Western Nebraska Behavioral Health's clinical team holds a meeting over Zoom.
Western Nebraska Behavioral Health's clinical team holds a meeting over Zoom. WNBH currently has eight clinic sites in western Nebraska. Photo courtesy of Catherine Jones-Hazledine.

In rural Nebraska, therapists are busier than ever. 

For years, providers in the region have been doing their best to provide adequate resources to their clients, who often face unique obstacles such as distance and, according to the USDA Economic Resource Service, a poverty rate higher than that of the state’s urban areas. 

Psychologist Catherine Jones-Hazledine started Western Nebraska Behavioral Health, made up of eight mental and behavioral health clinics across western Nebraska. Over 15 years in, she’s had the chance to see the need firsthand. 

“We’ve been here now about 17 years, and we keep expanding our clinics to reach more and more of these small communities, because there just are not enough providers or really resources of any kind,” she said. “Which is the reason that we’re here, but it’s also kind of an ongoing challenge.”

Rural communities not having sufficient resources for so long also meant the clients’ issues are unique, she said. A relatively small problem might have become something multi-generational, simply because it wasn’t dealt with early on. 

“Especially when we first started out here, there were no simple cases,” Jones-Hazledine said. “There were no, ‘I’m having some mild depression.’ It was like train wreck situations that had been going on so long.”

In the last few years, the coronavirus pandemic introduced another layer to all those challenges. That’s not unique to Nebraska. In October of 2021, 84% of psychologists who treat anxiety disorders and 72% who treat depression said they saw an increase in demand from the start of the pandemic, according to the American Psychological Association

Jones-Hazledine said WNBH’s waitlists are longer than ever before, even as they have more staff than ever before, a sign that need has risen. 

“In rural areas, there’s this threshold that people have to get to before they will reach out, like things have to be a certain level of extreme,” she said. “And I think the pandemic just pushed so many people over that line that they were finally willing to reach out.” 

She said that all of the stresses her patients were under magnified due to the pandemic. 

The high demand is affecting aspiring psychologists as well. Tara Wilson, a counseling associate professor at Chadron State College, said graduate students at the college are always able to meet their minimum work hours because of the demand. The way they have to learn is changing as well.

In prior years, Wilson said most of their clients would have been students looking for extra credit, or just trying to see what counseling is like. But the needs are more pressing now.

She sees that as mostly positive, but it does bring some extra stress. 

“Being a counselor for the first time can be a lot on one’s plate,” Wilson said. “In addition to now also having clients that have more significant concerns that they’re bringing into counseling.”

Wilson expects the need for therapy to stay high. Although a lot of people were pushed to reach out for help by the pandemic, she said some also are still in the process of digesting everything that has happened in the past two years.

“There’s a grief process because there was a lot of things that happened during the pandemic that we haven’t been able to fully process,” Wilson said. “There’s a lot of that looking back and just thinking, ‘What is going on right now and what happened?’ And now’s the time really when counselors can step in and work to meet those mental health needs.”

To work through the waitlists and get everyone the help they need, there’s been an increase in collaboration, Jones-Hazledine said. WNBH will keep in touch with people on the waiting list, and refer them to other practices if necessary. 

WNBH is also providing resources like webinars to those looking to start their own clinics. Jones-Hazledine said this teamwork has been one of the better things to come out of the pandemic. 

“It’s been really helpful in breaking down any kind of competition because we all have the same goal of trying to meet this need,” Jones-Hazledine said. “Every practice that we communicate with is in the same boat. I feel like we’re probably working collaboratively the best we have ever.”

Even with all the hardships, both Wilson and Jones-Hazledine said they’re happy to do what they do in rural areas. 

“It’s an incredibly satisfying place to work because even though there are all those stressful things and all those obstacles, it feels very important, what you’re doing,” Jones-Hazledine said. “You have days that are stressful and overwhelming, but you don’t ever really have a day that feels like it didn’t matter.”