It has long been assumed that rural living provided protection against mental illness compared to urban life. Notably, protective factors such as social stability, healthy lifestyle and community cohesion are often associated with rural life, while social isolation, poor lifestyle and disconnected communities, which increase the risk of mental illness, represent life in the big city.

That picture has since changed, and rural mental health was reported to have been declining, particularly since new socioeconomic factors have changed the face of rural communities. Particularly, low income, reduced social interactions due to geographic isolation, and restricted range of learning experience have increased rural children’s vulnerability to mental health problems such as anxiety.

Exploring the effect of urban versus rural living on symptoms, recognition of mental health problem, mental healthcare usage and the total impact experienced by child and family as a result of anxiety, no difference was found between urban and rural children on measures of anxiety, emotional and behavioral problems. These results indicate that there were as many anxious and externalizing (i.e., behavioral problems) rural children as urban children.

Other similarities that were uncovered involve parental recognition of a problem. Previous studies have reported that parents often fail to recognize that their child is having a problem when what is afflicted them is anxiety. Likewise, this study found that both urban and rural parents consistently fail to recognize anxiety as a problem in their child, while they were more astute at identifying externalizing problems.

This difference in perception could be attributed to the fact that anxious symptoms could be viewed by the parent as part of the child’s temperament and therefore not a target of change. Indeed, the symptoms and impact of anxiety are often less visible and more likely to impact solely at home or in non-disruptive ways, by contrast externalizing problems symptoms are often visually more obvious and unacceptable, particularly in situations where the difficulty is disruptive to many people, such as in class.

As a result of this discrepancy, children with externalizing problems are more likely to be referred for treatment than those with anxiety. Furthermore, it appears that rural children who are highly anxious are more severely impacted by the disorder than urban children with a similarly high anxiety level.


Lyneham, Heidi & Rapee, Ronald. (2007). Childhood anxiety in rural and urban areas: Presentation, impact and help seeking. Australian Journal of Psychology – AUST J PSYCHOL. 59. 108-118. 10.1080/00049530701317082.


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