“[T]he gap in rates between less urban and more urban areas widened over time, and rates in medium metro, small metro, and non-metro areas increased at a more rapid pace beginning in 2007–2008,” wrote Scott Kegler, Ph.D., of the CDC’s Division of Analysis, Research, and Practice Integration, and two colleagues in Morbidity and Mortality Weekly Report.
Overall rates rose from an average of 12.6 per 100,000 in 1999-2007 to an average of 14.4 per 100,000 in 2008-2015. However, rates jumped from about 15/100,000 in rural areas in 1999 to about 22/100,000 in 2015. In large central metropolitan areas, the rate went from about 11/100,000 to 12/100,000.
Kegler and colleagues suggested that some of the factors associated with the disparity were shortages of clinicians in less urban areas, as well as limited access to mental health care, social isolation, and the effects of the opioid overdose epidemic and the 2007-2009 economic recession (which struck rural areas especially hard).
“There is a growing need for comprehensive suicide prevention employing a broad public health approach,” they concluded. Besides general anti-suicide strategies, additional help for rural areas might include increasing the number of health care providers through incentives, expanding the use of telepsychiatry, and promoting social connectedness.
For more in Psychiatric News about rural suicide prevention, see “Understanding Access to Means of Suicide Opens Door to Prevention.” See also "Preventing Suicide: A Technical Package of Policies, Programs, and Practices" from the CDC.