One of the most pressing health needs facing rural communities is addressing residents’ depression, anxiety, and other types of mental health conditions. This is most acutely seen in the elevated rates of suicide in rural communities. Reports from the Texas Department of Health and Human Services show that the suicide rate in non-metro areas is 30-45 percent higher than in metro areas with 19.1 deaths per 100,000 residents and reflect a 53.5 percent increase of suicide mortality of since 2000. Rural communities in Texas and across the U.S. face a persistent shortage of mental health providers, making it difficult to meet residents’ needs. While new initiatives aim to address this by expanding telehealth and incentivizing providers to work in rural areas, these solutions are long-term and still limited by the overall provider shortage. Access barriers—such as lack of transportation, digital literacy, internet access, mobility issues, and chronic health conditions—further impact care across rural, suburban, and urban areas. These challenges, worsened by COVID-19, have contributed to rising rates of anxiety and depression, including in Central Texas.

Public libraries serve as key community spaces, especially for people at higher risk of mental health issues and with limited access to care. Although libraries recognize these challenges, they haven’t proactively linked their services to mental health prevention or used their programs to help reduce anxiety and depression early on. Only a few libraries offer social work support, but these are mainly for those facing homelessness or abuse.

“This initiative demonstrates what’s possible when philanthropy dares to listen, to test, and to create space for flexible solutions rooted in and shaped by community. Libraries for Health meets a real and growing need, addressing inequities in access to care we see across our region. We are encouraged by its potential to serve as a blueprint for other communities seeking to leverage trusted institutions to provide mental health support.

– Abena Asante, Senior Program Officer

This photo essay by documentary photographer and filmmaker Liz Moskowitz includes portraits of program participants and interviews with library staff, peer specialists and persons receiving services.