September 13, 2005

LINCOLN, Neb. — When rural Nebraskans have personal problems, they are most comfortable talking with family or friends and much less likely to turn to mental health or substance abuse professionals, according to the 2005 Nebraska Rural Poll.

This year's University of Nebraska-Lincoln poll asked how comfortable respondents were with talking to various people about personal problems. Researchers included questions in the 10th annual poll to better understand rural views on behavioral health services.

Eighty-two percent of respondents said they are comfortable talking to a family member and 79 percent to a close friend. Seventy percent are comfortable talking to a physician; 61 percent to a clergy member.

"This shows people really do depend on their families and friends, as we would hope," said Alan Tomkins, director of the university's Public Policy Center. He collaborated with Institute of Agriculture and Natural Resources researchers on the poll.

However, Tomkins said he was surprised and concerned that rural residents didn't express more confidence in behavioral health professionals.

Only 19 percent said they were comfortable discussing personal problems with a substance abuse counselor while 32 percent were comfortable with a mental health professional. That compares with 38 percent who were comfortable talking with a work colleague or supervisor and 35 percent with a teacher.

"It's great that they rely heavily on friends and family but they aren't trained professionals," he said. "Although many problems can be helped by supportive friends and families, problems such as drug addiction and serious mental illness need professional assistance. Nebraska has a strong behavioral health provider infrastructure and it appears rural Nebraskans aren't taking full advantage of it," he said.

Results probably reflect a lack of familiarity with behavior health professionals, said Becky Vogt, poll manager and analyst.

"It's not that they're more uncomfortable; they just haven't had contact so they have no opinion," Vogt said.

Sixty-three percent of respondents had no opinion about substance abuse counselors and 46 percent had no opinion about mental health professionals. Twenty-two percent said they were not comfortable talking to a mental health professional and 18 percent to a substance abuse counselor. That compares with 24 percent not comfortable with a work colleague or supervisor, 19 percent not comfortable with teachers, 17 percent not comfortable with a physician and 14 percent not comfortable with clergy.

Small town culture also may be a factor, said Randy Cantrell, a rural sociologist who works on the poll.

"There's no stigma attached to parking your car in front of your doctor's office, but there may be if you park at the substance abuse counselor's office," he said.

When selecting a behavioral health professional, licensure, insurance coverage and location of a provider are the most important considerations, the poll showed. The proportions of people that ranked various factors as important were: provider is licensed, 79 percent; covered by insurance or other third-party payment, 75 percent; close to my home, 66 percent; has spiritual beliefs like mine, 50 percent; or is part of a faith-based organization, 40 percent.

These findings will aid efforts to better serve rural areas, where mental health and substance abuse services often aren't easily accessible, Tomkins said. The Public Policy Center is working with state agencies and community- and faith-based groups on Nebhands, an initiative to provide behavioral health services to Nebraskans.

"Nearly half of all Americans will come face-to-face with mental health issues. We think it's very important to have mental health services available in these communities," he said. "The challenge is how we provide services in a consumer-friendly manner. We think the faith-based and community-based organizations can play a role."

This year's responses to perennial questions about individual well-being showed no major changes from the past, researchers said.

Thirty-nine percent of respondents said they are better off than five years ago, up slightly from 36 percent in 2004, which also is the 10-year average. The proportion that said they are worse off dropped to 18 percent from 23 percent last year, slightly lower than the 21 percent average over the past decade. Forty-three percent said they were about the same.

Looking to the future, 37 percent said they expect to be better off in 10 years, the same as last year and the 10-year average. The proportion saying they expect to be worse off in the future dropped to 21 percent from 23 percent last year and a 10-year average of 22 percent. Forty-two percent this year said they expected to be about the same, on par with the 10-year average.

The aspects of their lives that are most and least satisfying for rural Nebraskans have remained much the same over the past decade. Family, friends, religion/spirituality and greenery/open space lead the satisfaction list. Economic factors such as financial security during retirement, current income and job opportunities continue as sources of the greatest dissatisfaction.

Questionnaires for the scientific poll were mailed in March to 6,250 randomly selected households in Nebraska's 84 rural counties. Results are based on 2,851 responses. This year's response rate was 46 percent. The margin of error is plus or minus 3 percent.

The poll is the largest annual survey of rural Nebraskans' perceptions on quality of life and policy issues. Complete results are available online at Nebraska Rural Poll.

The poll is conducted by the university's Center for Applied Rural Innovation with funding from the Partnership for Rural Nebraska and IANR's UNL Extension and Agricultural Research Division.

9/13/05-VM

Alan Tomkins - Ph.D., J.D.
UNL Public Policy Center; Psychology
Director; Professor
(402) 472-5688

Becky Vogt
Center for Applied Rural Innovation
Nebraska Rural Poll Project Manager
(402) 329-4821

Randy Cantrell - Ph.D.
Center for Applied Rural Innovation
Professor
(402) 472-1772

Vicki Miller
Research Communications Coordinator
(402) 472-3813

Department: Center for Applied Rural Innovation