Mental health needs, including emergency department visits and suicide rates among youths, have skyrocketed in the US, but access to treatment remains inadequate. Before the COVID-19 pandemic, approximately half of the children with mental health needs in the US were not receiving treatment from a mental health professional. The pandemic exacerbated this crisis by further decreasing access to treatment and increasing psychosocial risk factors such as family unemployment, social isolation, and increased family stress. Consequently, a National Emergency in Children’s Mental Health was declared in a joint communication by the American Academy of Pediatrics, the American Academy of Child & Adolescent Psychiatry and the Children’s Hospital Association. Families cannot find mental health care for their loved ones; psychiatrists experience an insatiable need for their services; emergency departments are overrun by youths in crisis and waiting for an inpatient bed for days, if not weeks—many would argue that the mental health system needs to be fixed. But the key questions are: How do we fix it? And where do we start?

Is it any wonder there is a mental health crisis in rural America? Hurricanes, floods, regulations, lawsuits, high input prices, low commodity prices — and those are just a few of the challenges farmers face. Add to that the pressure to maintain the family farm, one that gets harder with each generation. Finally, factor in that farmers, and as an extension farm families, are tough and often reluctant to talk about their feelings. We aren’t good at asking for help. 

Two factors that make production agriculture an ideal occupation for many farmers — working in the country and being independent — are also catalysts for a mental health crisis in rural America. Isolation and the fierce independence in agriculture create an environment where mental health issues thrive, says Oklahoma State University Extension Professor of Economics Shannon Ferrell.

“Many common factors in production agriculture tend to isolate us, physically and emotionally,” Ferrell said. Ferrell explained that late in the 2010s rural America “was on the precipice of a farm crisis that looked a lot like the 1980s.”

To address the unprecedented mental health crisis among people of all ages, as part of his Unity Agenda, President Biden has put forward a comprehensive national strategy to tackle our mental health crisis, and used his State of the Union Address to call for a major transformation in how mental health is understood, accessed, treated, and integrated – in and out of health care settings. Across the federal government, the Administration has already invested nearly $4 billion in American Rescue Plan (ARP) funding to expand access to mental health and substance use services. The President’s FY23 budget goes further, by proposing over $27 billion in discretionary funding and another $100 billion in mandatory funding over 10 years to implement his national strategy and transform behavioral health services for all Americans. 

This month, the Biden-Harris Administration is taking additional, new actions to advance the President’s mental health strategy across its three objectives: strengthening system capacity, connecting more Americans to care, and creating a continuum of support.