Meeting Rural Men Where They Are

June is Men’s Health Month, a time when men are encouraged to check in on their own mental health and watch out for their friends’. That’s good stuff, and if more men did just those two things, we would all be better for it. But is it enough?

Suicide is associated with a complex combination of factors that often include mental health challenges. Rural men in our society are among the most impacted but are often invisible as a struggling group. The data don’t lie—suicide rates in rural America have been consistently higher than those in urban areas, and that gap has only widened. White men make up more than half of all suicides. While every suicide matters, these losses are often felt disproportionately in small communities and can have a devastating impact across the community itself. 

Men in rural areas face unique challenges. Stigma around asking for help, access to firearms, limited access to mental health care, poverty or financial problems, social isolation, family and work struggles, suspicion of outsiders, and cultures of bravado are just a few. The American Foundation for Suicide Prevention estimates 72% of U.S. communities do not have enough mental health providers to serve their residents. And the data show that most of these communities are rural. Given these challenges, we need tailored interventions if we are going to make any real strides in reducing the suicide rate in rural America.

To reduce suicide rates among rural men, we need to reach them where they are. If they are spending time at high school football games, barber shops, feed stores, the local café, doctors’ offices, city hall, and church, then we need to consider those places as intervention settings. The Confess Project of America, which trains Black barbers to be mental health gatekeepers, is one example of a program trying to do just that. There are some fundamental truths about suicide across all populations, but there are also some unique differences, which means our prevention approaches should be contextualized to each population. This is no different for rural men.

There have already been efforts to this effect, such as Movember and Man Therapy. Easily accessible online, such campaigns aim to increase awareness and reduce stigma of mental health and suicide through humor and culturally competent providers. Other community-based approaches include prevention programs in farming communities and peer-to-peer programs that train people with lived experience in listening and intervention, such as the Friendship Bench in Zimbabwe. The mental health field has been using peer-to-peer models for years—the innovation is around adapting these models specifically for rural men.

Another under-tapped resource in rural communities are faith leaders. Research shows that pastors are among the first people that community members go to when they’re struggling, higher on the list than physicians. This is likely truer in rural communities, where resources are more limited and confidentiality can be a challenge. So, faith leaders play an essential role in this work as well, especially given that every small community has a place of worship . . . or 3 . . . or 17. One program capitalizing on this is Soul Shop, a faith-based organization that provides suicide prevention training to faith leaders, teaching them the tools to minister to suicide and desperation. If 72% of communities do not have the resources they need, we must leverage what these communities do have. One of the goals of Soul Shop is to meet these faith leaders in rural communities where they are and empower them to have honest conversations and take steps to help.

Two weeks after providing a Soul Shop intervention training in a small Arkansas community, I got a call from the pastor/mayor, who had attended. He told me that one of his friends was speaking a little differently then he usually did, going through a divorce and custody battle, and had been pulling away from activities. Because the pastor knew what to look for and what to do, he asked his friend if he was thinking about suicide and the answer was yes. The pastor drove to his house, did a suicide intervention, and removed lethal means for a short period until his friend was better. Later this man told the pastor, “I know you saved my life.” This and legions of stories like it make the case—with a little training, faith community leaders are perfectly situated to assist in rural mental health ministry to men. 

Rural men often struggle, invisibly and in silence. But they come from communities where people are connected, care for each other, and have more resources than we realize. Learning how to optimize those people and places right under our noses could save lives. It already is.

Christopher Epperson 

Executive Director/Trainer 

Soul Shop Movement