“With the free bus, you didn't have to worry”: Mental wellbeing impacts of a free intercity transportation service in Canada

Public transportation is a key social determinant of health, and its absence can reduce mobility and erode social connections—placing a disproportionate burden on the mental wellbeing of equity-deserving populations. While the link between transportation and health is recognized, the specific mental health impacts of transportation access remain underexplored. This study addresses that gap by examining the mental health impacts of the first universally free rural intercity transportation initiative in Saskatchewan, Canada. We employed a qualitative case study design. Data were collected through semi-structured interviews with 43 participants (37 bus riders, 6 operational staff) and six conversation circles involving 18 participants in northern Saskatchewan. Informed by theories of structural violence and Indigenous self-determination, we used NVivo 14 software to conduct a hybrid deductive–inductive thematic analysis to generate themes and subthemes. We identified two sets of themes revealing how the free bus service promoted riders' mental health. The first set of themes reflected mental wellbeing improvements while the service was operational, including enhanced psychological wellbeing, increased autonomy, reduced stress, and strengthened social ties—anchored in a sense of safety and dignity. The second set captured the consequences of the service's abrupt closure: heightened anxiety, increased social isolation, and feelings of abandonment and government neglect steeped in racism. Affordable, accessible transportation is vital to mental wellbeing. Free, reliable public transportation reduces isolation and fosters wellbeing, while its absence—particularly in rural and marginalized communities can exacerbate social exclusion and psychological distress. • Lack of transportation is perceived as a form of racism and structural violence. • Lack of transportation in rural parts of Canada is connected with stress and a sense of alienation. • Free transportation improves mental wellbeing in rural communities. • Free transportation supports autonomy, independence and dignity for vulnerable community members.