Mental health in rural areas

• Living in a rural area can be good for your mental wellbeing, but it can also make it harder to access mental health support.
• If you are facing barriers and challenges, there might be ways to overcome them.
• If you live in a coastal community, you might face similar challenges. So, this advice and information can apply to you too.
• But there are some ways to overcome barriers and challenges.
• If services are far away, you can ask about phone or video appointments.
• If you feel lonely, joining local groups or online communities can help you connect.
• If you worry about being judged, remember that GPs are used to helping with mental health.
• If travel or money is a problem, you may be able to get help with costs or local support. 
• If you are unsure where to start, you can contact NHS 111 or your GP for guidance.
• Even small steps, like talking to someone or attending community events, can make a real difference.

Rural areas are places outside large towns and cities. They include villages, hamlets, farms and countryside communities across England.

Living in a rural area can benefit your mental wellbeing. Some people find it helps because of:

• Access to green spaces and nature
• A quieter environment
• Strong community support
• Less traffic and noise

While living in a rural area has many benefits, it can also bring challenges. Some people may experience:

• Rural isolation and loneliness
• Limited public transport
• Fewer local mental health services
• Longer travel times
• Difficulty accessing healthcare and support
• Financial pressures linked to housing, travel or work 

If you live in a coastal community, you might face similar challenges. So, this advice and information can apply to you too.

What are the signs that I might need help for my mental health?

You may notice the following emotional signs:

• Low mood
• Anxiety
• Stress
• Feeling lonely
• Feeling overwhelmed
• Losing interest in activities you usually enjoy

You may notice the following physical signs:

• Sleep problems
• Feeling tired
• Changes in appetite
• Difficulty concentrating
• Physical symptoms linked to stress

On our following webpages you can find out more information about:

• Anxiety disorders
• How can I improve my sleep?
• Stress – How to manage it: Causes, symptoms, and support options

What groups may be more affected by rural mental health challenges?

• Farmers. See ‘What can affect farmers’ mental health’ below.
• Young adults. They may face challenges such as limited education, employment, and social opportunities.
• Older people. They may be at greater risk of loneliness if they live alone, have health problems, or find it difficult to travel.
• Disabled people including people with long-term mental illness. Travel difficulties and fewer local services can make it harder to get help.
• People from ethnic minority rural communities might face additional barriers linked to culture, language, or discrimination. The following webpages provide more advice and information:

• • Asylum seeker and refugee mental health
  • Ethnic minorities and mental health
  • Feeling low or worried? Support for Irish Travellers

Some things that can affect farmers’ mental health are: 

• They often work long hours and often on their own, which can lead to loneliness
• Money worries and debts.  
  Their home is also their workplace, which can make it hard to switch off from work.
• Bad weather or unexpected events can affect their income and financial security.
• Changes in trade or the farming industry can create stress and uncertainty about the future.

Mental health can be a major issue in farming. Research found that:  

• Around 9 in 10 farmers under 40 think mental health is the biggest hidden problem facing farmers today.
• 3 people working in farming and agriculture die by suicide every week.

Women say that farming can be good for their mental health in many ways. But they also say that farming can sometimes have a negative impact too, such as: 

• Women in farming often find it hard to balance work and home life.
• Many feel they do not have enough time.
• Some feel left out of decisions on the farm.
• Others feel judged or not taken seriously.
• Some women also feel like they carry more childcare and home responsibilities.

What can I do if I am experiencing mental health issues?

If you are experiencing mental health issues, help and support is available. The quicker you reach out for this, the sooner you should start to recover.

For options for support, see our webpage Worried about your mental health? How to get treatment and support. These options include talking therapy, support groups, online support, and self-help.

The advice and information on this webpage can help too.

In this BBC video a Shropshire farmer says how checking in with his friends about wellbeing is important to him.  

You might find the following organisations useful to you: 

• RABI – the farmer’s charity: Provides free, online mental well-being service, counselling support, and a helpline for farmers. Helpline: 0800 188 4444.  
• Farming Community Network (FCN): emotional support and advice and information for farmers. Helpline 03000 111 999. 

Also see the organisations listed in Useful contacts below.

On our following webpages you can find out more information about:

• How do I manage thoughts of suicide?
• Anxiety disorders

Below we look at the barriers people face in getting mental health support in rural areas. And what you can do to overcome those barriers. We cover:

• When mental health services are far away.
• How stigma can affect mental health in rural communities.
• Digital barriers.
• Barriers to asking for help.
• Social isolation.
• Money worries.

Accessing mental health services in rural England may be more difficult if they are far away.

