On the surface, Polk County looks like a typical rural county in Wisconsin.

One hour east of the Minneapolis/St. Paul metropolitan area, it’s medium-sized with about 44,000 residents. There’s no dominant urban center. Instead, the population is scattered across 15 or so towns, with populations of a few thousand, and picturesque names like Clear Lake and Osceola.

Key industries include manufacturing, health care and education. And several hundred thousand acres of land are cultivated by around 1200 farms.

But there’s one area where, tragically, Polk County has stood out from the average. County health statistics show that five years ago, the rate of suicide in Polk County was nearly double that of the state. Also, about one in seven young people reported that they seriously considered suicide. In 2015 fourteen people in the county died by suicide.

One of them was Jordan Kletschka who was just 18 years old. His mother, Tristan, says Jordan was a handsome young man who worked hard in school, had lots of friends and a big heart. After high school, he struggled a bit to find his way.  Things got worse for him when he and his girlfriend broke up.

“He wasn’t diagnosed with a mental illness, but he wasn’t able to see beyond the heart-break. Things might have been different if we’d had more support,” she recalls.  In the months after Jordan’s death, Tristan vowed to find a way to help other families avoid the pain that she and her family still endure.

She organized a walk to raise money for suicide prevention and mental health. One year after Jordan died, about 500 walkers participated in the first Polk County Suicide Awareness Walk in Balsam Lake, a town with a population of only 900.

Barriers to getting help in rural areas

“Preventing suicide and addressing mental illness can be challenging anywhere, but it’s even tougher in rural areas,” says Heather Erickson, director of behavioral health for HealthPartners Amery Hospital & Clinic in Amery, Wisconsin. [Listen to a recent podcast on anxiety with Erickson.]

According to Erickson, there are several challenges that are unique to rural areas compared to larger cities.

• Scarce resources. Even if you are able to get an appointment with a mental health professional, getting to it can be tough. There is no public transportation and people often have to travel long distances to appointments.  She says lack of transportation too often keeps patients in the hospital longer than they need to be.
• Lack of Internet access. Despite the growing popularity of telehealth during the pandemic, many patients in rural areas cannot get care this way because they do not have access to broadband. Barriers include not being able to afford storage data to download platforms such as Amwell.
• Geographical and social isolation. One symptom of mental illnesses is that people experiencing them often don’t recognize the symptoms. They may be irritable, have trouble sleeping, or be drinking more alcohol than is healthy. But if friends, family or co-workers are not around to point out the change, they may not realize it’s time to seek help.

Negative stereotypes about mental illness are also among the biggest barriers to people getting help.

“There’s a culture of self-reliance and talking about substance use and mental health problems is often taboo,” says Erickson. “Neighbors know each other and people fear being gossiped about.”

Community unites around mental health

The Polk County Mental Health Task Force (MHTF) is helping to build a grassroots effort to address these challenges.

“This year, we are in new territory with more people experiencing stress as a result of the COVID-19 pandemic,” says Jennifer Griggs-Andress, executive director of the Polk County MHTF.  In fact, a recent report by the Centers for Disease Control and Prevention found a significant increase in mental health conditions as a result of the COVD-19 pandemic. Younger adults and essential workers were among those who are disproportionately affected.

Main areas of focus for the Task Force in 2021 include working with schools, the faith community and businesses to reduce stigma and improve mental health literacy. One primary initiative will bring in the National Alliance for Mental Illness (NAMI New Hampshire) to offer the Connect Suicide Postvention program. It provides a community or organization with tools to respond effectively to a suicide death in order to prevent additional suicides and promote healing for survivors of a suicide loss.

Another planned program includes offering Parent University educational events throughout Polk County.

“Topics will include mental health, such as helping parents distinguish typical teen behavior from signs of a mental health condition,” explains Griggs-Andress. They will also cover nutrition, physical activity, healthy relationships, alcohol and drug trends and internet safety. Local service providers will be invited along to explain what programs and services are available.

“We have amazing community partners with so much knowledge and expertise. The opportunity to bring them together in one place to support parents in their parenting journey and share information about available services and educational opportunities will be of tremendous value to our community,” she says excitedly.

Businesses Making It OK to talk about mental health

The need for tools to help businesses and communities become more actively involved is one reason why HealthPartners launched the Make It OK campaign in 2013. The makeitok.org website offers free posters, flyers and other resources for employers and communities.

Griggs-Andress says many businesses provide financial support to the Polk County MHTF. In 2021 the MHTF will offer support to employers, including staff training such as Make it OK, to help them become more actively involved.  Examples of what employers can do include:

• Dedicate company resources to supporting workplace mental health, for instance with lunch and learn sessions.
• Train supervisors to identify emotional distress and implement strategies to help employees who may be struggling.
• Promote workplace mental health in benefits packages such as Employee Assistance programs.
• Reject stigma and foster a culture in which seeking help is a sign of strength.

Tristan Divine knows that community and business action can help people get treatment and save lives.  She saw one example when her organization used money to bring in mental health advocate and speaker, Kevin Hines, who survived a suicide attempt from the Golden Gate Bridge.  

She recalls that there were standing room only crowds when he spoke at schools in Balsam Lake and Amery. Among the audiences were two teens who were struggling. Hines listened and connected them to resources. Tristan believes that simple gesture saved their lives. 

“When I started this five years ago, I wanted to save another family from the pain we went through and I believe we have done that,” she said.