The impact of navigating one's mental health in a rural community is a unique lived experience because of the many barriers associated with seeking and receiving mental health services. Using arts-based visual ethnography and an analysis of 47 semi-structured interviews, we examine the lived experiences of navigating mental health struggles and healthcare infrastructure in a rural community in the western United States. To do so, we leverage the tenets ‘social exclusion’ in tandem with an ‘availability, accessibility, acceptability, and appropriateness’ framework to situate our analysis centered around three key, intertwined themes: the internalized shame and stigmatization experienced by rural people with mental health struggles, exclusionary communal attitudes and practices that exacerbate rural individuals' experiences, and an unreliable, fragmented rural mental healthcare infrastructure that further aggravates the individual and community-level experiences of stigmatization and mental health struggles. Our paper concludes with participant-driven solutions for future policy- and community-level improvements to better address rural mental health.

由于在寻求和接受心理健康服务方面存在许多障碍，因此在农村社区中进行心理健康导航的影响是一种独特的生活体验。使用基于艺术的视觉人种志，并分析了47个半结构化访谈，我们考察了美国西部农村社区开展心理健康斗争和医疗基础设施的现实经验。为此，我们将“社会排斥”原则与“可用性，可及性，可接受性和适当性”框架相结合，将我们的分析置于三个相互交织的关键主题之上：农村智障人士经历的内在羞辱和污名化健康斗争，社区的排斥性态度和做法加剧了农村居民的经历，以及不可靠，分散的农村精神卫生保健基础设施，这进一步加剧了个人和社区层面的污名化和精神卫生斗争的经验。本文以参与者驱动的解决方案作为结束，以解决未来的政策和社区层面的改进，以更好地解决农村心理健康问题。