You may need to travel long distances to see a GP, attend NHS talking therapies appointments or access specialist support. Travel costs and poor transport links can create added barriers.

What can I do to overcome these barriers?

If you have an NHS appointment, but need help with travel, you can:

• check whether your local council provides a community transport service or has information on providers. These may be run by local charities,
• see if you qualify for the NHS healthcare travel costs scheme for people who have a low income or claim certain benefits, and 
• Ask the hospital, clinic, or GP practice that you are going to. You might be able to get help from non-emergency patient transport services (PTS).  This depends on your medical condition.  PTS may not be available in all areas. 

Lots of NHS services now offer phone or video appointments. You can ask the service about this.

Some people worry about being judged if they talk about their mental health.

In smaller communities, concerns about privacy may make it harder for people to ask for help. This can delay getting support.

Men in rural areas are less likely to ask for help for their mental health. They are also less likely to talk to someone about how they are feeling. This is compared to men in towns or cities, and women in rural areas.

The main reasons men in rural areas do not reach out for help are:

• Not knowing who you can ask for help.
• Feeling embarrassed or worried about mental health, due to stigma.
• Not knowing what support or services are available.

What can I do to overcome these barriers?

You might be worried about talking to your GP about your mental health. It might help you to know that GPs are used to patients talking about their mental health. One study shows about 4 in 10 GP appointments involve mental health. 

The faster you get help and support, the quicker your symptoms should improve.  

GP and other NHS services must stick to confidentiality rules.

If you worry about talking about your mental health, you are not alone. Many people worry about it, but getting help is a strong and positive step. Talking to someone you trust can help you feel better. Mental health is just as important as physical health, and it is okay to ask for support.

You can see our following webpage for further advice and information:

• I want to talk to someone about how I am feeling.

What if I am unsure how to get help for my mental health?

If you need help for your mental health but are unsure where to turn, you can:

• Call NHS 111 for help and advice
• Contact your GP surgery
• See our webpage for other options: Worried about your mental health? How to get treatment and support. These options include talking therapy, support groups, online support, and self-help.

Mental health issues are usually treated by the NHS with things like:

• talking therapies,
• medication, and 
• advice on things like exercise.

If you prefer to try talking therapies, you can access these without seeing your GP. You can contact your local NHS talking therapy service directly.

If you want to know about medication options, you should see your GP.

You can ask your GP practice if they have social prescribers or link workers. They can give you advice on other options to help your wellbeing like:

• joining local groups,
• taking part in community activities,
• getting support with loneliness, or
• finding opportunities to be more active.

Can I have a phone or video appointment if I prefer one?

You might feel more comfortable having a phone or video appointment. Lots of GP practices and NHS services now offer these. You can ask the service about this.

What organisations are there to support men’s wellbeing?

You might find the following organisations useful:

• Andy’s Man Club
• Men’s Sheds Association
• Men’s Minds Matter
• Men Who Talk
• Man Up

On our following webpage you can find out more information about:

• Suicidal thoughts and men – Causes, risks, and support

Many NHS and other mental health services are offered online. But you might experience poor internet connectivity or lack confidence using digital technology. 

What can I do to overcome these barriers?

How can I improve my digital skills?

You can:

• take a course to develop your digital skills. Learn My Way provide free courses on how to use the internet and digital skills to stay safe and connected.
• Visit your local library, if you have one. They might offer free digital skills support, help with using devices, accessing websites, sending emails, and completing online forms.
• Attend face-to-face digital skills sessions run by libraries, community centres, charities, or adult learning providers.
• Ask friends, family members, or colleagues to show you how to do specific tasks, such as online banking, video calls, or using apps.
• Join a digital support group where you can learn alongside others and ask questions in person.

What if I have poor or no internet connectivity?

You might live in a rural area and:

• not be able to get a standard broadband fixed line connection, or
• you have one but the connection is slow or does not meet your needs.

Worcestershire County Council have good information on broadband alternatives.  Although it is aimed at the residents of Worcestershire, the options they describe can apply to anyone in England.

But for some rural households, reliable broadband or mobile coverage might not be available.

Rural isolation and loneliness can happen when there are few people and places nearby.  It can make it harder to stay connected and feel supported and affect your mental health. It could increase the risk of things like depression, anxiety, and stress.

There has been a decline of traditional rural meeting places and services, such as:

• village pubs,
• banks,
• post offices,
• GP practices and pharmacies,
• local shops, and
• bus routes.

This has reduced opportunities for social connection. 

