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 review the various suicide prevention programs that have been implemented in rural patient populations across the United States. Studies that evaluated the impact of an intervention on mental health outcomes or suicide risk in a rural patient population were included in this narrative review. Suicide prevention strategies are categorized by type of intervention or program, including telehealth services, digital health initiatives, post-hospitalization outreach, and community-based interventions for at-risk patients. Findings from existing studies are synthesized. While the literature on rural suicide prevention programs is limited, studies to date suggest that community-based strategies with wrap-around services and telehealth programs that increase rural access to mental health care may be most effective for alleviating the burden of suicide in rural communities. Longer-term research studies in rural populations that measure suicide rates pre- and post-intervention are needed to inform future research, health policies, and clinical interventions.