Rural Health Fractured: Developing Mental Health Resources in Rural America

Jeremiah Hodshire (Host): I’m thrilled to be in the studio today with a very special guest, Chuck strand, executive director of Rural Minds. I didn’t know much about this service, and mission, really. I look at it as a mission that is available, and I really look forward to talking to their executive director, Chuck, today about that. You’re going to learn today from Chuck about some of the barriers, challenges and concerns regarding access to healthcare and so much more. Chuck, before we get started with the meat and potatoes of our questions, let’s talk a little bit about your role at Rural Minds. How long have you been there? What brought you to the organization, and, the greater question is there’s a lot of things to do in this world; why in the world did you choose this?

Chuck Strand (Guest): J.J., it’s great to be here. Thank you for having me. My name is Chuck Strand, executive director of Rural Minds. The organization is the only National 501C3 nonprofit that’s focused on providing free information and resources to confront the rural mental health challenges and the stigma surrounding mental illness. So, we advocate for the mental health equity in rural communities, promote mental wellness, and distribute educational content. We serve 46 million people living in agricultural communities, small towns, isolated areas across rural America.

So, I’ve been with the organization from the beginning, and we’re coming up on our fifth anniversary in October, and I was here to help get everything started and kind of tapped into my experience in the nonprofit space. I was with the prostate cancer nonprofit for ten years prior to Rural Minds, and I led that organization for the last four. Early in my career, I was with marketing communications, promotions agencies doing consumer packaged goods work. I really as far as response to why I chose this field, I really wanted to do something that had a personal connection to what I care about most. So, I got into patient advocacy, and when I was in the prostate cancer space, we did some work with mental health in terms of the impact that side effects for treatment might have on some people. I really became more interested in mental health, and it really brought me to the realization that for me personally, I think that mental health is really the foundation for overall health. So, when this opportunity came around to connect with the founder of the organization, Jeff Winton, I was very excited about partnering with him. We’ve got an awesome team of people that are all focused on the same goal, which is just to really improve mental health in rural communities and address the unique challenges that are specific to folks who live in rural America.

JH: Shared with our producer that having read your bio and a little bit about the work that you’re doing, you know, this is mission minded work. I mean, it’s certainly a need in our communities. I’ll talk a little bit here in just a few minutes about the need in rural Hillsdale County, and how services like you offer could impact positively our community members. Before we get into all of that, we like to humanize our guests a little bit with our listener. Maybe a fun fact about yourself, something interesting that you can share with our listeners to help relate. You know that you are a true person and not just all work.

CS: My wife and I have raised our family in the Chicago metro area, but I grew up in a very small town in Upper Michigan, near the shores of Lake Superior, Ironwood. So, I spent a lot of time outdoors year-round in the North Woods. We saw the family cabin on the shores of Lake Superior. Over the years, I’ve done a lot of kayaking around the Apostle Islands, which I really enjoy, and making the best of what I’ve got available in Chicago throughout the winter. I’ve for the past couple of winters, I’ve kayaked with some friends on the Chicago River, and during the summer I am sculling in Lincoln Park Lagoon between the Lincoln Park Zoo and Lake Michigan. So, I’m trying to, you know, take advantage of the outdoor opportunities that don’t exist everywhere. I do definitely like to get back up into the North Woods as much as possible

JH: Well, I didn’t even know you’re a Michigander, so that’s great to know. That’s a fun fact, given this as a Michigan based podcast. Well, as I said earlier, Chuck, it’s great to have you on the podcast. We’re going to jump into some things here in just a minute. For our listeners who just tuned in today, we’re talking about mental healthcare and the access in rural communities to mental healthcare. Chuck is here to provide information on the state of mental healthcare in our nation right now, issues in the care model and delivery of it for mental health and its impact on our community. Specifically, as we look at rural, we’ll talk about stigma, barriers to care, and of course, what all this has to do with rural health. So first of all, let’s start in our discussion about how did Rural Minds start. Let’s talk about the global picture of its mission.

