California’s rural youth struggle alone with mental health

By Alonzia Quinn, Special for CalMatters

Emma Bogart, 19, and Jordin Raven Tauzer-Pardo, 19, chat at Santa Rosa Junior College in Santa Rosa on Sept. 26, 2024. Photo by Adahlia Cole for CalMatters

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Imagine a high school student in rural California, struggling with a mental issue for weeks with no one to talk to. The nearest therapist is hours away, the youth’s family can’t spare the time or gas and even if they could get there, the next available appointment isn’t for months. 

It’s likely the student will keep showing up to school, pretending everything’s fine. 

Now imagine a trained classmate they could talk to after class — someone who could listen, really understand and help them find support.

In rural America, young people face some of the most alarming mental health challenges in the nation, with rates of depression, anxiety and suicide far outpacing those of their urban peers. Suicide rates among rural adolescents and young adults are nearly 50% higher than those in suburban or urban areas. California is not an exception to this trend.

Limited insurance coverage and severe shortages of mental health professionals only deepen the crisis. About two-thirds of rural counties lack a psychiatrist, 8 in 10 lack a psychiatric nurse practitioner and nearly half lack a psychologist, experts say. 

States have tried bridging the gap through telehealth, but systems connecting patients with caregivers online fall short when about 30% of rural households lack reliable internet. 

And while artificial intelligence has been proposed to promote access to help, its impact remains limited in rural areas where technological barriers persist. Besides, no algorithm can replace the empathy and trust that come from a human connection.

For rural students, getting help can feel nearly impossible. A “quick trip” to the doctor might mean driving 50 to 100 miles — if a provider is available. Distance and other barriers lead to missed appointments, inconsistent treatment and worsening symptoms.

Gov. Gavin Newsom should support legislation ensuring every rural high school offers access to mental health peer support programs. State Sen. Susan Rubio, a Democrat from West Covina who this year introduced mental health education legislation, is well positioned to lead the effort.

My own journey into youth mental health advocacy began with a similar goal: helping students feel supported and comfortable reaching out.

I grew up in Iowa, where care was limited and stigma ran deeper than our corn fields. 

On the Waterloo Youth City Council, I spent two years working to change that. Our biggest win came with a bill requiring schools to print crisis hotline information on student ID cards. When the bill passed the Iowa House, it felt like a victory not just for policy, but for every student who might see that number in a moment of crisis and decide to reach out.

California recently took a similar step, requiring that schools add the 988 Suicide and Crisis Lifeline to student IDs. It’s meaningful, but awareness alone isn’t enough. Knowing where to turn doesn’t always make it easier to ask for help. 

Sometimes what students need most is a face-to-face connection — a peer who understands.

Leave no student behind

Peer support programs train students to bolster one another, offering empathy, connection and a first point of contact for those who might otherwise struggle in silence. In structured elective classes with teacher oversight and clinical guidance, peer supporters learn to listen, document responsibly and know when to refer someone to a professional. 

Several California high schools have piloted this model, but many rural schools have been left out. With funding available through the Behavioral Health Services Act — a 1% tax on incomes over $1 million — California has the opportunity to expand these programs and ensure rural students aren’t left behind.

Some may worry that focusing on rural schools leaves urban students behind, but rural students face the steepest barriers, often attending school without a single counselor or psychologist. This legislation isn’t about playing favorites; it’s about closing an equity gap. 

Now imagine that student in rural California — the one silently struggling — finally having someone to turn to right down the hall. That single connection can turn isolation into hope. 

Young people want support that feels genuine, relatable and free of stigma. Peer programs can make reaching out less intimidating and more human. If California truly wants to meet the mental health needs of its youth, it must ensure no student faces the silence alone.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.