The Hidden Crisis in Rural America

It’s prohibitively difficult to access mental-health services in rural America. That’s because, relative to urban areas, rural counties have so few mental-health professionals. The majority of nonmetropolitan counties in the U.S. don’t have a psychiatrist, and almost half lack a psychologist. The paucity has resulted in a public-health crisis—rural Americans suffering from a psychiatric condition are more likely to encounter police than receive treatment. Each year, 2 million mentally ill Americans, most of whom aren’t violent criminals, end up in jail.

This is the case in Cochise County, Arizona, a sprawling area nearly the size of Rhode Island and Connecticut combined, but with 3.8 million fewer residents. Many 911 calls in the area involve people with mental-health issues, and according to Mark Dannels, a local sheriff, 67 percent of the people in Cochise County Jail were diagnosed with a mental-health condition.

In the short documentary Out of Sight, Out of Mind, directed by James Burns for PBS Independent Lens, Dannels and other residents of Cochise speak to the alarming implications of the area’s lack of psychiatric resources.

“There’s an increasing demand for mental-health services across the board, and we can’t keep up,” Dr. James Reed says in the film. Reed is one of just two mental-health professionals serving the entirety of Cochise County.

“With the lack of resources in a county like Cochise, it is a revolving door [to prison],” Dannels says. “The options are limited … one option that remains constant is the arrest. I’ll be the first tell you, that’s not the answer.”