CS: Well, the organization was founded by Jeff Winton, and it was in response to the family tragedy that that was experienced with the death by suicide of Jeff’s nephew, Brooks. At the time, Brooks was 28 years old and left behind three-year-old twins, and the family had a dairy farm. Jeff still is on a dairy farm in upstate New York. When Brooks passed away, many people in the local community, small farming area just assume that they might make something up about the cause of death for Brooks and Jeff and his family, his mother especially, really was adamant about wanting to tell the truth and break down some of the stigma because similar things had happened to other people over the years in terms of how people dealt with death by suicide in rural communities. They really wanted to make a difference. So, Jeff delivered the eulogy at Brooks funeral, and after the ceremony, a lot of people came up to him and they talked about their own challenges and something that might have happened in their family or in their community. It really made Jeff realize that there was a real need for mental health conversations in rural communities. So, he made the decision at that time to want to do something a little bit later, though, because the twins, Brooks son and daughter were only three. So, Jeff and his family waited until the twins were in their teens before they launched the program and the organization.

So that’s really the story behind Rural Minds. Before Jeff launched Rural Minds, he also talked to many of the existing nonprofits that are in this space, mental health space, including Mental Health America, Depression Bipolar Support Alliance. They have great information that’s available to anybody, anywhere. For whatever reason, the statistics in rural America, in terms of the mental health challenges and the fact that people in rural communities are overall 49% more likely to die by suicide than folks in urban areas. Something is missing, something is not connecting. The larger organizations that Jeff spoke to really welcome the opportunity for rural minds to kind of supplement what they are doing overall, but realizing that it’s different in rural, we really are a very needed and important niche within the mental health space. With the barriers that we’ll talk about a little bit later, in addition to the higher statistics for mental health incidents is just really underscores the need for what we’re doing. So, we’re growing quickly. It’s all due to the great partnerships we have on many fronts. Many people and many organizations that are sharing our mission and the work that we do. So, we’re grateful for that. It’s good to know we’re able to do things that are needed. We always reach out to find out what is needed, because we don’t ever produce something that we think people need or want. We do a lot of listening and connect with people on the ground in real communities to understand what they need, what’s missing, how to make it culturally relevant, and then partnering with people that are in rural America to deliver the information.

JH: I would assume that there’s some similarities obviously, as you meet with these community members. one of the similarities will be the aspect of barriers, and barriers and rural communities, I’m sure, are consistent from rural community to rural community. Taking away the conversation initially about the stigma. Let’s talk about barriers to mental health access and in wellness programs in rural communities. So, if you could tell us, what, in your experience, having spent now five years working in this environment, what are the most significant barriers for our patients who need mental health in rural communities?

CS: Well, unfortunately there are there are many and they kind of fall into two categories. There are the barriers that are more inherent in geographic and technological aspects, and then there are also lifestyle barriers. Top of the list, there’s a severe shortage of healthcare providers overall, especially mental health professionals in rural communities. People have difficulty getting an appointment with the limited availability of these mental health professionals and they’re often further away. So, it takes more time to drive longer distances. Like we know, many rural areas and communities don’t have public transportation. There’s no rideshare like Uber or Lyft, and many small areas don’t even have a taxi service. There’s also the unreliable, expensive, and sometimes non-existent internet service. 30% of households in rural America don’t have internet, which of course, makes it impossible to do online virtual appointments or telehealth appointments. There’s often a lack of health insurance coverage, due in part to the weakening agricultural economy and financial instability. So those are kind of like the structural, so to speak, barriers, but they’re also barriers to mental healthcare that are inherent in a rural lifestyle.

Really the biggest barrier is the stigma that surrounds mental illness in rural America. There’s this self-imposed perception that asking for help is, you know, you should solve your own problems. Self-reliance is a virtue but that is counter to what’s needed for getting help many times with, with the mental health situation. So, people because of that sigma, they’re afraid of being judged negatively from others as being incompetent or less capable. There also can be a lack of trust in anyone maintaining confidentiality in a small, close-knit community, and oftentimes people just feel isolated without having access to talk with someone outside of their community who really understands what it is to have a mental health challenge in a rural community. Finally, any segment of the population that you can think of that would be in major metropolitan areas. Those folks are still in rural communities. They just might feel more isolated and more alone. So, there are greater barriers around race, class, disability, sexual orientation and gender identity.

