If your mental picture of northern Maine features rolling hills and peaceful potato farms, chances are you got a big jolt when a recent New York Times analysis found that the small Aroostook County city of Presque Isle is the nation’s “epicenter of anxiety” – in a state whose level of anxiety is the highest in the country.

It turns out that people in isolated areas have good reasons to feel anxious. Compared to residents of more populated areas, however, rural Mainers have a much more difficult time getting treatment for mental health issues – though it doesn’t have to be that way.

The level of anxiety in Maine is 21 percentage points higher than the national average, according to the Times analysis, which looked at the rise in anxiety-related Google searches over the past eight years. The Times determined that the places with the highest search rates have three things in common: lower levels of education, lower median incomes and a greater percentage of the population in rural areas.

Maine is poorer than other states – and the same can be said of those in Presque Isle compared to people in most other parts of Maine. Over 20 percent of Presque Isle residents live in poverty (the state poverty rate is 14 percent), and over 16 percent are unemployed (Maine’s average is 3.7 percent).

It’s a mix that unsettles families and causes a lot of stress, Brent Scobie of Acadia Hospital, a private Bangor psychiatric hospital, told the Press Herald this week. But the same financial instability that causes the need for mental health services is also a significant stumbling block to getting them.

That’s because thousands of Aroostook County residents – like other low-income people all over Maine – don’t have insurance and can’t afford to see a care provider, thanks to the LePage administration’s rush to cut MaineCare rolls and its repeated rejection of proposals to expand Maine-Care eligibility. Lacking coverage, too many people don’t get preventive mental health care, increasing the chance that they’ll end up in the emergency room and in crisis.

There are other roadblocks, of course. As in many small towns and rural areas, the stigma of a mental health diagnosis and the lack of anonymity likely keeps some northern Mainers from seeking assistance. Then there’s the shortage of mental health professionals in the area, though there’s good news here: Eastern Maine Healthcare Systems (which includes Acadia Hospital and a medical center in Presque Isle) is stepping up the use of telemedicine, which lets patients in rural Maine “meet” with doctors over a video link.

Many of the tens of thousands of Mainers who suffer from anxiety and other mental health issues aren’t getting the help they need to get better. The efforts by caregivers and administrators to bridge this access gap will help only incrementally, unless Maine’s legislators do their part, stand up to Gov. LePage and stand behind Medicaid expansion.

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