Rural Mental Health
Feeling alone when we are hurting can make life feel so painful; having nobody to share our worries with can make everything feel so much worse. But so can having someone around who we don’t want to know that we are struggling.
We can feel alone wherever we live. Most of us will be able to think of times when we have felt alone at a party, in a crowded café or at home with parents or partner. And most of us can recall occasions (I know I certainly can) when someone has asked me if I am feeling okay – and that ‘someone’ has felt like the last person on earth that I would want to share my thoughts and feelings with.
Feeling alone, when living in a remote or isolated rural area, is something that I want to think more about in this article. What do we do when there is nobody around to talk to? Nobody to share our thoughts and feelings with? Being alone is more common in rural areas, and though being alone does not necessarily mean either feeling alone, or being lonely, spending long periods on our own can be difficult. And in a rural community, where the population is small, and the choice of confidantes is limited, who can be turned to for support when life gets tough? How to get help when the only people around are those we feel it is impossible to open up to?
Here in Scotland, representatives of a wide range of groups – statutory organisations and NGOs – are in the early stages of a partnership to plan what can be done to improve rural mental health and encourage well-being in rural communities. Some belong to organisations familiar with the issues of land-based industries and agriculture, some work in health or social care, others are experienced in campaigning and fundraising. Representatives of the church are also involved, and all acknowledge the potential of congregations to help: the church is one of the few organisations that has a presence in almost every community in Scotland.
This article is a more personal reflection on what the mental health needs of rural people might be, what could be done to improve rural well-being, and the potential role of rural congregations.
“Callum” [not a real person – but his situation is not untypical] is a young man who lives with his widowed mother or a croft on the north-west coast of Caithness – the most northerly Scottish county. He has finished his final year at school and is spending the summer working on the croft. He is not sure that he wants to spend the rest of his life in this place, but he loves the crofting life, and he feels responsible for his mother; he hasn’t done well in his exams so he is not sure what other work he could find.
While he was at school, he had lots of friends and sometimes met up with them at weekends as well as on schooldays. But bus times made that difficult – as did the weather, especially in the winter months – and he did not like to ask his best friend’s mum too often if he could stay over in the town after a night out. And Neil is away now for the summer: he got this wonderful opportunity to go off to help at a kids’ camp in USA before starting at uni. in Glasgow in the autumn. Other friends too are moving away, and Callum is becoming more and more conscious that he is not just alone but that he is lonely.
And while Callum is out seeing to the sheep, and doing battle with the weeds in the vegetable patch, his mother “Morag” [also not a real person] finds herself worrying about him. Not only worrying; she is starting to feel guilty, because she realises how dependent on her son she is becoming. “It’s because of me that he’s not leaving this place like his pals”, she tells herself, then hears herself adding, “but I wouldn’t half miss him if he did go”. She is not exactly housebound, but definitely not as able as she used to be, and she doesn’t drive. Waiting at the road end is ok in this weather, she tells herself, but in winter it is hard to face the cold, and hanging around for the connecting bus before reaching the town. Easier just to stay at home. But the more she sits around, the less easy she finds it to make the effort to get out.
The two of them have always got on well – more so since Calum’s dad passed away – but they’ve never talked about the really important things. Morag doesn’t want to bother her son with her ‘old woman’s ailments’ and her worries; and Callum would never admit to his mum what is going on inside his head.
This reticence in Calum and Morag to share anxieties and concerns highlights the other problem I referred to at the beginning of this article – that people around us may know us so well that it is hard to open up to them. This is not always the case, of course: sometimes the best person to talk to when the going gets tough is the person who knows us best. But not always. Callum has thought about telling the neighbouring crofter how frightened about the future he often feels. He even went across the fields to meet him one day. But he changed his mind when he thought to himself: “how could I tell old Andy how I’m feeling, and then chat to him at the sheep sales like we’ve always done?” Better to keep his worries to himself.