JH: So let me go back because I’m interested in, you know, we talk about some of those barriers, you talk about transportation, for example. Let’s talk a little bit about some of the solutions to that. What would you offer a community that’s listening today that says, Chuck, that’s my community. So, we don’t have transportation now. What do we do? I mean, what advice or suggestions based on your what you’ve reviewed in the models exists for rural communities that have no public transportation to get patients out, what would you what would you recommend to their leadership, their CEOs? How could they get these services there?

CS: As far as the solution really, I think it’s not so much that, in and of itself, transportation is the barrier, but the fact that the stigma is so great that people don’t feel comfortable asking for a ride or having their car being gone. If you only have one car in the family, it’s a challenge to go in the first place. If people are like, well, where are you going? Why do you need a car for a day? I think even though we have these physical barriers that that are going to be part of how some people are living based on where they live and, and their economic status in terms of what they can afford in terms of one car or many. No matter how many cars you might have, there’s still that stigma about, you know, where you’re going and people don’t want to have their truck spotted in front of a clinician’s office because people, you know, the good and the bad thing about being in a small community is everyone knows you, everyone knows what you’re doing. It can be nice because people care, but also, it’s tough to have anything that you want to keep to yourself without having that get out as common knowledge.

JH: I want to talk in a few minutes, Chuck, about maybe toolkits or, or resources that will be available for communities to be able to break some of that stigma. Before we do that, let me ask you a question. You know, you gave a very alarming statistic about suicide rates in rural compared to urban. I did not realize the incident rate was so high as a comparison in rural. Let’s talk a little bit about that. Why do you find that percentage higher in rural? What would be your estimation of why that is? As we look at that, obviously, as you see that higher need for services, what factors contribute to that mental health in those rural areas?

CS: Well, it is a combination of all of these barriers because it does preclude people from being diagnosed or even if they’re concerned on their own and they want to pursue healthcare. It’s typically it’s further away. It’s, like we mentioned, harder to get an appointment. The primary care physician is often the person that is diagnosing and treating someone in a real community or possibly it’s E.R. because like physical ailments, people in rural communities often avoid going to the doctor. So, it’s for the variety of reasons we’ve talked about, you know, they’ve been wanting to be away from their job or their farm or their family or not having access to doing that. So, it really is. I don’t know if there’s just one thing that would lead to that.

The other shocking statistic is based on the latest information from the CDC; youth overall that are high risk, but youth who are from 15 to 19 years old in rural communities are 74% more likely to die by suicide than their counterparts in urban areas. So that’s shocking. As if the other stat wasn’t bad enough, but in response to these statistics, we’re developing programs that are specific to that segment of the population. So, we’re just working now on finalizing the pilot program for a Rural Youth Mental Wellness Program, which will be launching in September. We’re very excited about that. It’s to what we’ve learned, and again, back to us not creating something with the assumption that we know what people want. The Rural Youth Program was formed from an advisory committee of rural teens and young adults that 15 people from Future Farmers of America, 4_H, the National Grange, Cornell and of course Rural Minds. We had an ongoing dialog and we kicked it off with a hybrid presentation and meeting where we really kind of just provided some examples of what’s already out there and then drill down into, why aren’t these working? Why are these not aligned with how you want your information and what you’re looking for, and develop the program around that input? So, it was many months, but almost a year to develop the program. Now it’s in the pilot stage with some additional input from a few folks who are in in the advisory team and in their communities. We’re really looking forward to finalizing the content and launching that in September.

