The Failure to Utilize Mental Health Services in the American West: Case Study of the Lite Day Treatment Program in Big Hom County, Wyoming

Abstract

The American West differs from what professional scholars have been studying for years -- "Rural America". Although they share several key characteristics, Frontier Rural America is distinguished by great degrees of isolation (less than 7 persons per square mile), great distances from central market areas, difficult terrain and climate, unstable economy, and even higher degrees of social problems (suicides, homicides, drug/alcohol abuse, violence in the home) per capita. Yet, in these little towns, sprinkled throughout the American West, few social services can be found and, those existing, often close down due to lack of community interest, support, and use. The social service programs offered are often based upon urban models failing to adequately consider the cultural belief systems of the West. This is not surprising if we take into account the lack of information in existence on the topic. Other factors influence the lack of response to mental heath care services introduced to Frontier Rural America. By interning at a newly introduced social program in Big Horn County, Wyoming, holding community and program member discussion groups, and creating and conducting a randomized questionnaire, I uncovered some of these factors. It is possible that the findings may also apply to other frontier rural communities in the United States also struggling with high degrees of social problems coupled with a low degree of mental health care use.