Rural and remote mental health in Canada: Evidence brief on best and promising practices

Rural and remote communities in Canada face unique challenges in providing access to quality mental health services. People in these communities must often travel great distances to get the help they need. Where services do exist, they are frequently stretched thin, with long wait lists, high turnover rates, and poor communications infrastructures (despite the increased […]

The impact of COVID-19 on rural and remote mental health and substance use

This policy brief provides an overview of the developing issues and unique mental health and substance use challenges that COVID-19 poses for rural and remote communities. It builds on a preliminary scan the Mental Health Commission of Canada (MHCC) completed at the outset of the pandemic and on an evidence brief on best and promising practices written just before […]

Health needs for suicide prevention and acceptance of e-mental health interventions in adolescents and young adults: Qualitative study

Background: Adolescence is a phase of higher vulnerability for suicidal behavior. In Germany, almost 500 adolescents and young adults aged 15-25 years commit suicide each year. Youths in rural areas are characterized by a higher likelihood of poorer mental health. In rural areas, appropriate support for adolescents and young adults in mental health crises is […]

Help-seeking behavior among adults who attempted or died by suicide in Ontario, Canada

Introduction This study aims to determine the relationship between rurality and help-seeking behavior prior to a suicide or suicide attempt. Methods Data from 2007 to 2017 were obtained from administrative databases held at ICES, which capture all hospital, emergency department (ED), and general practitioner (GP) visits across Ontario. Rurality was defined using the Rurality Index […]

A review of strategies and interventions for suicide prevention in the rural United States

Suicide is a leading cause of death in the United States, with people living in rural areas disproportionately impacted by higher suicide rates. Limited access to healthcare, poorer socioeconomic conditions, stigma surrounding mental health treatment, and greater access to firearms all contribute to increased rates of suicide in rural communities. In this article, the authors […]

Exploring community-based suicide prevention in the context of rural Australia: A qualitative study

Suicide rates in rural communities are higher than in urban areas, and communities play a crucial role in suicide prevention. This study explores community-based suicide prevention using a qualitative research design. Semi-structured interviews and focus groups asked participants to explore community-based suicide prevention in the context of rural Australia. Participants recruited ((n = 37; ages 29–72, Mean = […]

A community-led suicide prevention initiative for young people in regional and rural Australia: The Live4Life model

Young people living in regional and rural areas of Australia are at an increased risk of suicide and have unique barriers and facilitators to seeking mental health support. As such, specific mental health and suicide prevention programmes that are tailored to young people within their communities are required. Despite this, peer-reviewed literature on such interventions […]

Prevalence and associated factors of suicidal behaviors among Bangladeshi rural community people: Findings from the ‘BD ComMen Study’

Background Suicide is considered as one of the major public health concerns, which can be prevented with cost-effective and timely intervention. In Bangladesh, very few studies assessed the suicidal behavior of rural community people. Thus, this Bangladesh Community Mental Health Study (BD ComMen Study) attempted to understand the current situation of suicidality in Bangladeshi rural […]

Stakeholder insights into implementing a systems‑based suicide prevention program in regional and rural Tasmanian communities

Purpose With emerging evidence indicating that systems-based approaches help optimise suicide prevention efforts, the National Suicide Prevention Trial sought to gather evidence on the appropriateness of these approaches to prevent suicide among at-risk populations, in regional and rural communities throughout Australia. The Tasmanian component of the Trial implemented the LifeSpan systems framework across three distinct […]

Influence of contextual factors on death by suicide in rural and urban settings

Purpose To examine the association between contextual factors, represented by geographic and community health variables, and suicide among rural and urban Department of Veterans Affairs health care users (VA users). Methods We performed a retrospective cohort study of 12,700,847 VA users between 2003 and 2017. We assigned contextual factors based on individuals’ home address at […]

Together with veterans: VA national strategy alignment and lessons learned from community-based suicide prevention for rural veterans

Background Rural veterans are at increased risk for dying by suicide compared with urban veterans, yet interventions for preventing suicide among rural veterans have been limited. Objectives (1) Describe how Together With Veterans (TWV), a community-based intervention to prevent suicide among veterans in rural communities, aligns with the VA National Strategy for Preventing Veteran Suicide; […]

Reducing rural veteran suicides: Navigating geospatial and community contexts for scaling up a national Veterans Affairs program