JH: That’s incredible. We’ll drop something in the show notes to advise our listeners about how they can gain access to information regarding that, because I think that’s important. Let’s shift gears a little bit and talk about, you know, as we face all of the challenges with healthcare reimbursement coverage issues, you know, that presents a barrier to access at times, because where do I go? Right now, I would submit to you that we’ve identified some flaws in our system. Patients that come into the emergency department that may be, you know, just simply sent back home because potentially there’s no bed openings. They are going to give them a self-evaluation tool. Essentially, they put them on a safety plan, and then they send that patient home. In many times when I talk to professionals, I hear, you know, it’s their ability to refer to centers that have bed available and you know, that they want to get the patient to the best spot possible and the consumer to the best spot possible, to be able to get resources to help them. Oftentimes those resources are limited in rural America. We have a ten-bed inpatient behavioral health unit, but most rural communities, if they had one, they’re closing them right now because they’re cost centers. Insurance companies are certainly very difficult to work with and in most cases with mental health, it’s a mental health authority, and it’s governed by the state and it’s governed by local municipality. Some of their ideologies and philosophies can bleed over into how they treat that population. So, I want to ask you, Chuck, you’ve been around the country, you know, what are the flaws that you’re seeing in the system right now that are preventing access to mental health services for our rural communities and the population that need them most?

CS: Well, across the board, the current healthcare models are more focused on reactive care rather than preventive care. With the One Big Beautiful Bill Act, with the reduction of federal Medicaid spending by a trillion over a decade, it’s got major impacts on patient eligibility, state budgets, hospital funding, and a rural America. The Medicaid cuts severely threaten local health infrastructure. It’s pushing already financially fragile hospitals toward closure, and nearly one third of all rural hospitals are currently considered to be financially vulnerable. So, there’s a significant number that are facing immediate threats of closure, and because the rural hospitals are typically among the largest employers in rural towns and communities, a closure really does trigger a deep local economic situation as far as distress, potentially. Then also the expiration of the Affordable Care Act’s enhanced premium tax credits has ended, leading you know, there’s severe health insurance premiums hike across the country. So, rural residents are disproportionately affected. The premium increasing beyond what many lower income people can afford to pay, and which leads to more people without insurance. Just to share a stat from the American Hospital Association, they project that rural states will experience an average 30% decrease in marketplace coverage and a 37% increase in uninsured populations, which is devastating.

JH: It presents another significant problem because as the tax credits fall aside and as the average commercial rate and the Medicaid payments reduce in rural communities, we find they’re heavy Medicaid population, obviously, because they’re poorer and the coverage goes away they get, you know, uncompensated care is what we get paid for. So, we provide the care and the emergency department. That’s not the best place to get healthcare services, especially as it relates to mental health services. You wait there for a caseworker to come in maybe 7 or 8 hours later, and then they arrive. So fully agree with you that the impact of the HR1, I won’t call it a beautiful bill. H.R.1 is, has been and will continue to be very devastating for rural communities in all areas of aspect, but specifically mental health services, because as these hospitals are closing their behavioral health units, that is the that is the first community benefit need that I can identify outside of obstetrics that we need to provide to our local community. Once medicated and once in group therapy, (patients) integrate fully back into society. That’s very important. I want to ask you this question. We have an ambulance shortage issue right now in our community. Are you seeing that patients are boarded in the E.R. more frequently and longer periods of time? Are you seeing that across the country? I know that’s not part of our dialog today, but I’m really most interested to hear your perspective on are we getting patients out to the places they need to go?

CS: Well, as far as in the ER department, I really can’t speak to that. I don’t have any stats as far as you know, what might be the situation across the country. I do know that, you know, obviously people do go to E.R. for mental health, but it is a small percentage overall from what I understand. I don’t know the stats as far the number of beds or that type of thing.

JH: Absolutely. No worries. It’s something that we’re monitoring here is just getting the patient to the proper place where they can receive the best care possible. Especially, you know, what we find, it’s a challenge across the country pediatric behavioral health services. You know that population. You talk about a population that’s overlooked in rural America. You know it’s tough for adult population, but pediatric is so much more difficult. Placement is 200 miles away for me for any type of services. So, Chuck, let’s say this; executive is listening, which many do. We often hear from hospitals across the country that have similar problems. So, that’s why we have the podcast to bring them awareness and education. Let’s talk about resources. So, what’s available from your organization to the CEO who says yeah Chuck good job, you’ve just described my community, now what do I do about it? What resources are available?

