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Improving Mental and Behavioral Health in Mountain West Communities

Our mental health is a critical part of our overall health. Unfortunately, so many who battle mental illness or substance abuse may not seek treatment for many reasons. Stigma, access and affordability are just a few of the barriers that keep people from getting the critical care they need. While these issues are a global challenge, they unfold differently in mountain communities. In these areas, access to much-needed care can be more difficult to find, and the more intimate feeling created by small-town living can become its own barrier to seeking help. In addition, traditionally marginalized communities can have even greater barriers to care.

Mountain communities’ rural nature also creates difficulty in attracting and retaining quality mental health providers. Residents often have to travel long distances to receive care due to local provider shortages. Moreover, populations in mountain communities are becoming increasingly culturally and linguistically diverse, and providers are often unable to offer culturally responsive care for non-English speakers. Adding to these challenges, these areas also experience seasonal fluctuations in population, which can exacerbate feelings of social isolation in both seasonal and year-round residents. High costs of living and housing insecurity can erode financial stability and overall well-being. Mountain towns also experience significantly higher rates of drug and alcohol misuse, which are often accepted as the cultural norm of the community.

This confluence of risk factors for behavioral health challenges leads to higher rates of substance abuse and suicide in these communities.

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25%
Binge drinking, on average is 25% higher than the national average1

50%
Up to 50% higher reported rates of alcohol-induced deaths2

2-3x
Suicide rates are two to three times higher than the national average in some communities – 47 per 100,0003, compared to the national average of 14 per 100,0004

While these communities face difficult statistics, there is enormous motivation and momentum to reverse these troubling trends. At the local level, organizations are hard at work de-stigmatizing mental healthcare, streamlining siloed systems and providing options for support and resources. Innovative non-profits, health systems, funders, and local governments are working together to address these important issues for all community members. We firmly believe that all those who need assistance and treatment should be able to access quality healthcare. The Katz Amsterdam Foundation works with community partners to address and challenge the stigma that exists and improve access to critical health services.

Behavioral Health Challenges in Mountain Communities

Elevated risk and reduced protective factors

Social Dynamics and Party Culture

Mountain resort communities have unique social dynamics and culture. They have many characteristics of rural communities – small populations, limited entertainment options, geographically isolated, etc. These communities also experience high fluctuations in population throughout the year due to a large seasonal workforce and tourism, making it difficult to establish and maintain the deep social connections that are a foundation of mental wellbeing. In addition, an organic biproduct of a tourism-based economy is a culture with a heavy emphasis on partying and substance abuse.  Long-term residents are affected by this culture which promotes social acceptability around alcohol and substance misuse. These factors contribute to increased risk factors for behavioral health challenges.

Mental Health Knowledge and Attitudes

Attitudes toward and knowledge of mental health services contribute to people’s willingness to seek help and the ability to help others. Mental health stigma is pervasive across society, but stigma can be intensified in small mountain communities. Lack of anonymity and fear of being recognized while getting services make initiating care more difficult in rural locations. Another barrier to seeking care is the “paradise paradox” – a sense that people living in beautiful vacation destinations should be happy all of the time, and therefore might feel it isn’t acceptable to not be okay and possibly suppress their issues.

Difficulty getting the right care at the right time

Provider Capacity

Similar to other rural communities, mountain resort communities have difficulty attracting and retaining behavioral health professionals. Many communities are a designated health professional shortage area (HPSA), according to Health Resources and Service Administration (HRSA). Additionally, small year-round population numbers can make it difficult for providers to maintain a full client load, and office space is expensive due to high real estate costs. Behavioral health professionals often operate in isolation and lack professional support and mentorship due to the low overall number of providers in their town. Moreover, the populations in mountain communities are becoming more culturally and linguistically diverse, and providers are often unable to provide appropriate care for communities of color and indigenous populations, which further exacerbates the inequities that exist in the behavioral health system.

Affordability and Accessibility of Care

Due to the limited number of providers in mountain resort communities, people can face long wait times and often have difficulty getting the appropriate type of treatment. Similar to other rural communities, traveling long distances to access care can be a challenge, and inclement weather and difficult roads can further compound this issue for mountain communities. Cost of care and finding providers that accept insurance, are other prominent barriers to treatment.

Picture of wildflowers

Our Approaches

The Katz Amsterdam Foundation believes that social and emotional well-being is essential for people and communities to thrive. We work to catalyze learning, collaboration and innovation among behavioral health leaders in remote mountain communities to support individual and community resiliency while increasing access to behavioral healthcare.

Mountain road

Our Priority Areas

The Katz Amsterdam Foundation works in mountain resort communities to reduce behavioral health risk factors and increase access to behavioral health care. In addition to the approaches supported, the Katz Amsterdam Foundation focuses on two priority areas in partnership with local non-profits in each community to improve health care and services.

Decrease substance misuse and increase healthy activities

Mountain resort communities often have high rates of binge drinking and other substance misuse. This can be attributed to the concentration of a young workforce that is high risk for substance misuse and community cultures that center around alcohol use.

Recognizing that both genetics and environmental factors contribute to an individual’s propensity to move from substance misuse to substance use disorders including addiction, this initiative focuses on changing the environmental factors that can reinforce substance misuse. The focus of this initiative is on creating a community culture that reinforces healthy behaviors and makes it easier for people to avoid the progression from misuse to addiction. This includes expanding the availability of activities that are not centered around alcohol and drug use and reducing the stigma and other barriers associated with seeking help for unhealthy substance use.

Increase mental health equity for communities of color

Achieving health equity and eliminating health disparities that are the result of racism are a priority for the Foundation. Grounded in an understanding of the social determinants of health, we believe that health equity is achieved when race, income, and other socially determined circumstances are no longer a predictor of mental and behavioral health outcomes. Thus, we are focused on reducing mental health and behavioral health disparities by helping to create equitable systems that embrace and service the cultural differences and needs of communities of color.

Behavioral Risk Factor Surveillance System, 2016; PRC Custom Research, 2019
2 Center for Disease Control and Prevention, 2017-2019; 3-year average across all communities calculated and compared to national benchmark
3 Colorado Department of Public Health & Environment COHID, Gunnison County, Colorado 2018
4 Center for Disease Control and Prevention, 2017-2019

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