As a part of our ongoing policy work in rural eastern North Carolina, we hold monthly sessions in which we listen to our community to identify priority issues and then fuse community knowledge, international best practices, and local connections to solve them.

Continuing with discussions of community-based health, we centered this month’s discussion on youth mental health outcomes in North Carolina as a whole, along with the discrepancies in access to care for certain counties. Members detailed the unique barriers to mental health care for their respective counties such as stigma, lack of insurance, and a lack of local counselors. Finally, we brainstormed both community and systems level solutions to address the gaps in youth mental health care.

Discussion Highlights

• Firstly, we established the current state of youth mental health in North Carolina and the correlation between economic distress in rural counties and greater barriers to mental health care.
  • As of 2024, per America’s School Mental Health Report Card, North Carolina ranks 42nd in the country for youth mental health and has only met 25.6% of its school psychologist need.
  • Additionally, looking across the last five years of the North Carolina Community Needs Health Assessment, the top 10 most economically disadvantaged counties in North Carolina stated mental health services were the number one priority to “improve the health of your friends, family, and neighbors.”
• Participants examined both individual and common barriers to care in their counties along with various techniques to break down stigmas surrounding mental health.
  • A therapist in Wilson County described how due to there being a lack of men and people of color in the mental health field, many people have difficulties connecting with therapists and therefore seeking out mental health care.
  • Another therapist in Bertie County explained how often “the gap is trying to relate to them” and that by him sharing his experiences battling anxiety with students and patients he can more effectively connect to them.
• Next, we delved deeper into how both economic stress and geography exacerbate already present mental health needs.
  • Members described how due to the lack of local mental health experts and transportation difficulties, Tele Health services are often required in addition to additional strain being put on the few local counselors.
  • School counselors in both Nash in Waugh-Person counties illustrated that “we have employment issues, we have housing issues, we have food issues” leading to mental health care taking a back seat.
• Finally, members examined community and statewide solutions to mental health care gap, finding that at both school and county levels establishing relationships is the most important and effective tool to improving care.
  • Coming from the nonprofit sphere, one member described how nonprofits and other community-based organizations often have difficulties forming relationships as they spend so much time hunting for grants and provide the essentials instead of creating connections.