CS: Well, before I talk about, you know, the resources of Rural Minds, because we’re pretty much front facing with helping everybody. I can share some thoughts as far as how hospitals and healthcare professionals might better support, because there are several things that come to mind. So, the hospitals and healthcare professionals really could, could better support real mental health by integrating behavioral health more in the primary care clinics, expanding telehealth services, training community peers to reduce the cultural stigma. So, we know that people in rural communities want to get their information from somebody they know and trust. So, if there’s someone in the community that can be trained to help recognize people struggling and point people to the right resources, which does lead us to Rural Minds. Those are those are helpful. Since rural populations often only rely on primary care, providing mental health screenings more of them with more licensed mental health counselors and clinics that serve areas would really make diagnosis and potential treatment more standard. I know that is done in some clinics, but the more the better. That could be more prevalent. That would be really helpful.

Then just not much we can necessarily do about the expansion of broadband, but when there’s an opportunity to raise our voice, or as far as from a legislative standpoint on expanding broadband, freeing up some funding that’s been earmarked for that, and relaxing the telehealth policies that allow specialists to treat patients across state lines, those who can’t travel long distances, that type of thing. Because there’s this, this distance as a primary barrier to accessing physical healthcare, mental healthcare mobile units, of course, are helpful, but that’s, you know, that’s expensive. We recognize that that can only serve a limited number of people. The resources that we provide at Rural Minds, they’re all free. They are all accessible online. We recognize not since not everyone has access to the internet, much of what we have to offer is in a PDF so that can be printed easily and, you know, distribute it to other people. Kind of the model that we use to develop the programs. I mentioned one example with the rural youth program, with having the content and the platform, the strategy, the distribution, based on what we understand is needed in this case, with youth, we do the same thing with other programs and working with other organizations.

We’re all about partnerships. So, we have partnerships with national organizations that have a footprint in rural communities, such as the National Grange, the American Soybean Association, National Association of Wheat Growers, several others. The point is that we don’t pretend to know what’s needed. So, we need to listen and have the ears on the ground for people in those communities to help inform what the gaps are. Once we develop something, we run it by these people to make sure it is culturally relevant. I mean, not that one size fits all, because another misnomer is that rural America is pretty much, you know, it’s not homogeneous anything, but there are all these different pockets of populations, and we tend to have a common vision of the red barn and idyllic rolling hills around it, and that’s part of it. It’s much more than that. So, I think making sure that it’s culturally relevant for the people that we want to reach. Then once the program is complete, it’s on our web page and it’s accessible, it’s free, but it’s really not helping anybody unless people are accessing that.

So, we then allow again the on rely again on the people who have helped to create this with us in partnership to pull the information down, use it, distribute it, do presentations, talk about it. We never intended for this organization to be about us. It’s us listening to what’s needed, providing the information and then empowering people with the tools, with the information, with the resources so they can, you know, be the solution for making things better in their local community. We even know from early on we launched the organization. We had poll results from 1000 real voters. I think it was 78% of people wanted more information, free information about mental health resources and even acknowledge the fact they need something for youth and rural communities. So, we know there’s a need for this and we also recognize the stigma. So, we’re trying to do what we can to understand how we can best create this content and make it relevant and accessible so people can use it to really empower others in their community to be part of the solution to improving mental health in rural areas.

JH: I want to ask two separate questions before I get to the closing today. First, as you weigh all of the things going on in this country as it relates to healthcare, you know, we talked about H.R.1, the Big Beautiful Bill. We talk about limited access. I want to know from your perspective, you’ve been you’ve been in this aggressively for five years, right in the middle of it. What keeps you up at night when you think about the environment that we’re in, you know, what’s got you concerned? Talk to me about that.

