As we wrap up Mental Health Awareness Month, we must continue to recognize and do the work needed to break down the barrier and stigma around mental health care. Unfortunately, this work can be more tenuous in rural areas due to unaddressed intergenerational trauma, a lack of full systemic support, and the stigma associated with seeking mental health support. However, interns from the College of Education and Human Development's Counselor Education Program through the Downing Counseling Clinic are bridging the gap in care for students in these communities.

A multidisciplinary approach must be used to combat the barriers that exist in rural communities where the rates of suicide are nearly twice as high as the general population (CDC, 2021). 

Director of the Downing Counseling Clinic, Adrienne Renwick, spoke to the challenges these communities face. "Rural areas in Nevada tend to be underfunded and distanced significantly from centralized services and without access to the more typical resources of larger cities, such as public transportation, recreational programming, health and social services and mental health services. There are also some differences with respect to how mental health concerns are viewed and approached between urban and rural areas."

Currently, three counseling student interns meet with youth at the middle and high schools in Fallon, Nevada. These students act as a support that requires them to become a part of the system that is changing the narrative around mental health. The students are further supported by on-site supervisor Cindy Black, who is pursuing her Ph.D. in Counselor Education and Supervision. 

Black reflected on her time as a school counselor "There isn't enough support to go around in a rural community, and having access to direct services on-site has made the school counselor's job a little easier as well as providing the care for the students and staff. I feel that providing mental health services on-site in the rural school district and at no cost to the clients has been a tremendous support for the students." She continued, "The program is a win-win for everyone. It exposes the student clinicians to the special needs of a rural community while providing much-needed support."  

These student interns, from the Marriage, Couple and Family Counseling and the Clinical Mental Health Counseling tracks, are responsible for screening students, providing individual counseling sessions, working with wraparound service providers, and building relationships with the school staff. 

Third-year Clinical Mental Health Counseling intern Celia Wilson, who worked in the community, talked about her experience, "I chose to work out in Churchill County school district for practicum because I knew I wanted to work with underserved children and adolescents. In many rural settings, school is the only opportunity for children to receive mental health services. Being able to provide these services for children who normally would not receive them is invaluable."

Wilson also wanted to mention the professional benefits she has had from being a part of this internship location. "Clinically speaking, I have learned a lot more about issues specific to rural populations. For example, issues such as generational trauma and substance misuse are often magnified due to the geographic isolation of these communities, and for children, it is often more difficult for them to get out of these cycles than children who live in more populated areas." She continued, "Personally, I have learned that the best way to become involved in these communities as an outsider is to build rapport with students and families and be the support they need"  

The schools greatly benefit from on-site mental health services as some barriers to critical care and lifesaving interventions are removed. 

This fall, the rural outreach program at the Downing Counseling Clinic will extend to Humboldt County, where three student counseling interns will be providing telehealth sessions to students ages six to 11. All three student interns are in various stages of being trained in teleplay therapy in preparation for the expansion.  

For rural communities, continuing the conversation around mental health sheds light on a topic that far too often gets lost in the shadows. These conversations can help to lower stigma and will hopefully eventually eliminate some of the barriers to pursuing mental healthcare, making it accessible to all. 

Renwick closed by saying, "There is a strong community mindset in rural Nevada, and some of the most innovative grassroots efforts I've experienced have come from our rural communities. It benefits all of Nevada for our urban and rural areas to work more collectively to address the gaps in children's mental health services; we have much to learn from each other." 

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org.