On our following webpages you can find out more information about:

• Anxiety disorders
• Depression
• Stress – How to manage it: Causes, symptoms, and support options

What can I do to overcome these barriers?

You could try:

• Joining local groups
• Volunteering
• Attending community events
• Keeping in touch online or by phone
• Seeking peer support

Building social connections may reduce loneliness and improve wellbeing.

See our following webpage for information and ideas to help with social isolation:

• Social inclusion and mental illness - How can I become more connected

Money worries can affect anyone. In rural areas, extra costs such as fuel, transport and housing may create additional pressure.

Financial stress can affect sleep, relationships and mental wellbeing.

What can I do to overcome these barriers?

You can get free, expert advice and information on money issues from:

• Mental Health and Money Advice. Online advice and information on money issues, including debt and welfare benefits. 
• Money helper. Helps with benefits and everyday money issues. call 0800 011 3797.
• Money wellness. Free money, benefits, and debt advice online, over the phone, or webchat. 0161 518 8285. 

If you need free, expert advice on debt, you can contact:

• National Debtline. Call 0808 808 4000. 
• StepChange. Call 0800 138 1111. 
• Debt Advice Foundation. Call 0800 6226151.
• Contact local debt advice organisations. You can find them on Turn2Us.  Choose ‘debt’ from the drop-down menu and put in your postcode. 

Depending on your circumstances you might be able to apply for different welfare benefits. This includes if you are on a low income. You can contact the following organisations for free, expert advice and information:

• Citizens Advice. Visit your local office for advice or call on 0800 144 8848. 
• Mind welfare benefits line. For anyone with mental health problems who needs benefits advice. Call 0300 222 5782.
• Money helper and Money wellness. See above for details.
• Contact local benefits advice organisations. You can find them on Turn2Us.  Choose ‘benefits’ from the drop-down menu and put in your postcode. 

What is the crisis and resilience fund scheme? 

If you cannot pay for basic things, you might be able to get help from your council. This includes heating oil.  This help might be a loan, money, or help from a charity. 

This is known as the crisis and resilience fund scheme.

On the government website you can find your local council. 

National organisations

• Royal Countryside Fund.  They work alongside farming families and rural communities across the UK to provide the support, funding, and opportunities they need to thrive. 

Local organisations

ACRE - Action with Communities in Rural England. Each county in England has a Rural Community Council (RCC). They support community-led initiatives in rural areas and champion rural development issues. ACRE is the umbrella body for the 38 RCCs across England. Find your local ACRE 

We Are Farming Minds. For farmers in Herefordshire only. Provide a helpline, free counselling, free mental health awareness workshops, and social groups for men and women farmers. Helpline: 0808 802 0070. 

YANA - You Are Not Alone: East Anglia only. Provides mental health support for anyone involved in agriculture and associated rural businesses. Helpline: 0300 323 0400. 

Rural Communities Mental Health Foundation: Northamptonshire, Buckinghamshire, and Bedfordshire only. A mental health awareness and suicide prevention charity for people working and living in rural and agricultural communities and their support networks. They provide website information, mental health first aid, and mental health courses.  

West of England Rural Network. Bath and Northeast Somerset, North Somerset and South Gloucestershire. Supporting sustainable, resilient and inclusive rural communities. 

Can I self-refer for NHS talking therapies?

Yes, you can self-refer to your local NHS talking therapies service. This means you can go directly to them for help without seeing your GP.

You can find your local NHS talking therapy service by:

• searching on this NHS website 
• calling NHS 111 and asking, or
• asking your GP. 

See our Talking therapies webpage for more information. 

Do I need internet access to get mental health support?

No. You can contact your GP, call NHS 111, attend appointments in person, or use phone appointments, if available.

Is what I tell my GP confidential?

You might feel worried to ask for help. Your GP will usually keep what you say private. They will only share your information without your agreement if:

• you or someone else is in danger,  
• there is serious risk of a crime,
• you cannot make decisions for yourself,   or
• if they need to share information with other NHS staff involved in your care.  

For more information see our Confidentiality and your mental health information webpage. 

Where can farmers get specialist support?

There are several organisations that provide special support to farmers. See the Useful contacts section for more details.

What can I do if I feel lonely?

You could join local groups, volunteer, or connect with others online or by phone.

Can I get mental health support without travelling far?

Yes, many services offer phone or video appointments you can use at home.

What if I feel worried about asking for help?

It is normal to feel this way, but talking to someone can really help.

Who should I contact first for mental health support?

You can contact your GP or call NHS 111 for advice and support.

What can I do if money or travel is a problem?

You may be able to get help with costs or free advice from support services.