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VIDEO: Outreach center supports mental health needs of the rural poor

Andy Golebiowski

East Aurora’s image stands as a beacon of what you would expect out of a small town. Iconic shops, famous restaurants, Victorian Homes. But that image masks a daunting reality where trailer parks and poverty are more common. WBFO’s Nick Lippa visited the Rural Outreach Center, an organization that serves southwestern New York and supports the needs of the rural poor, including mental health services.

Rural poverty is known as the invisible poverty. It’s spread across a wide geographic area, making it difficult to receive services even if you want them. Driving around East Aurora with Rural Outreach Center Executive Director Frank Cerny, it’s easy to see how not having a vehicle can be crippling.

“So that in itself creates its own sort of trauma if you will. And as a result of the social isolation and inability to access connections and assistance, it leads to mental illness that ranges from simple anxiety all the way to more diagnosable conditions,” Cerny said. “So mental illness is pretty prevalent in the rural areas.”

The Rural Outreach Center, also known as "The ROC," will often send employees or volunteers to pick up program participants for services back at their facility, an unintimidating large white trailer. It’s there, Cerny said, they can establish trust to address key issues.

“We're not an agency that's going to spend 45 minutes with somebody and send them off. We're not an agency that gives them a handout and then sends them off and expects them to survive on their own. They know that we're cared in their long term well-being,” Cerny said. “On average, it takes six years to move someone out of poverty with some pretty intensive work. So they know we're committed for the long term. We're not just going to push them out the door because we don't have enough time.”

At the ROC, their belief is to help those actively in a whole matter. Whether that be parenting, nutrition, creating financial stability, civic engagement and social skills just to name a few. The first step is working to provide a stable environment.

“We try to understand what their immediate needs are. Whether it's an empty refrigerator or they're going to be evicted next week, or anything like that. So we try to take care of their urgent needs right away,” said Cerny. “But then we very quickly fall into a time where we get them to assess where they're at, what their needs are, what their goals are, and what they need to reach their goals. And then we provide all the resources with over 70 partners that they need to reach their goals. So it's participant-driven. They define their goals, they set their goals, and we provide the resources, whatever they might be, to help them reach those goals.”


“We call them participants for a reason, because we feel like what we ask people to do is to participate in what their goals are and their objectives,” said ROC Social Work Director Maria Knickerbocker who has been with the organization since its formation.

Knickerbocker said they are seeing more and more people open up about accepting help for mental health related issues.

“We offer intensive case management, basic case management services, and then we offer counseling for kids through play therapy, and for adults, and it's on a variety of levels. We're now getting a lot of training in trauma, trauma work. So, we're getting credentialed in that area,” she said.

If you want to get to a mental health agency in Buffalo or Orchard Park from East Aurora, it requires a 30-plus minute drive. Knickerbocker said that’s one reason why many rural residents don’t attempt to get care.

“We see a lot of people with various types of trauma, attachment issues. We work with a lot of people with, say, depression, anxiety, Post-Traumatic Stress Disorder, and they may never have received mental health services,” she said.  

Over 60% of the poverty in Erie County is outside the city of Buffalo. Cerny said it’s a community in need that often feels ignored.

With the need for mental health resources on the rise across the country, WBFO's Nick Lippa spoke with Erie County Mental Health Commissioner Michael Ranney about some of the current challenges and what they're looking at to improve moving forward.

“The rural population, as we saw in the 2016 election, feels absolutely left behind, and statistically, they have been,” Cerny said. “In the rural areas, they still haven't recovered back to 2008 levels. The incidence of suicide, the incidence of substance abuse, the incidence of domestic violence, all of those things are higher in the rural areas. Not in the numbers, but in the percentage, in the incidence.”

Local resident Amy Smith has been talking with Knickerbocker for four years, who she happened to meet at a yard sale. She is currently on disability and said without the ROC, it would be very difficult for anyone to get assistance in the area.

“I speak to Maria on a weekly basis for a basic counseling to help me with my anxiety and trying to get through not being able to work because of injuries and such. She keeps me afloat,” she laughed. “She keeps my smile on.”

Credit Andy Golebiowski / WNED
ROC Social Work Director Maria Knickerbocker in her office

She’s been out of work for the past two and a half years with numerous ailments and had back surgery in January of 2018 before addressing other health concerns.

“After that I had, they called them incisional hernias. The doctor said it looked like I was hit with bird shot in my belly there was so many holes,” Smith said. “So I just had that one done on March 6. But through it all, (the ROC has) done everything they can to be supportive of me here and help me get through all of that.”

Smith has been to other mental health facilities in the past, but always ends back up at the ROC. 