Objective To develop and use planning maps to prioritize and facilitate county-level recruitment for Together With Veterans (TWV), community-based rural Veteran suicide prevention program. Method Choropleth maps were created for 49 U.S. states, with four mutually exclusive categories indicating eligibility for the TWV program and increasing levels of need assigned to each county based on […]

Mental health first aid training for extension agents in rural communities

Objective The goal of the current study is to evaluate the effectiveness of Mental Health First Aid (MHFA) in broadening the network of gatekeepers in rural communities. Method Extension agents in Mississippi who completed MHFA training were recruited via email to participate in a 22-item, web-based, quantitative and qualitative, six-month follow-up survey that measured demographic […]

Strength in numbers: The promise of community-based participatory research in rural education

Montana is a state that is ravaged by a suicide epidemic and mental health crisis, particularly among its youth. In an area in which harsh climates, geographic challenges, and distance to rural healthcare providers are significant barriers to mental healthcare accessibility, educators are faced with the acute social and emotional challenges of their students on […]

The role of social work in confronting the farmer suicide crisis: Best practice recommendations and a call to action

Although estimates of prevalence vary, suicide rates among farmers are high and pose an important challenge for mental health policy and practice. The lack of mental health resources in many rural communities is a significant barrier to improving farmer mental health outcomes. The current paper will review (1) current findings related to the psychosocial functioning […]

Men, suicide, and family and interpersonal violence: A mixed methods exploratory study

Research has shown a link between gender, violence, and suicide. This relationship is complex, and few empirical studies have explored suicide and family and interpersonal violence perpetrated by men. Drawing on a coronial dataset of suicide cases and a mixed  methods design, this study integrated a quantitative analysis of 155 suicide cases with a qualitative […]

Mental health service use, suicide behavior, and emergency department visits among rural US veterans who received video-enabled tablets during the COVID-19 pandemic

Objective  To evaluate the association between the escalated distribution of the US Department of Veterans Affairs’ (VA’s) video-enabled tablets during the COVID-19 pandemic and rural veterans’ mental health service use and suicide-related outcomes. Design, Setting, and Participants  This retrospective cohort study included rural veterans who had at least 1 VA mental health care visit in calendar year […]

Relationship among social capital, employment uncertainty, anxiety, and suicidal behaviors: A chained multi-mediator mediation modeling analysis

Objective Social capital is a significant predictor of suicidal behaviors among Chinese rural migrants. However, the mechanism, including the impact of employment and mental health, has not been fully understood. This study aims to examine the complex relationships linking social capital to suicidal behaviors. Method Data were collected from a probability sample (n = 1,245) of rural […]

Beliefs about causal factors for suicide in rural Alaska Native communities and recommendations for prevention

Rural Indigenous communities in Alaska suffer staggeringly high rates of suicide. In close-knit Alaska Native villages, each suicide leaves a trail of affected family and community members in its wake. This research aimed to understand community perceptions of what causes suicide in rural Alaska Native villages and generate recommendations for prevention strategies. In-depth interviews were […]

The bounds of suicide talk: Implications for qualitative suicide research

Following the implementation of a provincial suicide prevention gatekeeper training initiative in western Canada between 2015 and 2018, we conducted a focused ethnography designed to capture the post-initiative context within one small community. Analyses of our field observations and interviews with community members suggest suicide prevention work is represented in multiple informal or coordinated actions […]

Assessment of rural-urban and geospatial differences in perceived handgun access and reported suicidality among youth in Colorado

Objectives  To understand the associations of rurality, school-level prevalence of easy handgun access, and suicidality measures in Colorado youth, to explore spatial distribution of school-level measures, and to identify communities with high prevalence of both easy handgun access and suicidality. Design, Setting, and Participants  This cross-sectional study used data from the 2019 Healthy Kids Colorado Survey, an […]

“A country boy can survive:” Rural culture and male-targeted suicide prevention messaging

The low rate of help-seeking and high rate of suicide completion among men has prompted public health officials to create suicide prevention campaigns that specifically target men. Drawing from data collected as part of a larger study of fire recovery in a rural county in Northern California, this paper utilizes 68 interviews with fire survivors […]

Analysis of suicide after cancer diagnosis by US county-level income and rural vs urban designation, 2000-2016

Objective  To examine whether the risks and patterns of suicide mortality among people with a cancer diagnosis differ by US county-level median income and rural or urban status. Design, Setting, and Participants  A retrospective, population-based cohort study following up individuals who were diagnosed with cancer between January 1, 2000, and December 31, 2016, was conducted. The Surveillance, […]