MENTAL HEALTH IN ROBESON COUNTY 1

A Report on Mental Health and Overall Well-Being in Robeson County, North Carolina

Chandler Briggs, Autumn Koehler, Makenna Lagaly, Julie Rice, Haley Smith

University of North Carolina at Chapel Hill

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A Report on Mental Health and Overall Well-Being in Robeson County, North Carolina

The county being discussed in this report is Robeson County, North Carolina. Robeson

County is located in the southern part of the state and has a population of about 130,000. This

county is also among the 10% of counties in the United States that are majority-minority, with

American Indian, African-American, and Hispanic residents making up 68% of the population.

This report will analyze three variables in Robeson County, and discuss their implications. The

variables being discussed are physical activity, the amount of poor mental health days, and the

ratio between population and mental health providers. These factors are important because

physical activity and mental health providers have an effect on the amount of poor mental health

days a citizen has. 

From the year 2002 until 2004 there was a significant decrease in the number of people

who were reporting themselves to be inactive and then a significant increase again after the year

2004. From the year 2006, Robeson County has seen a slight increase of people who reported

they were inactive (Figure 1). According to the University of Wisconsin Population Health

Institute (2020), 45% of the population in Robeson county has adequate access to locations for

physical activity whereas the North Carolina average is much higher at 74%. Studies have

conveyed how there seems to be a positive correlation between increase in physical activity and

increase in mental well-being (Harris, 2018). This study can help provide a possible explanation

for why Robeson County’s rank in overall health is ranked 100, as the level of physical inactivity

in Robeson County is significantly higher than North Carolina’s average in the past years. 

Poor mental health days are defined as the reported days where people feel as though

their mental health is not good, which includes stress, depression, and problems with emotion

(University of Wisconsin Population Health Institute, 2020). In 2017, the average number of
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reported poor mental health days in Robeson County was 5.2 while the average for North

Carolina was 4.1 (Figure 2). Robeson County contains 249 mental health providers with 530:1

being the ratio of population to mental health providers (University of Wisconsin Population

Health Institute, 2020). Overall in North Carolina, this ratio sits at 410:1 (University of

Wisconsin Population Health Institute, 2020). While the population of Robeson County

experiences a higher proportion of poor mental health days compared to the state of North

Carolina, they also fall short on the ratio between population and mental health providers (Figure

3).

(Figure 1)

(Figure 2)
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(Figure 3)

A useful action for improvement in Robeson County is for policy makers to create more

recreational areas and sidewalks that allow for physical activity. Physical inactivity has been

documented to correlate with lower levels of positive mental health (Tamminen et al., 2020).

Physical inactivity is a risk for poor mental health and may be why the mental health of residents

of Robeson County is suffering. One study found that voluntary physical activity and commuting

physical activity for at least 30 minutes a day resulted in positive mental health (Tamminen et al.,

2020). This information can encourage policy makers to create more recreational areas such as

parks or walking trails. The construction of more sidewalks would allow for a safer commute for

walking or biking. The parks and sidewalks would act as motivators for residents to participate in

physical activity, which would most likely increase their mental health as well.

Additionally, more mental health providers should be located in Robeson County. One

study of rural counties and the services for people with serious mental health needs found that

the needs of the community were not being met because there were not enough quality staff

members (Storm et al., 2020). This suggestion for policy makers is due to the fact that Robeson

County has one mental health provider for every 530 residents. This task can be met by offering
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mental health professionals loan forgiveness for those who work in the underserved area (Finley,

2019). Finally, mental health professionals in urban areas can implement tele-practice in order to

reach residents of Robeson County. Very few inpatient psychiatric and substance abuse facilities

are located in rural communities (Finley, 2019).  Individuals in the county who suffer from

serious mental health matters cannot often afford to travel far. Providing telehealth for mentally

ill patients in rural areas results in reports of higher patient satisfaction and efficacy (Finley,

2020). 

Within Robeson County, a lack of physical activity, poor mental health days, and the

ratio among mental health providers per resident is detrimental as it concerns the overall well-

being of each citizen. Between 2002 and 2004, there was a significant decrease of individuals

who reported themselves as being physically inactive. A helpful solution to this is for local

policy makers to create more sidewalks and recreational areas, which can allow access for

physical activity to occur. The average number of reported poor mental health days in Robeson

County was significantly different upon average, showing that Robeson County was 5.2,

compared to 4.1 in North Carolina. Additionally, mental health providers per resident was 530:1,

which is also below average compared to North Carolina’s. Loan forgiveness and tele-practice

for residents is crucial. If the implications above can be met, the well-being of the residents can

improve.
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Resources

Finley, B. (2019). Psychiatric mental health nurse practitioners meeting rural mental health

challenges. Journal of the American Psychiatric Nurses Association, https://doi-

org.libproxy.lib.unc.edu/10.1177/1078390319886357

Harris, M. (2018). The relationship between physical inactivity and mental wellbeing: Findings

from a gamification-based community-wide physical activity intervention. Health

Psychology Open, 5(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774736/ 

Storm, M., Gill, E., Bruce, M., Fortuna, K., Pincus, H., & Bartels, S. (2020). Coordination of

services for people with serious mental illness and general medical conditions:

perspectives from rural Northeastern United States. Psychiatric Rehabilitation Journal,

43(3), 234-243. http://dx.doi.org/10.1037/prj0000404

Tamminen, N., Reinikainen, J., Schmidlechner, K., Borodulin, K., Opas, T., & Solin, P. (2020).

Associations of physical activity with positive mental health: a population-based study.

Mental Health and Physical Activity, 18, https://doi.org/10.1016/j.mhpa.2020.100319

University of Wisconsin Population Health Institute. (2020). County Health Ratings.

https://www.countyhealthrankings.org/.