“There are larger facilities that you can get to. They’re not as personal. It’s more of a cookie cutter I tell (Maria), where everything is the same,” she said.

It’s not uncommon for families not to have a car. When they do, Cerny said it’s often one that is only used to get to work.

“In our service are there are just under 3000 people who have no transportation, so think about that. They live in rural area where they're quarter or half mile away from their nearest neighbor. There are no bus lines, no public transportation. And just under 3000 of them have no vehicles. They're really isolated,” Cerny said.

Smith said she’s seen ROC volunteers drive program participants all the way to Rochester for doctor’s appointments.

“This can be your kind of middle man for services if you need them. You can come here and they can kind of help you, guide you. If you have to get downtown for something, they’ve given people rides downtown to get that help,” Smith said. “They really are a big buffer in the community between the services people need and being in the rural community.”

Michael DuFrane, another local resident who comes to the ROC, lives with ADD and battles addiction. He said many in the community feel ashamed to ask for help.

“Too much false pride, man. You know? I mean, we want this picture to be beautiful and happy and things are wonderful, but we're paddling like a duck underneath,” he said.

DuFrane said it wasn’t until a few years ago he was diagnosed with ADD.

“I went through my childhood not knowing what was wrong with reading, this and that. To this day, I still read with something black at the top and I work down because my eyes just want to roll up and I go all over the place,” he said.

His daughter deals with oppositional defiant disorder, ADHD, anxiety and OCD.

“It's an alphabet soup for her, but she has a lot of stuff in her head that's going on; she's busy in her mind,” DuFrane said.

When asked where DuFrane would see himself and his daughter if they didn't have access to the services for mental health—

“It'd be a mess,” DuFrane said.

In order for their programs to work, the ROC believes they should focus on at least two generations.

“My ex-wife worked in the business too so she knew of agencies,” DuFrane said, “what to look for, what not to look for, and if there wasn't places like this out here, a lot of us would really be hurting kids and what do we do? We raise hurt kids and then what are they going to do? They're going to raise hurt kids. So it's the ham bone story. Great-Grandma cut the ham off because the pan was too small, we still do it now just because it was done.”

One thing helping parents and children work on their mental health together? A play therapy program. Knickerbocker said they’ve seen positive results as it’s grown exponentially.

“We're also working with those parents, and the parents will say, ‘I had trauma growing up, but I never received services for it,’ or, ‘I never had the opportunity to get help, but I want a better life for my child. I want them to be able to be in a better place than I'm at, get a better job, work through whatever challenges that they might have.’”

DuFrane said his friend Cliff DeFlyer, co-owner of the well-known shop Vidler’s, encouraged him to reach out.

“When I came I was hurting spiritually, emotionally, financially, everything. So they helped us out, they helped me get into Medicaid, they had somebody take me through it.”

DuFrane’s advice for those on the fence about reaching out for help?

“Reach out. Just step out of your comfort zone. Your sanity is worth it, your child's sanity is worth it, and we're called to do that as parents. That's your job,” he said. “That's our job. Advocate for my child the best that I know how and if I don't know how, I better figure out a way to learn how to, otherwise we're both going to be a mess.”

With more residents overcoming stigma, Cerny said the ROC trailer is running out of room. 

“We do more in one day than we did in a month four years ago. Last year, comparing 2017 to 2018, we increased by 450 percent. So the way I describe it is we've lifted up the rock of rural poverty, and what we've found is ugly and broader than we would have thought.”

Cerny is hoping to move to a larger facility in the future to accommodate the growing need.

“I keep waiting for a plateau and we haven't seen that,” Cerny said. “We have more intakes per week than we had per month, four or five years ago. So number one, we need a facility. We just can't continue to serve the number of people we're serving out of a double wide trailer with an addition. We also need some public support. I don't mean private support, I mean public. Government support if we're offering the services that we do to the counties that we serve.”

In the meantime, Cerny said East Aurora is stepping up to help their neighbors.

“We have over 100 volunteers that come from this immediate area that help us out. We couldn't survive without that. And they are very generous, financially, community. We couldn't survive without that generosity,” he said.

The ROC has been embraced in an area where everybody knows each other. As they grow, their work continues to destigmatize a long-standing issue that impacts all communities— simply asking for help.

The Rural Outreach Center is located at 730 Olean Road, East Aurora, NY 14052. They can be reached at 716-240-2220.

Nick Lippa leads our Arts & Culture Coverage, and is also the lead reporter for the station's Mental Health Initiative, profiling the struggles and triumphs of those who battle mental health issues and the related stigma that can come from it.
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