And Morag? Well, she’s come to much the same conclusion. She started to talk to the receptionist about how lonely she was feeling, that day she went in to the surgery to have her blood pressure checked. But then she remembered that Jean at the shop and the receptionist are cousins; and imagines that in no time at all, all her neighbours will hear how she’s feeling. And so, she says nothing. And suffers in silence.
What might help?
Thinking what might help is a huge question. The best way of finding out is, of course, to ask each person; everyone’s situation is unique. What Callum would appreciate is likely to be very different from what his mother Morag would find most helpful. We can’t be sure, though, until we ask. Helping others – except in extreme or emergency situations – is not about doing, or providing, for them. It is about being in partnership with them to discover what is most helpful, and then working together to try to make these things happen.
Most problems that make us feel down, or frustrated, or hurt, or afraid, or give us a whole range of painful thoughts and feelings, are complicated and complex: if they weren’t, we’d have worked out for ourselves long ago what to do about them! So any plans to help other people require us to think ‘outside the box’ and to look at the bigger picture.
If Callum is feeling lonely, the chances are that other young men in similar circumstances might be feeling lonely too. Each, it is true, may long for a different outcome: girlfriend, pals to meet up with at weekends, colleagues to discuss work with. But a potential way of helping all of them might be to campaign for a better bus service, or to organise youth evenings in the local primary school.
If Morag is feeling her life is becoming restricted to round the house, it is likely that other women are feeling trapped at home also. Again, each may dream of their ideal solution: improved health, a friend calling in, doing something that makes her feel useful again. Help might take the form of setting up a befriending service, recommending that a health clinic is set up each month in the local hall, or starting a series of evening classes to learn new skills.
Who can help?
The short answer to the question, ‘who can help?’ is ‘anyone’ or ‘all of us’. We humans are created to need each other; to be inter-dependent. We can all probably think of a time when life suddenly felt that bit more bearable because someone at the bus-stop smiled at us, or because a neighbour paused to say ‘hello’.
We can all smile and say ‘hello’: we can all help each other. Even on days when we don’t feel much like smiling, knowing our smile might have helped someone else can help us feel better too. ‘Love your neighbour’ is a message found in the Bible, but it is good advice for everyone.
Helping each other through the inevitable ups and downs of life is something we all can do. But when it comes to sharing significant parts of our life-story, or we’re going through a particularly difficult time, we want to choose who it feels easiest, or safest, or most helpful to talk to. Sometimes, that will be a health worker, or counsellor or other ‘professional’ support. And some ways of helping require planning, or money, or both. On our own, we can’t get that befriending service up and running; it will take more than one person to persuade the Council to repair the old toilets in the village hall so it can be opened up and used regularly. People need to come together, to discuss what would help; to plan what is needed; to decide how to get what is needed. And then, to get on and do it.
Who can help to do what?
In this section of the article, I want to focus on what church members can do – as individuals, but just as importantly as a congregation. Many congregations are already doing lots of things to help in their local community: running lunch clubs, offering lifts and much more, as well as providing opportunities for worship and prayer. It might be helpful, though, for those involved in such activities to pause and ask ourselves some questions, such as:
--- ‘could we do more – or do things differently – to help people who may find coming through the door of the church difficult feel really welcome?’
--- ‘could we alter our style of worship, or change some of our more traditional language, so that newcomers can more easily understand the message we want to share?’
--- ‘is our lunch club (or ‘knit and natter’ group, or whatever activity we organise) at the best time for the people who would benefit most from coming?’
--- ‘what more could we do so that the people in our community can experience the love of God through the practical outworking of our commitment to ‘love your neighbour’?’
Christians in rural areas have wonderful opportunities – as well the responsibility – to help their local communities to become ‘communities of well-being’ in which everyone is supported and encouraged through good times and bad. As I mentioned earlier in this article, the church (at least here in Scotland this is true) is one of the few national organisations that has members in every community; and in many Scottish villages, the church is the only building available for public use.