CS: I really think that, as I mentioned, rural America is not all about one industry. The fact is that our agriculture industry and the farmers and ranchers that are responsible for making that industry successful are in rural America and much of what they do does have a major impact on other areas in the community and other businesses and that type of thing. So, the point is, I think when we look at the critical role that a very small percentage of our population plays, and this is specific to farmers and ranchers and agricultural workers, we are really reliant on things like 2% of the population, you know, feeds the country and parts of the world. I find myself guilty of this, too. I’ll go to the grocery store and I’ll fill up my cart with, you know, nicely packaged fresh meat, poultry and fresh vegetables and fruits and that type of thing. Even the packaged materials that we get, we don’t stop to think that all of this is coming from farmers and ranchers and agriculture workers who plant, graze, harvest, slaughter, package and ship all this to us so we can have it at a grocery store, or order it off of a menu in a restaurant.

The mental health, the physical health of everybody in rural communities is important, but specific to our food security, we should be elevating the importance of what people are doing and giving more resources, more insurance, more financial stability to these groups of people and the opposite is happening. So that’s what keeps me up at night. We’re doing what we can to help make a difference. We can’t do everything. We can do something. So, we’re doing what we can do, but this really requires a national movement and, and legislation to turn things in the direction of helping the farmers and the ranchers and the people who are doing all the work that a lot of other people don’t want to be doing and aren’t able to do. So, it’s an important recognition for us all to have and to not just recognize it, but to do something about it.

JH: Yeah, sobering in nature to think about it, you know, to your statistic, you know, 2%, you know, are feeding and packaging, you know, what we see in that grocery store. This is primarily being done in rural America where there are these barriers and deserts to care. So, that’s something that we need to be mindful of. It’s a great analogy. I’ve never even thought of it when I go to the store and pick that pack it up, you know, what was on the other end of it. It’s a great perspective. Well, let’s end positive. What one thing has you excited right now as you work in this environment, and are you looking forward to a specific program at your organization? Are you looking at something nationally that you know, like, you know what this is? It’s hope. It’s an opportunity. Share with us a little bit about what that is.

CS: Well, I really am excited about the launch of the I mean, the work that we’re doing overall is really gratifying. I know that we are making a difference. Again, it’s not about us and we’re not going to know the people that we help because a lot of people are, you know, getting the information and it’s helping and it’s a good thing. They’re able to continue doing what they’re doing and hopefully help other people. Our future, of course, is youth, no matter if it’s in a rural community or any part of the country or the world. So, it’s so important to be able to provide youth with what they need in order to succeed and provide for the future. I think that, you know, we often hear about somebody who’s has major challenges on a physical basis as far as going through life, but yet they’re very hopeful. There are very vibrant and they’re contributing and they’re doing in purposeful work and doing the best they can what they have. On the flip side, we see people that are seemingly have everything going for them and they’re dying by suicide. So, to me personally that really helps me understand and recognize the importance of mental health as being the foundation for overall health. The fact that we’re doing this work specific to focusing on the challenges that that rural youth have is very gratifying. It’s very empowering as far as giving the information to the people who need it and letting them run with it.

So, I think that, you know, we are setting are doing what we can to help set up a situation where we will decrease the stigma that surrounds mental illness. That’s such a huge initiative. It’s really a critical first step because, well, it’s already happening. It’s critical that it’s it happens on a larger scale because like any other problem, we have to name it. We have to talk about what the problem is and how to go about solving it or reducing it. If no one can talk about it or not enough people are talking about mental illness, especially in rural communities that’s a huge challenge. I think that’s one of the things that I’m most hopeful about, because I think younger people are more comfortable about talking about mental illness, mental health. Back in the day, cancer was known as the C word. And, you know, hopefully we’ll get to that point where we are talking about mental health. Like we talk freely about cancer these days as we should.

