In the past, rural teens have been more likely to kill themselves as compared to their urban counterparts. Is the same true today, now that technology has woven us together more tightly? Sadly and surprisingly yes: Between the years 1996 and 2010, a new study finds, the rates of suicide among teens and young-adults ranged twice as high in country settings compared to city areas. In fact, the suicide rate in rural areas is nearly double that in cities... and rising.

Constantly, we are told that technology has made us more connected — certainly the Internet has improved our ability to access knowledge and culture, and so today we more easily bridge the potential differences between countries, continents, languages, and cultures. In fact, anyone with a computer and an Internet connection can view a class in biology at UC Berkeley or learn about ancient Greek culture at Yale. For those of a more artistic bent, movies can be made (and promoted) with a simple smartphone while an endless number of instructional YouTube videos exist for those wishing to learn how to draw, paint, or throw pottery. There would seem to be no reason anyone would feel hopeless — ever.

Sadly, this is not the case, as researchers from The Ohio State University Wexner Medical Center discovered.

"We were not surprised by the higher rates in rural areas," Dr. Cynthia Fontanella, clinical assistant professor of psychiatry and behavioral health and lead author of the study, told Medical Daily in an email. "What was surprising is that the gap/disparity is widening over time. As for the advances in technology, although more technology is available, the 'playing field' is not necessarily level due to differences in the culture surrounding rural life." By this she meant country folk more than city folk may be influenced by the stigma surrounding mental health and a perceived need to be self reliant. "This is much slower to change than the technology," Fontanella commented.

Isolation

An analysis of data derived from the National Center for Health Statistics found, for people between the ages of 10 and 24 in the United States, “suicide was the third leading cause of death in 2010 behind only unintentional injuries and homicide,” stated the authors of the newly published research. From 1996 through 2010, 66,595 young people between age 10 and 24 died by suicide. Probing these numbers, the researchers discovered the rural versus urban suicide rate among males was nearly 20 and 10 for every 100,000, respectively, and for females, slightly more than 4 and 2 for every 100,000, respectively. A little more than half (51.1 percent) of all suicides involved a gun, while a third (33.9 percent) died by hanging; disproportionately, more rural youths killed themselves in these two ways.

Dramatically, suicide rates were found to be four times higher for young men than young women.

The researchers attribute the differences in self-destruction rates as due to rural people having less access to mental health services, more access to lethal means (guns), greater isolation, and the social/economic trends working against them — between 1990 and 2010, for instance, “nonmetropolitan counties lost population through out-migration and decreased birth rates,” noted the authors in their study. No jobs during the recession compelled many to move to cities, with those left behind feeling increasingly isolated. About 90 percent of those who commit suicide suffer from a major psychiatric problem such as depression or bipolar disorder, the researchers say, while substance abuse, which increases impulsivity and messes with mood, factors into many other deaths.

The researchers suggest school-based interventions as well as telemental health — using technology to provide counseling services, say — could help identify those at risk and provide better monitoring.

“Access to mental health care in rural areas is a key issue; many rural counties do not have even one psychiatrist, psychologist or social worker serving the region," Fontanella told Medical Daily. "This lack of access can compound the severity of illness. People living in rural areas have to travel longer distances to see health care practitioners and wait longer for appointments, so by the time they receive care they may have developed more serious conditions.”

Source: Fontanella C, Hiance-Steelesmith DL, Phillips GS, et al. Widening Rural-Urban Disparities in Youth Suicides, United States, 1996-2010. JAMA Pediatrics. 2015.