the reality of alcoholism and rural mental healthcare for women in the united states

Alcoholism and drug abuse have become a major problem for women in the United States. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), nearly 5.3 million women in the United States consume alcohol to a point where their health and safety is compromised. Of that 5.3 million, over 4 million are dependent on alcohol, so much so that they face difficulties controlling their usage, and experience withdrawal symptoms. For many experts, these numbers seem low.

‘There is still a cultural stigma attached to female drinking versus male,’ Dr. Moe Gelbart of the Thelma McMillen Center for Alcohol and Drug Treatment tells Everyday Health author Jennifer Acosta Scott.

‘As such, women’s alcohol problems will tend to be more “underground” and hidden.’

While it’s clear that addiction in America is a growing concern, women’s dependency to alcohol has increased drastically over the past few decades.

In the nine years between 1998 and 2007, the number of drunk driving arrests for women had risen by over 30%, while in the same time period, men’s arrests dropped by 9%. Additionally, hospitalisations for women who were impaired rose by 52% over a nine year period, while men’s rose just over 9%.

The problem is exacerbated in rural areas of the United States, where men and women alike do not have the same access to mental health resources and facilities that people in metropolitan areas have access to.

This may come as a surprise to many. Although the 2010 implementation of the Affordable Care Act ensured that mental and behavioural health treatment would be an essential benefit covered by insurance providers, mental health care, intervention from a social worker, and substance abuse counseling simply isn’t available in many rural communities.

‘Right to care does not mean access to treatment,’ Columbia University Psychologist Paul Appelbaum tells The Guardian. ‘…The capacity just isn’t there to treat [patients].’

Part of the problem in rural healthcare comes from a term coined by professor Goutham Menon, who directs the Social Work Program at University of Nevada, Reno. Many rural communities suffer from “brain drain,” which occurs when students from rural communities attend college, but move to metropolitan areas rather than returning to their own communities.

This means, for many women in rural areas, rather than receiving treatment, they instead frequent the criminal justice system and emergency rooms.

‘Where we don’t have those services for mental health patients, they wind up cycling back through our jails and our emergency rooms,’ Texas state Senator Charles Schwertner tells NPR.

Substance abuse is a complicated problem for women in rural America. By and large, women are less likely to seek help for substance abuse treatment, but in areas where medical intervention is scarce, women are even less likely to seek intervention for their problems.

Part of the solution, of course, lies in de-stigmatising mental health issues throughout the medical field, and encouraging both men and women to seek help for their addiction. The other half lies in recruiting and keeping mental health resources available in the communities that need them most.

Solving this problem is more complicated than it seems, however. Psychiatry faces a supply problem as it is, and it may be up to government intervention to reward psychiatry students to spend time in rural communities. Without this dual effort, women in disenfranchised communities will continue to suffer from addiction and mental health disorders.