Improving Mental and Behavioral Health in Mountain West Communities
While mental health and substance use are critical challenges across the country, they unfold differently in mountain communities. In these areas, residents face higher risk factors for mental illness and fewer protective factors. For example, residents of mountain resort towns have higher rates of drug and alcohol misuse, which are often aligned with the party culture in these communities. Moreover, access to care can be difficult to find because many communities struggle to attract and retain quality mental health providers and offer more acute services. Residents must often travel long distances to receive care due to local provider shortages.
Populations in mountain communities have become increasingly culturally and linguistically diverse, and providers are often unable to offer culturally responsive care for non-English speakers. As a result, historically marginalized communities can have even greater barriers to care. For example, communities of color in mountain resort towns experience additional risk factors (e.g., loneliness, lack of community trust) and more barriers to getting care when needed (e.g., few bilingual bi-cultural behavioral health providers).
Adding to these challenges, mountain resort communities also experience seasonal fluctuations in population, which can exacerbate feelings of social isolation for both seasonal and year-round residents. High costs of living, housing insecurity, and lack of available childcare support can also erode financial stability and overall well-being.
This confluence of risk factors leads to higher rates of mental and behavioral health challenges and substance misuse.
25%
Binge drinking, on average is 25% higher than the national average1
50%
Up to 50% higher reported rates of alcohol-induced deaths2
1.3x
Suicide rates are 1.3 times higher than the national average in some communities – 17 per 100,000, compared to the national average of 13 per 100,000
While mountain resort communities have faced these challenging 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 critical issues for all community members.
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 and geographic isolation – and significant discrepancies in wealth, more specific to resort towns. 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 embedded with partying and substance abuse. Both new community members and long-term residents are affected by this culture that 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 can 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, and therefore might feel it isn’t acceptable to not be okay or to ask for help.
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 community. Moreover, the populations in mountain communities are becoming more culturally and linguistically diverse, and providers are often unable to provide culturally responsive care for communities of color, 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 type of treatment they need. Those living in mountain resort communities must often travel long distances to access care and face additional challenges like extreme weather conditions and dangerous roads. The cost of out-of-pocket care and finding providers that accept insurance are other prominent barriers to treatment.
Our Approach
The Katz Amsterdam Foundation believes that social and emotional well-being is essential for people and communities to thrive. The Foundation helps western mountain resort communities address mental and behavioral health challenges in two ways:
- Building capacity of innovative programs that focus on reducing substance use disorders, advancing equitable opportunities for mental health supports for communities of color, or helping communities collect data to understand the ever-evolving behavioral health concerns.
- Supporting a network of mental and behavioral health professionals and organizations by enabling shared learning across mountain resort communities, and by coordinating and co-creating shared resources that individual communities would not have the resources or scale to do independently.
At the Foundation, we believe that when multiple communities come together to collaborate on large initiatives – from building shared measurement systems to crisis response programs to advocacy efforts – it becomes possible to achieve more than what each community could do on its own. That’s why the Foundation supports individual programs as well as a network of mental and behavioral health professionals and organizations.
Our Program Priorities
Through its grantmaking, the Katz Amsterdam Foundation supports programs that focus on at least one of three priority areas:
- 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 at high risk for substance misuse and community cultures that center around alcohol use.
- In this initiative, the Foundation hopes to help reduce the prevalence of substance misuse by supporting innovative, culturally responsive, and community-designed prevention, intervention, and treatment options.
- Achieving health equity and eliminating health disparities that are rooted in 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.
- That’s why this initiative is focused on supporting the development or scaling of innovative, culturally responsive, and community-driven mental and behavioral health supports that are designed by and for communities of color.
- Katz Amsterdam supports developing or scaling innovative, culturally responsive, and community-driven mental behavioral health supports designed by and for communities of color.
- Building data collection infrastructure and capacity for data analysis and sensemaking can take time, resources, and expertise that many communities do not have, especially when resources for access to care are in such high demand.
- The Shared Measurement Framework Initiative helps communities collect, analyze, and use data through community surveys and other supports to better understand their population’s mental behavioral health needs. With data in hand, local leaders can tailor programs and allocate resources to where they are needed most.