A new report spotlighted some of the challenges to accessing behavioral health care for the one in seven Americans who live in rural areas.

Those behind the findings say there are solutions to boosting care access in states such as North Dakota.

Kendall Strong, senior policy analyst at the Bipartisan Policy Center, said integrating behavioral health into primary care can help improve health outcomes and get patients the mental health and substance-use treatment they need. She pointed out just like physical health issues, if you do not tackle behavioral problems that arise, it can develop into something much more serious.

"If you are having issues with substance use, or depression, anxiety, and you let it fester, we know it gets worse," Strong explained. "And when that happens, you often need more acute care later on. More acute care, as we know, is often more expensive."

One of the report's recommendations is to boost training and other resources for North Dakota's more than 20 federally qualified health centers, which have pioneered a team-based approach to care. When patients go in for their annual medical checkup, they can also meet with mental health, dental and even vision care professionals during the same visit.

The lack of mental health professionals is one of the biggest barriers to accessing care in rural America. The report recommended strengthening workforce development programs, including the Teaching Health Center Graduate Medical Education Program.

Strong emphasized providers are more likely to work in places where they get their training, and most medical schools and residencies are in cities and suburbs.

"And if you don't practice in a rural area, if you're not from a rural area, if you don't live in one already, you're less likely to train there and stay there," Strong stressed. "So we think that allowing the program to be expanded, continued and built upon will allow more providers to train in rural areas."

Strong said the unique challenges in states like North Dakota, such as the ripple effects in tribal areas and the noticeable percentage of military Veterans, really stand out in trying to foster bipartisan support in Congress.

"We think that those ones that are specific to rural areas are helpful in that even if we're offering them under the idea that they will help rural areas, they're really going to help the system as a whole."

May is Family Wellness Month, and Minnesota households are encouraged to work on goals beyond the surface level of success.

One expert said family members can explore dimensions that go a long way in shaping wellbeing.

In a post-pandemic world, University of Minnesota Extension Department of Family, Health, and Wellbeing Educator Sharon Powell acknowledged that society isn't as laser focused on career or academic success in defining how well a person or family is doing.

Physical health should be near the top. But Powell added that with mental health a bigger priority these days, it's one way in which households can get a sense of whether or not loved ones are thriving.

She said a good frame of mind opens more doors.

"You feel happy and content and like you're contributing to your family's wellbeing," said Powell, "and to your community and even beyond."

Powell said if you notice sudden mood changes or a family member becomes withdrawn, it might be good to inquire about their emotional state, and whether it needs to be addressed.

On the topic of money, Powell said amassing wealth isn't the key, but financial stability is important. She said financial literacy guidance from nonprofits is a good place to start.

She said when families get ahead of the situation by setting spending goals aligned with their income, they have better sense of autonomy in this area.

"People feel better about their finances," said Powell, "when they feel that they have some choice in where their money's coming and going from."

Lastly, Powell said family members can't take daily communication for granted.

Saying hello to each other every day, or occasionally asking how things are going can help, but Powell said there's more you can do. That includes the often shared pieced of advice of being an active listener.

"Being an attentive and curious communicator," said Powell, "is a great way to show love for people."




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Mental health counselors focused on Nebraska's high rate of binge drinking during Alcohol Awareness Month, which just wrapped up.

Alcohol abuse is often associated with other addictions. Nebraska's binge drinking rate is among the highest in the nation and the number of alcohol-related deaths is on the rise. Alcohol was blamed for at least 720 fatalities in 2020, the latest year data were available.

Aileen Brady, CEO of the Community Alliance in Omaha, said alcohol abuse and addiction affects families and friendships but can also lead to safety issues among employees who may be alcohol dependent.

"If their reactions are not as sharp, if they're not sleeping well and if they're distracted with the sense of needing to have that drink, it's going to affect our workplaces, as well," Brady explained.

Brady adds alcohol and other substance abuse disorders affect at least 65% of Nebraskans seeking mental health treatment at Community Alliance. Nationwide, the National Survey on Drug Use and Health said more than 224-million people 12 and older report having consumed alcohol during their lifetime.

Brady added it is common among alcohol addicted people or those who abuse it to assume drinking will improve their mood, which she said can happen temporarily, but long-term, has the opposite effect.

"That might last for a period of hours, and then once they stop the drinking and they are coming down off of that use of alcohol, then the depressant sets in," Brady observed.

Brady added Community Alliance continues to dispel myths about the effects of alcohol and raise awareness about the negative physical and mental health outcomes of drinking too much.


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Budding flowers, warmer temperatures and longer days are welcome signs to many in Maryland after the long, dark months of winter. Some people might believe warmer weather improves mental health after seasonal depression in the winter months, but that's not always the case. Many people experience increased mental-health struggles as spring rolls around.

When people's feeling in the springtime doesn't meet their expectations, said Cynthia Cubbage, director of family and post-adopt service for the Barker Adoption Foundation, it can make mental-health issues worse.

"When people are looking forward to spring because it's a time of renewal, and those expectations don't happen, and then nothing gets better for them because it's deeper than that," she said, "then they get really stressed and depression can really set in. And it's because of the expectations."

Suicide rates rise in the spring and not winter, according to Johns Hopkins Medicine. Researchers find that seasonal allergies play a role. A person with rhinitis, which causes allergy symptoms, is more than 40% more likely to be depressed.

Cubbage said there are many ways people can combat those feelings: Get outdoors as much as possible and get out socially as well. But she reminded folks that sleep is vital.

"Definitely prioritize sleep, even though we're having more daylight," she said. "It makes people want to stay up longer - that they should be doing things - and to remember that's a big transition for your body. They should still prioritize their sleep. If they were still going to sleep at eight or they were putting their kids down at eight, that should continue."

Cubbage added that, if you continue to feel depressed or down even after trying those suggestions, it's best to seek out professional mental-health help.