People who have a mental illness or are going through a time of poor mental health often face – or fear – stigma. Congregation members can help here by including ‘mental health’ as a topic on the Guild syllabus or by asking the minister to focus on ‘mental health’ in his or her sermon during Mental Health Week. We can also give confidence to others to speak out, by talking of our own experience of depression, or loneliness, and being open about our own struggles and need for support. We should find the confidence to do this, secure that our fellow Christians will support us, and through the faith that reminds us that we are supported by our loving and caring God.
When we think about each person’s skills and interests, a congregation – even one small in number - has a wealth of ‘people resources’. And our buildings can be used for a whole range if purposes. Yes, we might need to make some changes to the layout – replace pews with chairs; add a toilet or kitchen. But grants are available, and working in partnership with organisations looking for somewhere to meet can result in exciting new activities taking place in your community. Remember Callum and Morag? There are many ways in which a faith community can help them and people like them.
Callum is keen to have the chance to meet up with folks his own age, and has mentioned he’d like a youth group to start in the primary school building. He has also said that the bus timetable is no good for getting into the town – and back – in evenings and at weekends.
Is there someone in your congregation who could invite the town’s youth worker, or your church’s regional youth leader, to discuss how a youth group might get started? Is there anyone willing to take on a leadership role? If the school can’t be opened in an evening for the young folks, could the church hall be used instead? Do you have a member who knows who to contact in the Council about improving the bus service? Or who has contacts in other places who have successfully campaigned for improvements? Can one of the school transport vans be booked for evenings or weekends? Are there people in the congregation willing to take turns at driving it?
Morag, too, would benefit from contact with people her own age; people who share her interests. She’s said she would make use of a befriending service, if one were set up; and she thinks classes sound like an interesting new challenge. Accessing health care without hours spent getting to the health centre in town, and back again, would be much appreciated.
The church can help her – and people like her – too. Your building might make an ideal location for classes. And if a couple of members were to set up a rota for teas and coffees, or even soup and a sandwich, that would be an added attraction, which would be especially appreciated by tutors travelling longer distances to teach the group. Members also may be willing volunteers in a befriending service. Do any of you have contacts in other communities who could guide you on how to get started? Or get in touch with community nursing, and discuss partnering with them to ensure everyone who might benefit from a visit knows how to ask for one? The church hall might make a suitable health clinic; and if it is near to the road, and closer to cables, it is likely to have better internet connections than many people’s homes.
This gives the possibility of online appointments: maybe less ideal than face-to-face, but often preferable to long journeys to meet a particular specialist. And on the subject of internet – in rural areas where broadband is so restricted or unreliable, why not use your premises as an internet café, and give people the opportunity to chat with their friends on email or skype, as well as over coffee and cake?
Once we start thinking, there are so many possibilities! Churches have buildings that can be used for a range of community activities, and people willing to help. In rural communities, though, numbers are few, so working together with other organisations is very important. Local congregations know the local community so are in a good place for helping to identify what is needed. And many organisations will be glad of such local knowledge and willingly work together for the benefit of everyone.
Church members have something unique to offer to their local community: the good news that God is present with everyone; that love and peace and hope are God’s gifts to all people in all communities; that the God who sent his Son so that all might find ‘life in all its fullness’ (Bible: St John 10.10) wants all people to live well. It is important that this unique dimension to caring is recognised and shared.
But is also important to remember that God’s love is not only experienced through what we do aswell as what we say. It is also shared through the work of all people who seek to ‘love their neighbour’: people of all faiths and none.
When churches work together with Health and Social Care staff, with Councils and Education Departments, with farming and fishing Unions, and with so many others, there is so much that can be done. By working in partnership, together we can help individuals to live well and communities to be transformed – into communities of well-being in which people are cared for, neighbours are loved, and everyone lives well.
Lorna Murray, January 2017
FCN [Resource and Helpline] – Farming Community Network - http://www.fcn.org.uk/help/health
Countryfile [TV Programme] resource page - http://www.countryfile.com/explore-countryside/food-and-farming/farmers-and-mental-health-where-go-help
Farm Safe [New Zealand] - http://www.fcn.org.uk/help/health - and also a comprehensive review from New Zealand in 2012 [see this PDF]