehealth sessions into private rooms in settings like a community center, public libraries where members of the community could rent out these spaces for their sessions. This would make services accessible to anyone no matter their resource level. 

If I live in a rural area and I want counseling, where do I start?

Deciding what is needed is the first step. If you want counseling services, figuring out if you want to work with a psychologist, a social worker, a marriage and family therapist or a clinical mental health counselor can be helpful. From there, figuring out if you want to use insurance or do cash pay and otherwise figuring out what your financial needs are and what you can afford.

The Downing Counseling Clinic at the University of Nevada, Reno offers sliding scale fees, since the graduate students conducting the sessions are in their last year of training before becoming counselors. The sliding scale is special because some people might not want to have mental health services billed on their insurance or might not have insurance at all. The clinic can often still accommodate people in financial distress because of lost jobs or tight expenses.

The best way to get scheduled with the Downing Counseling Clinic is to email their office.

Megan Little, Ph.D. is the Director of the Downing Clinic. She is a licensed professional counselor with her Ph.D. in Counselor Education and Supervision from the University of Arkansas. Her clinical background has been focused on college mental health and interpersonal trauma work. She teaches clinically focused classes such as pre-practicum and practicum while also overseeing the Downing Clinic.