I can’t say for myself that this has been an issue, but I have lived in very large cities for most of my life.
“Your neighbors don’t have a clue in a city if you’re going to go get some help. But everybody [in a small town] will know if your pickup truck is parked outside of the mental health provider’s office,”
It does bring to mind a conversation I had back over a year ago though with someone dealing with addiction about going to meetings in their hometown. They simply wouldn’t. They’d travel more than an hour out of town to attend a meeting because in the small town where they lived everyone would be “up in my business about it”. Which is one, a failure of the group, but secondly a failure of society. People shouldn’t have to be ashamed to seek help for their mental health. Alas, we aren’t there yet, so people will continue to either avoid getting help, or have to go way out of their way to get it.
All that to avoid being embarrassed by something that 25% of the population deals with at one time or another. That’s stigma for you.