New Study Shows Elevated ‘Psychological Distress’ in the Rural West Amid Pandemic

Researchers say the survey demonstrates the need for mental health support throughout the region.
Psychologic distress, rated on a scientific scale using self-reported data, was extremely prevalent throughout the rural West during the first months of the pandemic. (Raggedstone/Shutterstock

by | Jan 4, 2022 | Health

Rural western residents have been struggling over the past few years, according to a new study from authors, including social scientist Justin Farrell, who wrote “Billionaire Wilderness.”

A survey of 1,203 adults from 11 western states–excluding metropolitan regions–found that nearly half the respondents experienced, at the very least, mild mental health challenges during the first year of the COVID-19 pandemic. About 15% of residents were found to have “serious” levels of psychological distress. 

“Nonmetropolitan” counties are classified as areas not connected to an urban core of more than 50,000 people, or where a significant portion of locals don’t commute to a metropolitan area. (Screenshot courtesy of the Rural West COVID Project)

Survey subjects were asked to self-report if they felt various symptoms related to distress in the previous 30 days, including feelings of nervousness, worthlessness, hopelessness or restlessness. They were also asked about their exposure to COVID-19 and their political and economic well-being. 


“These results, I think, serve as kind of a cry for attention when it comes to what appears to be very serious issues of psychological distress across the rural West,” said Dr. Tom Mueller, a professor at the University of Oklahoma and co-author of the paper. 

Mueller said the responses surprised him not just because of the sheer numbers but also because of the sharp increases in mental health challenges compared to the rest of the country. Pre-pandemic “serious distress” levels were estimated to be at just 3-5% nationwide, and Mueller said he believes those levels were unlikely to be much higher in the rural West prior to 2020. 

“So, that’s a pretty dramatic increase based on our general population understanding of this measure, which has been kind of reported as being a consistent measure over time,” he said.

Economic struggles due to COVID-19 disruptions were also common in the surveyed area. 13.4% of respondents reported temporary unemployment in the first year of the pandemic, which was more than double the national average during the same time period. 

“The labor markets are more vulnerable, particularly in the West. A lot of them are tied to various natural resources that can boom or bust. Or in the case of COVID that are attached to tourism, which has been highly affected,” Mueller said.

But while economic turmoil directly related to the coronavirus pandemic did show a correlation with more serious mental health cases, according to the study, financial struggles weren’t as connected with folks experiencing more mild symptoms of psychological distress. To the authors, that indicated that other factors, such as social isolation, travel impacts and cultural struggles, are also contributing to the poor psychological health statistics of the region. 

Actually contracting the novel coronavirus–which nearly 15% of respondents said they did at the time of surveying–also did not correlate with psychological distress. Self-rated health, which factors in physical wellbeing, also remained stable.

And while a number of limitations are present in the data–contacting people in these areas can be difficult, and research on similar subjects in the region has been limited–Mueller said the results regarding psychological distress paint a stark, grim overall picture that should alert local policymakers. 

“There’s a lot of places overall in the rural West that are really struggling and have been for a while,” Mueller said. “I think that’s another reason why we’re seeing these mental health impacts. And even if this level of mental distress wasn’t associated with COVID, it’s still a huge problem and a huge issue.” 

Yale sociology professor and Wyoming native Justin Farrell, who has studied political and social dynamics in the Rocky Mountain West for years, co-authored the new study with Mueller and three others. He said data in this subset of the U.S. has lagged behind other parts of the country, and he hopes their findings will motivate researchers and funders to look into rural western issues more often.

“There’s such a lack of reliable information in some of these underserved areas of the West compared to some of the urban areas, where there was a lot of really good data coming out immediately about the pandemic and about the virus and its impact,” Farrell said. 

He also said some of the political results should surprise longtime residents of the rural areas he surveyed. Around 75% of the counties in the study voted for Trump in both 2016 and 2020, but a majority of respondents support coronavirus relief packages from the federal government. 

“I don’t think the pandemic is breaking down historical political patterns in a major way. But it did shift how people were thinking about aid from the federal government.” 

And though small mountain towns like Jackson Hole and Aspen made up just a small slice of rural areas surveyed, Farrell said they do play a role in the challenges to mental health much of the region is facing. That’s due to both the housing crises faced by resort areas, as well as funding crunches outside of them. 

“I mean, the price of one home in Jackson could probably fund a good portion of what we’re talking about, at least in the State of Wyoming,” Farrell said. “But in Cheyenne, lawmakers are still resistant to any sort of tax or any sort of requirement of more from the ultra-wealthy who are moving into those areas.”

Data for the study was collected by a firm specializing in rural surveying, and the overall research was funded by the National Science Foundation. More research documenting the impacts of COVID-19 on the rural West can be found at

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About Will Walkey

Will is KHOL's first full-time reporter and producer. Originally from Tacoma, Washington, he recently graduated from Columbia University with a Master's Degree in journalism. He likes to read and write about housing, local politics, and history, and spends most of his free time fishing or biking. He's excited to be living in Wyoming, and looks forward to honing in on his unique radio voice by highlighting the locals that make Jackson special. Contact Will with tips at, and follow him on Twitter at @WillWalkey.

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