Health care crisis: Study finds rural Americans most vulnerable to suicide

Published 9:31 am Wednesday, July 11, 2018

By Jagdish Khubchandani
While the highly publicized deaths of celebrities have shocked America in recent weeks, 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 mental health 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.
Suicide rates are 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 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, it may not come quickly enough for some. According to the Centers for Disease Control (CDC), nearly 45,000 Americans lost their lost their life to suicide in 2016. The CDC suggests that 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 general health/physical health issues/disability, and financial and legal issues all contribute to rising suicide rates in the United States.
For that very reason, suicide prevention should be a national priority with schools, worksites, faith-based organizations, communities and individuals. Health care professionals also have a key role in addressing mental illnesses.
Over the last 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 that 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. In the worksites, 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 suicides.
It is time our elected officials and leaders of health care organizations examine the very 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.
(Jagdish Khubchandani is an associate professor of health science at Ball State University.)

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