By Elizabeth “Lizzie” Washington of Mountain Voice
What do you see when you see Appalachians? Do you hold safe spaces for them? Do you include them all? Not just the Whites but also the Blacks?
When I am approached with the question, “Where are you from?” or “Tell me a bit about yourself,” I stumble. My heart beats five times faster. I become unsure of what to say. I have a story. Everyone does.
The Place I Come From
My story is simple: I ain’t rich. I grew up next to a ditch. A ditch filled with snakes, cups, and beer bottles. On a street filled with hard-working folks living paycheck to paycheck.
All my life, I have had to fight, to prove myself, to work harder for what I want, and to survive circumstances that often felt impossible to escape. I was raised in the Mississippi Delta, where the young people in my town called it “Moorhead Miami” to feel connected to the city. My childhood friends and I embraced this, wanting to be seen as city kids instead of country kids. My small town is shaped by poverty, racism, proud Christianity, and survival, all of which played a role in my upbringing. Nevertheless, growing up in Mississippi was not all bad.
My homeplace instilled values in me that I will forever cherish, such as hard work, respect for all people, and caring for others who don’t have. I remember my parents giving even when we had little to nothing ourselves. I watched my community survive through togetherness. I watched strong Black women who were leaders sacrifice for others and continue to show love and grace despite hardship. I learned resilience from my community, my people.
Nevertheless, my homeplace also exposed me to limited opportunities and silence surrounding mental health struggles among both teens and adults. While I understand many people in my community were surviving the best they could, mental health was often ignored or dismissed. I watched Black men, including my brothers, cousins, uncles, and even my father, make life-impacting decisions between gangs, dropping out of school, going to prison, or simply being murdered at the young age of twenty-one.
Although I did not grow up in Appalachia, learning about the region has helped me recognize many of the same struggles that exist in my hometown. While our histories are different, both communities know what it means to live with poverty, limited opportunities, and silence surrounding mental health.
Mental Health, Poverty, and Social Justice in Rural Communities
In an article from Berea College, “Mental Struggles in Appalachia”, a Berea College student describes realizing in middle school that they were “not okay” but not having the language to understand anxiety and depression.
They also questioned why people in their hometown belittled those struggling with mental health. As I read their story, I realized I was not the only person who had witnessed this kind of silence, and that it was not okay. I have seen people around me struggle with their mental health without having the words to describe what they were feeling.
Words such as Anxiety, depression, trauma, and grief were often misunderstood or ignored instead of being talked about openly. Rather than asking how someone was doing, many people simply expected them to keep quiet and keep going.
As I continued researching, I learned that poverty and mental health often relate to each other. The MIT study helped me understand that living in poverty can increase a person’s chances of experiencing depression and anxiety. It also showed that struggling with mental health can make it even harder for people to escape poverty.
Sometimes it wasn’t simply about the choices people made. It was also about what they had access to and what they did not. If people don’t have transportation, affordable healthcare, or someone they trust enough to talk to, getting help becomes much harder.
I don’t believe where someone grows up should decide whether they can get help, find hope, or simply have someone who listens. People in rural communities, whether in Appalachia or the Mississippi Delta, deserve places where they can ask for help without feeling embarrassed or judged. They (everyone)deserve mental health education, access to counseling, and communities that encourage healing instead of silence.
All in all, my community taught me how to survive. It taught me resilience, generosity, and strength. For those lessons, I will always be grateful. But survival and healing are not the same thing. It means taking the tape off our mouths, breaking the silence surrounding mental health, and making sure every person, no matter where they come from, has the opportunity to be heard, supported, and healed.
I Dare You…
I leave you with this question: Do you truly hold safe spaces for Appalachians (for all Appalachians), including Black Appalachians, or do we continue to let silence speak louder than compassion?
Works Cited
Berea College. “Mental Struggles in Appalachia.” Gravy, Berea College, https://www.berea.edu/gravy/mental-struggles-in-appalachia. Accessed 11 July 2026.
Ridley, Matthew, Gautam Rao, Frank Schilbach, and Vikram Patel. “Poverty, Depression, and Anxiety: Causal Evidence and Mechanisms.” Science, vol. 370, no. 6522, 2020, https://economics.mit.edu/sites/default/files/2022-09/poverty-depression-anxiety-science.pdf. Accessed 11 July 2026.
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- #HealingMatters
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- #CommunityCare
- #HopeAndHealing
- #BlackMentalHealth
- #EveryVoiceMatters
- #YouAreNotAlone