We're urging Governments across the UK to overhaul its mental health support for rural areas as our new report shows that current provisions are insufficient and ‘neglect’ struggling countryside communities.

Our new report reveals that despite rural communities facing a unique set of daily complex challenges, the NHS and current mental health services cannot provide the required level of support. It says financial stress and the cost of living crisis compound pre-existing hardships and push people to breaking point.

Individual needs are forgotten

Loneliness, isolation, and the rural premium are just some of the common issues faced by those living in the countryside. But farming communities also face additional economic and environmental challenges which are often out of their control – such as poor weather, rising costs and the ongoing impact of Brexit. The new report found that these communities are seemingly being left to just ‘get on with it’ as individual needs are forgotten.

We're warning the UK Governments that by not providing vital bespoke support, they are ‘neglecting’ rural communities as the NHS and third sector simply cannot cope.


Recommendations to the UK Governments include making area-based mental health plans to reflect the specific challenges and profile of rural communities.

It’s absolutely vital to improve access to a wider range of psychological therapies – and our new report suggests using the counselling workforce in primary care settings, through the Primary Care Networks in England, and within multi-disciplinary teams based within GP hubs in Scotland, Wales and Northern Ireland.

Services 'plugging the gap'

The report also strongly advises that the UK Governments must provide appropriate funding for third sector specialist services - which is currently ‘plugging the gap’ and providing vital support where statutory services are unable to help.

Dr Lisa Morrison Coulthard, Director of Professional Standards, Policy, and Research at BACP, said:

“The cost of living crisis has greatly impacted rural communities. Farmers face numerous unique mental health challenges due to closures from disease, bad weather, reduced Government support, and post-Brexit funding issues. Rising input costs worsen their situation and Government is often perceived as lacking understanding of external market forces and their effect on the farming sector – which fuels the belief that farmers are being neglected.

“The current Government funding support available for rural areas is much lower per head than for their urban counterparts - so public services in these areas suffer and the communities who rely on them are greatly disadvantaged by location. The lack of available or accessible NHS services in some rural areas has also meant that third sector organisations often ‘pick up the tab’ for underinvestment.

Address needs of countryside communities

“Governments across the UK must address the different needs of countryside communities, and provide essential bespoke support. Economic and environmental challenges have meant that access to mental health support in countryside communities is inconsistent and often compounded due to delayed accessing of support until it reaches crisis point.”

New data from our annual Public Perceptions Survey1 also shows that three quarters (74%) of the UK admit their mental health being worsened by the current cost of living crisis - an increase of a third since 2022.2

Nathan Shearman, director of therapy and training at Red Umbrella and a qualified psychotherapist and counsellor, said:

“People in rural areas can be hardy and stoic, but they’re also vulnerable and open to receiving help – when it’s done right. Our experience of providing counselling to farmers in remote areas shows that if you’re prepared to take services to the people who need them, they will engage. We’ve literally saved lives operating this way and have shown it can be done”.

In rural areas, the average wage is 7.5% less than the urban equivalent;3 throughout the cost-of-living crisis, those residing in the countryside have been subject to the ‘rural premium’, which has meant that their everyday costs such as fuel and transport can amount to 10-20% more than the wider population.4 Likewise, inflation of raw and agricultural resources (by which rural industries are disproportionately impacted) reached sums of 25-30%, compounding distress amongst rural communities.5

Our report and recommendations has been issued to Parliamentarians and key decision makers and is based on the expert testimony of therapists and services who have provided vital mental health support to people during these challenging times.

Read the report Understanding the cost of living crisis – Valuing our mental health


1. About the Public Perceptions Survey: Since 2019, the BACP has conducted an annual survey to measure the opinions and attitudes of the British public towards mental health.  The survey data was collected using a self-complete, online methodology. A nationally representative sample of 5,249 adults (aged 16+) was taken from YouGov’s online research panel and results were weighted to provide a nationally representative dataset. Fieldwork for the 2024 survey was conducted between the 16th and 28th February 2024.

2. Public Perceptions Survey 2022 - 53% of respondents said that the rise in the cost of living and inflation had a negative effect on their mental health and wellbeing.

3. Citizens Advice Rural Issues Group. (2022). Hopeless: A Summary of our Report on Poverty in Rural Life. Available at: https://rsnonline.org.uk/images/meetings/RSP-Vulnerability-Group/25.04.22/citizens-advice-summary-report.pdf (accessed: 03.01.24).

4. The All Party Parliamentary Group for Rural Business and the Rural Powerhouse. (2023). THE RURAL PREMIUM: exploring the impact of the cost-of-living crisis in rural areas. Available at: https://media.cla.org.uk/documents/APPG_The_Rural_Premium.pdf (accessed: 09/12/23)

5. The All Party Parliamentary Group for Rural Business and the Rural Powerhouse. (2023). THE RURAL PREMIUM: exploring the impact of the cost-of-living crisis in rural areas. Available at: https://media.cla.org.uk/documents/APPG_The_Rural_Premium.pdf (accessed: 09/12/23)