Let’s Stop Suicide in our Rural Communities
Joan Grant Keltner
Suicide is among the top 15 leading causes of death, currently ranking as #11 in the United States (CDC Wonder, 2025) and a high priority in rural American. In fact, suicide rates in rural areas have steadily inclined and almost doubled over the last decade, with rates increasing 46% in more rural and less densely populated locations compared to 27.3% in urban areas. American Indians and Alaska Native people in rural areas have the highest rates of suicide (CDC, 2024). For both males and females, firearms, suffocation, and poisoning are the most common forms of reported suicide. Suicide rates for males are significantly higher than females and those who live in rural areas have 1.5 higher rates for emergency department visits for nonfatal self-harm when compared to their urban counterparts (Garnett et al., 2022).
So how can health providers implement strategies to lessen suicide in their communities? The Suicide Prevention Resource for Action offers strategies, methods for advancing these strategies, and the best evidence to lessen suicide in communities and states (CDC, 2022). Select strategies include:
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Enhancing economic assistance programs (e.g., finances and better housing)
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Promoting safe environments (e.g., lessen access to common methods used for suicide, such as firearms, develop community and organizational policies that enhance and support healthy living, and develop community policies and practices that lessen access to and use of illegal substance use),
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Increasing access to and delivery of suicide prevention programs (e.g., promote health insurance policies to promote coverage of mental health conditions, offer grants and other incentives for health providers, and create emergency help lines and resources),
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Generating healthy connections (e.g., enhance healthy norms by peers, and engage community constituents in shared activities),
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Enhancing coping and problem-solving skill training (e.g., provide social support and resilience programs, offer parenting programs regarding healthy parenting skills and relationships),
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Identifying and assisting suicide-risk individuals (e.g., train gatekeepers such as personnel staffing hotlines in suicide prevention assessment and dialogue, and promptly respond to crises, ensuring safety and follow-up after a suicide), and
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Decreasing potential personal and environmental harms (e.g., intervene after a suicide, using debriefing sessions, counseling, and support groups for surviving friends, family members/significant others; report and message about suicide safely and provide suicide prevention public messaging among community members about warning signs and resources available to help individuals at risk for suicide before a crisis occurs).
We know that to be successful, understanding contributing factors and successful suicide prevention and action efforts must be developed in collaboration with rural community leaders to make them culturally appropriate. Because few treatments ae successful in preventing suicide, programs focused on prevention are key. These programs specifically focus on significant factors in their rural communities that increase the risk of suicide, such as limited financial means and access to firearms. Evidence supports the use of web-based programs that are anonymous and more available in rural areas, with the ability to be expanded (Barnhorst et al., 2021). Together, it takes a community of rural advocates, organizational and policy leaders, and health professionals to address this issue.
References
Barnhorst, A., Gonzales, H., & Asif-Sattar, R. (2021). Suicide prevention efforts in the United States and their effectiveness. Current Opinion in Psychiatry, 34(3), 299–305. https://doi.org/10.1097/YCO.0000000000000682
CDC. (2022). Suicide Prevention Resource for Action: A compilation of the best available evidence. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. https://www.cdc.gov/suicide/pdf/preventionresource.pdf
CDC. (2024, May 16). Suicide in rural America. https://www.cdc.gov/rural-health/php/public-health-strategy/suicide-in-rural-america-prevention-strategies.html
CDC Wonder. (2025). Provisional mortality statistics, 2018 through last week results form: Deaths occurring through February 08, 2025 as of February 16, 2025. https://wonder.cdc.gov/controller/datarequest/D176;jsessionid=9B483D0152104F6CE5EA87902C99
Garnett, M. F., Curtin, S. C., Stone, D.M. (2022). Suicide mortality in the United States, 2000–2020. NCHS Data Brief, no 433. National Center for Health Statistics. 2022. https://dx.doi.org/10.15620/cdc:114217
