Rural youth in California are struggling alone with mental health

By Alonzia Quinn, especially for CalMatters

This comment was originally posted by CalMatters. Sign up for their newsletters.

Guest Comment written by

Imagine a high school student in rural California struggling with a mental health problem for weeks with no one to talk to. The nearest therapist is hours away, the young man’s family can’t spare the time and gas, and even if they manage to get to him, the next available appointment is months away.

The student will likely continue to show up at school pretending everything is fine.

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

In rural America, young people face some of the worst worrisome mental health challenges in the nation, with high rates of depression, anxiety and suicide overtaking those of their urban peers. The suicide rate among adolescents and young people in rural areas is nearly 50% higher than those in suburban or urban areas. California is no exception to this trend.

Limited insurance coverage and a severe shortage of mental health professionals only exacerbate the crisis. About two-thirds rural areas lack a psychiatrist8 in 10 don’t have a psychiatric nurse and almost half don’t have a psychologist, experts say.

States have tried to bridge the gap through telehealth, but systems connecting patients with caregivers online fall short when about 30% of rural households do not have reliable internet.

And while AI has been suggested to promote access to help, it impact remains limited in rural areas where technological barriers persist. Also, no algorithm can replace the empathy and trust that comes from human connection.

For rural students, getting aid can feel almost impossible. A”fast travel“to the doctor can mean driving 50 to 100 miles—if there’s a provider. Distance and other barriers lead to missed appointments, inconsistent treatment, and worsening symptoms.

Governor Gavin Newsom should support legislation ensuring that every rural high school offers access to mental health support programs. State Sen. Susan Rubio, a West Covina Democrat who introduced mental health education legislationis well positioned to lead the effort.

My own journey in 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 the stigma ran deeper than our cornfields.

I spent two years on the Waterloo Youth City Council to change that. Our biggest win came with a a bill requiring schools to print a crisis hotline student handbook information. When the bill passed the Iowa House, it felt like a victory not just for politics, but for any student who can see that number in a time of crisis and decide to reach out.

California recently took a similar step, requiring schools to add a 988 suicide and crisis hotline to student books. It makes sense, but awareness alone is not 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 disciple behind

Peer support programs teach students to support each other by offering empathy, connection and a first point of contact for those who would otherwise struggle in silence. c structured elective hours with teacher supervision and clinical guidance, peer supporters learn to listen, document responsibly, and know when to refer someone to a professional.

Several California high schools have tried this model but many rural schools are omitted. With funding available through Behavioral Health Services Act — 1% tax on income over $1 million — California has an opportunity to expand these programs and ensure that rural students are not left behind.

Some may worry that a focus on rural schools is leaving urban students behind, but rural students face the steepest barriers, often attending school without single counselor or psychologist. This legislation is not about playing favorites; it is about closing the equity deficit.

Now imagine that the student in rural California—the one silently struggling—finally has someone to turn to all the way down the hall. This one connection can turn isolation into hope.

Young people they want support that feels realrelated and stigma free. Peer programs can make communication less embarrassing and more human. If California truly wants to address the mental health needs of its youth, it must ensure that no student faces silence alone.

This article was originally published on CalMatters and is republished under Creative Commons Attribution-NonCommercial-No Derivatives license.