In this episode, host Brandon Li sits down with Jeff Winton, founder of Rural Minds, a nonprofit dedicated to advocating for mental health services in rural America. Jeff shares his deeply personal story of how a family tragedy inspired the creation of Rural Minds and sheds light on the mental health crisis in rural communities, where stigma and lack of access to care create unique challenges.

We live and work in rural communities. I (Jeff) am the founder and chairman of Rural Minds and from rural upstate New York. I (John) spend part of my time in the least populated county of North Carolina and serve as the chief medical officer and executive vice president at Otsuka in the US. Our experiences in rural America have shown us that in rural communities, though unique in their people and landscapes, mental health inequity is ubiquitous. Across the country, rural residents are struggling to address the growing and seemingly intractable mental health crisis.

Forty years ago, the nation was dealing with the onset of an historic crisis with the farm economy. Land was foreclosed, livestock were sold and people left the farm for the city.

And sadly, farmers were dying by suicide, partly because they didn't know how to deal with the impact.

It is better now, but a great deal of work remains to be done to ensure rural residents have adequate access to mental health care.

“Iowa is 45th in the nation when it comes to mental health providers per capita,” says David Brown, Extension behavioral specialist with Iowa State University. “Fifty percent of Iowans live in areas where mental health care is not very accessible. Things have gotten better, but a lot of work remains.”

Rural Minds founder and chairman Jeffrey Winton of Mayville in Chautauqua County is building connections for mental health services across rural America. Winton was the keynote speaker Wednesday at Trauma Symposium 2024 presented by the Cattaraugus County Trauma Informed Coalition in the Dresser-Rand Auditorium at the John J. Murphy Professional Building. The seeds for Rural Minds were planted on Sept. 3, 2012, with the death of his nephew, Winton said.  A Chautauqua County native, Winton’s life changed along with the rest of his family 12 years ago when his 28-year-old nephew Brooks, the father of three-year-old twins, took his own life.

Despite significantly higher rates of suicide among rural residents, mental health resources in rural Kansas continue to be lacking, panelists in Dodge City said last week. Chuck Strand of Rural Minds, a national non-profit, said self-reliance can be a challenge and an opportunity. "Someone mentioned the challenge of people in rural communities being very self-reliant and do-it-yourself," Strand said. "That mindset can be necessary to survive and thrive in rural communities, but it can be a real challenge when that mindset is driving a response to a mental health challenge or a potential mental illness." Rural Minds offers the information and resources so people can do it themselves, he said. Rural communities have a lack of access to both mental and physical health providers, Strand said. Telehealth has filled some of that gap. However, 30 percent of rural homes don't have access to reliable internet access.

Use of telemental health services expanded quickly during the COVID-19 pandemic, and all signs indicate this trend is here to stay. More than half of patients (57 percent) say they prefer using telehealth for regular mental health visits, according to a recent J.D. Power survey. A study from the Kaiser Family Foundation also found that more than one-third of outpatient care visits for mental health and substance use disorders are conducted via telehealth. Increased patient demand for mental telehealth services, as well as permanent policy changes allowing reimbursements for telemental and telebehavioral healthcare, mean providers are highly incentivized to implement the technologies and security measures needed to deliver optimal telemental care.