JH: Absolutely as we should. Well great perspective. You know, great work that you’re doing. We’re going to drop in the show notes how to access resources, how to get an audience with your team. What is available to the rural CEO that’s listening today saying we need to build a partnership. All of that’s going to be made available to our listener today. Before we close, we always like to do a segment called Rural Health Recommendations. As young leaders are listening to this podcast, I get the emails that say, how do we do this? How should we handle that? What about this? We thought, you know what would be great? Take our experts like you on this program and just get a tip from them that we then promote to our listeners. So, this is called Rural Health Recommendations. From your vast amount of experience, I’m going to ask you give us some sage advice for the new leader today that’s rising up in healthcare, saying, you know, there’s some challenging times. How do we keep our hospital open?

734 are slated to close in this country as a result of H.R.1 and other mitigating factors such as healthcare inflation, rising costs. We just had a hospital announced yesterday, closure tomorrow. They’re closing 45 miles from here. The hospital is closing altogether three days’ notice. We’re hearing more and more of those stories. Over 150 hospitals have closed in this country since 2010. All of them rural. It’s why we launched the podcast was for that specific reason to tell our communities across this country that we have to advocate for rural. With that, for the young CEO, maybe, maybe it’s not the young CEO, maybe it’s just a new leader who’s been in an organization but just promoted to a leadership role. What sage advice would you give them? What advice you know, what wisdom for them to keep on keeping on in this very tumultuous environment?

CS: I would say that doing the work that is being done in this space, it’s all about wanting to be there to help other people, to provide opportunities and resources for people to get the healthcare they need, whether it’s physical or mental, whatever it might be. With that said, too much is not enough. So, I think it’s so important to focus on self-care, in addition to caring for other people. Back to the stigma. Just because you might be a healthcare leader. It’s okay. You’re human. It’s okay to say that you are having a physical or emotional mental health issue. So don’t be part of the stigma. Talk openly about it, bring it into everyday conversations. If you have a personal story to share, like our founder Jeff Winton, he talks openly, freely about his tragic personal story. Not everybody can do that, but to the extent that you have the ability to share what you feel comfortable, or even maybe a little bit uncomfortable about, if it’s going to make a difference and help you help somebody else put it out there.

Also, it’s important for us all the check on family members, check on friends to see how they’re really doing, not just how’s it going, but, you know, really kind of pay attention. If you’re concerned that somebody is struggling, be brave and ask them about it and even to the point of, you know, asking, are you thinking of harming yourself? One thing I want to mention to it’s the three digit code 988 has been around for a couple of years, but it’s truly amazing how many people are still not aware of it. So, I want to mention that 988 is a national three digit dialing code for the Suicide and Crisis lifeline in the US, and by dialing 988, you’re connected to free, confidential 24/7 support for anyone that’s experiencing emotional distress and or mental health crisis or suicide thoughts. You don’t need to be in a suicidal state to call 988. Ask a question that could help you. Maybe it could help someone you care about. It’s an amazing resource. Again, for mental health information and resources that are free of charge, culturally relevant for rural just visit RuralMinds.org.

JH: Excellent. Thank you so much. I think the theme of this podcast over the past several months, and you said it has been the charge to our listeners to tell your story. I think that’s so important. Tell the stories. Let it be known. Don’t do this in a silo. There are resources available, whether it’s from Rural Minds or your local CMH partnerships. Whatever it is, find a partner, but tell your story. I think that’s so incredible. So, Chuck Strand, executive director, Rural Minds, it’s been great to have you on the podcast. I look forward to getting you back here in the year and talk about how the initiative has gone for your youth initiative. Would you be willing to do that?

CS: Yeah, that’d be awesome. Thank you. I’d love that.

JH: Let’s do that. So, we’ll get that booked up for you. So, it’s been great to have you on this podcast. Thank you so much for joining us. And thank you to our listeners for tuning in to Rural Health today. Catch our next segment, Rural Health News to stay up to date on the current state of rural healthcare every Monday, wherever you get your podcast. And don’t forget to check out the latest updates and resources from Rural Health Today at ruralhealthtoday.com, and make sure you subscribe to the show so you never miss an episode. Until next time, remember rural health strong.