Unpacking the contribution of interpersonal isolation on mental health in rural and agricultural communities - PROJECT SUMMARY / ABSTRACT There is a growing mental health crisis among rural and agricultural communities in the U.S., including high rates of depression, suicide, and substance use (Reidhead et al., 2020), with substantial economic and life expectancy consequences (Stein et al., 2017). Social isolation (i.e., objective markers of little contact with others) and loneliness (i.e., perceived isolation) are widely recognized as important determinants of health (Cornwell & Waite, 2009) and suicide ideation (Klonsky & May, 2015) particularly in rural populations (Henning- Smith et al., 2018b). Existential isolation (EI) is a third type of interpersonal isolation defined as the subjective feeling that others do not understand one’s own subjective experiences (Helm et al., 2019). Research suggests EI differs in substantive ways from loneliness and social isolation, including incremental validity over loneliness in predicting depression and suicide ideation (Helm et al., 2020). Recent research has identified parallels between the EI and rural mental health landscapes (i.e., greater prevalence among men, less intention to utilize mental health services, associations with a fragmented cultural identity and community alienation), suggesting EI may be a potent predictor of rural mental health outcomes. Yet no research has examined the role of different types of isolation more generally, and the experiences of EI specifically, in agricultural and rural populations, leaving a notable gap in our understanding of rural mental health. The proposed research seeks to fill this gap and provide foundational insights toward identifying avenues for future targeted interventions. By partnering with the University of Missouri Extension, the proposed research will utilize a multi-method approach to identify the relationships between types of interpersonal isolation, mental health, and substance use in rural and agricultural communities. Participants will be recruited from an existing database of farmers, ranchers, and farm families identified by existing MU Extension outreach programs. An initial cross-sectional study will assess interpersonal isolation, mental health, substance use, perceived community stigma towards mental health, and attitudes towards mental health services to identify the prevalence and baseline relationships between interpersonal isolation, social stigmas, and mental health. A subset of this initial sample will be recruited for longitudinal assessments to examine temporal and mediational pathways between interpersonal isolation, mental health, and substance use. An additional and independent subset of the initial cross-sectional sample will be recruited to complete qualitative measures of personal experiences with isolation, mental health, and community stigma to develop a deeper understanding of the lived experiences of rural and agricultural community members. Consistent with NIH’s mission to increase understanding of health barriers and NIMHD’s mission to support research that improves minority health and reduce health disparities, the proposed study will increase understanding of how interpersonal isolation contributes to the mental health crisis in rural and agricultural communities, with the goal of providing insights toward avenues for future targeted interventions.
