If you’re lucky enough to live in the countryside, you’ll know it can literally be a breath of fresh air; that’s why there are so many television programs, books and travel stories about getting away from town life and heading to the fields, the mountains, the woods, or the quieter parts of our coastline in the UK and Ireland. But dealing with a mental health issue in rural communities can present additional problems for you and your support network of family, friends and colleagues.

Statistics abound on rural mental health and wellbeing:

• In 2018, Anglia Ruskin University found that LGBT teachers in rural areas are more likely to experience mental health issues than their peers in urban areas of the UK.

• In a 2017 survey by Scotland’s Rural College, nearly two thirds of people in rural Scotland said they had experienced depression.

• Also in 2017, Solent MIND revealed that one in five people living in rural areas will have mental health problems.

We must remember that, however idyllic the picture of rural life, the reality is that mental services are patchy in many areas, and your sense of isolation can increase because of environmental factors.

Rural Transport Problems Can Jeopardise Wellbeing

People who live in cities take it for granted that a bus, train or taxi can usually be found at the drop of a hat. Those in rural areas know how annoying it can be when an hourly bus service is cut to once a day, or a taxi from the train station costs a small fortune.

The scarcity of transport affects how often you can attend medical or therapy appointments, and how easy it is to meet friends, commute to work or take children to school. With so many hurdles in the way, it’s all too easy to isolate yourself without meaning to. It can also impact the treatment of your loved ones – in 2018, the Care Quality Commission’s review into child and adolescent mental health services across England found that ‘geographical factors contributed to fragmentation. All of the larger counties with more rural areas that we visited had problems with travel distances’. In one specific case, the CQC reported that a Child and Adolescent Mental Health Services team ‘ rarely did home visits because the amount of time spent travelling would impact on the number appointments they would be able to offer.’

Fewer Talking Therapies Nearby

Whatever your mental health concern, it’s important to find the right therapist for you. There is no ‘one size fits all’; therapists have different ways of working, and often specialise in treating certain issues – for example, they focus on addiction or on eating disorders. The nearest therapist may not be the best for your needs.

You’re likely to have to travel further to therapy if you live in a rural area, which means factoring in more travel time and those pesky transport issues. Just bear in mind that seeing the wrong therapist who lives five minutes away will do more harm than travelling for half an hour to see a genuinely helpful person.

Lack of Face-to-Face Peer Support

The internet is brilliant at bringing like-minded people together, but there’s no substitute for real human connection, especially when it comes to mental health. At Christine Tizzard Psychology, we not only provide individual treatment where you can benefit from face-to-face interaction, but we’re also experienced at running group therapy sessions, bringing you together with others in a similar situation. Mental health conditions such as anxiety can make it difficult to open up to strangers, but group therapy provides a non-judgemental and therapeutic environment for you to explore your thought patterns using Cognitive Behavioural Therapy (CBT). However, living in a rural area can make it harder to find and access group therapy; groups provided by charities or local authorities are based in built-up areas and may have long waiting lists.

You may be prone to heavy self-criticism (‘I’m a terrible driver’; ‘I always mess things up’) and catastrophising (‘What if I can never be happy again?’; ‘If I mess up that presentation at work, I know they won’t give me the promotion. They might even sack me’). By exploring these thoughts with other anxiety sufferers and a therapist, you’ll realise that thinking something doesn’t make it true. Whether you live close to our head office in West Sussex or you’re further afield, talk to us about the possibility of group therapy, which could help reduce your sense of isolation. As you progress with group therapy, you could even start lift-sharing with people who live nearby.

Tourist Season Brings Additional Pressure

Anyone living in a tourist-dependent village will know it’s a case of feast and famine – those who work in the industry are stretched to the limit in summer and during any school holidays, but winter is eerily quiet for them. If you’re a business owner or casual worker, the money you earn in busy periods may have to keep you going for months. This means you risk getting burned out during seasonal peaks, and you might be tempted to ignore mental health issues that arise at this time, to keep money coming in.

However, when your mental health is suffering and you don’t act to tackle it, you put your mind and body at risk. It may help to imagine a friend telling you they have a similar mental health issue. Wouldn’t you ask them to seek help, rather than tell them to carry on being distressed?

With therapists in many parts of the UK and Ireland, Christine Tizzard Psychology can reach into those under-served rural areas, unlike other psychology practices tied to one town or city. Contact us from your piece of countryside and we’ll do our best to help.

Written by guest contributor Polly Allen for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).