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The Journal Gazette

  • Khubchandani

Friday, December 07, 2018 1:00 am

Rural suicide rate getting insufficient attention

Jagdish Khubchandani

Jagdish Khubchandani is an associate professor of health science at Ball State University.

While the highly publicized suicides of celebrities shocked America in 2018, rural areas are suffering the most. Each year, thousands of Americans in small towns take their own lives after suffering – often for years – without adequate access to mental health professionals.

I recently led a research team to investigate why people in small-town America are dying in frighteningly high numbers. In our report, “Rural Mental Health Professionals' Perspectives on Workforce Issues,” 95 percent of mental health professionals in rural communities who were surveyed said they can't meet the needs of people in their communities.

In addition, 90 percent said it was difficult to recruit and retain qualified professionals. The main reasons were the inability to pay competitive wages and to provide professional development opportunities. The majority also reported that mental health issues in their communities are not well researched and known, nor is there an accurate assessment of the number of mentally ill people in their area of practice.

The suicide rate is an indicator of social and emotional wellness of a society, which is probably at its lowest point in relation to health and wellness. Suicide is now a leading cause of death in Americans, with firearms implicated in a majority of such cases. With guns as a fixture in rural areas, access to death is often easy and quick.

But even if rural Americans had access to mental health facilities, help may not come quickly enough for some. According to the Centers for Disease Control and Prevention, nearly 45,000 Americans lost their lives to suicide in 2016. The CDC suggests that the majority of those who died of suicide in 2016 did not have a known mental illness.

Not all the individuals who died by suicide showed clear signs of distress to people around them. Increasing loneliness, relationship issues and high rates of divorce, rising rates of substance and opioid use, increases in chronic disease, poor health/disability, and financial and legal issues all contribute to the rising suicide rate in the United States.

For that reason, suicide prevention should be a national priority for schools, employers, faith-based organizations, communities and individuals. Health care professionals also have a key role in addressing mental illness.

Over the past decade at Ball State, we found that most American mental health professionals were not adequately trained on preventing gun-related suicides. Mental health care providers said their high-risk patients had easy access to guns.

In our studies with school personnel, most did not have the time to assist students struggling with interpersonal violence, another cause of suicidal ideation. Among employers, similarly, harassment and job insecurity are significant contributors to poor mental health.

Prevention efforts focused on youth can reap high benefits. Frustratingly, despite recommendations from national organizations, health care providers find it difficult to screen for depression and anxiety, both of which have been strongly linked with suicide.

It is time our elected officials and leaders of health care organizations examine a system that is no longer able to serve rural Americans.

In an era when drug use is skyrocketing in small communities, we should re-examine our priorities to stop more people from dying.