A scoping review of community-based suicide interventions in rural United States
Abstract
Background: Rural communities in the United States (US) are disproportionately burdened with higher suicide rates than non-rural ones. They often suffer from structural and cultural barriers, making it less likely for suicidal individuals to obtain help (e.g., fewer trained mental health professionals, transportation challenges, stigma). With 75% of its counties being rural, Georgia is highly impacted by these trends. Few prevention programs are adapted for and/or evaluated in rural settings, with no review synthesizing US prevention efforts in this area. To facilitate increased adaptation/implementation of rural suicide prevention programming, we conducted a scoping review of the literature to evaluate the state-of-the-science and identify gaps.
Methods: Utilizing PRISMA-ScR guidelines, we identified relevant literature on rural suicide prevention efforts across four databases. Using dual screening/extraction throughout, we included peer-reviewed, original research articles in English studying any program/intervention/service implemented in a rural setting, targeted suicide as a primary aim, and were community-based in scope (i.e., excluded policy and individualized/family treatment). We extracted information on population (e.g., youth, veterans), program type/components, and effectiveness/implementation outcomes, and identified trends and emergent themes.
Results: After title/abstract screening 1699 articles, 53 went to full-text review. Of the final sample of 29 articles, most focused on youth (62.1%), particularly AI/AN youth (34.5%), followed by veterans (10.3%). Over half (58.6%) focused on process/implementation outcomes rather than evaluating program effectiveness in reducing suicidality. While a range of strategies/programs were used, few approaches focused on postvention strategies or reducing access to means.
Conclusion: Results highlight the dearth of literature on prevention programming in rural US settings, particularly for generalized populations. Community-academic partnerships should evaluate existing efforts. Future research should focus on additional at-risk populations. Our study offers investigators a guide to the existing evidence base and growing patterns in the field of suicide prevention in a much-needed yet overlooked area of study.
Keywords
Suicide prevention; rural health disparities; community-based programming; evidence-based practices; literature review
A scoping review of community-based suicide interventions in rural United States
Background: Rural communities in the United States (US) are disproportionately burdened with higher suicide rates than non-rural ones. They often suffer from structural and cultural barriers, making it less likely for suicidal individuals to obtain help (e.g., fewer trained mental health professionals, transportation challenges, stigma). With 75% of its counties being rural, Georgia is highly impacted by these trends. Few prevention programs are adapted for and/or evaluated in rural settings, with no review synthesizing US prevention efforts in this area. To facilitate increased adaptation/implementation of rural suicide prevention programming, we conducted a scoping review of the literature to evaluate the state-of-the-science and identify gaps.
Methods: Utilizing PRISMA-ScR guidelines, we identified relevant literature on rural suicide prevention efforts across four databases. Using dual screening/extraction throughout, we included peer-reviewed, original research articles in English studying any program/intervention/service implemented in a rural setting, targeted suicide as a primary aim, and were community-based in scope (i.e., excluded policy and individualized/family treatment). We extracted information on population (e.g., youth, veterans), program type/components, and effectiveness/implementation outcomes, and identified trends and emergent themes.
Results: After title/abstract screening 1699 articles, 53 went to full-text review. Of the final sample of 29 articles, most focused on youth (62.1%), particularly AI/AN youth (34.5%), followed by veterans (10.3%). Over half (58.6%) focused on process/implementation outcomes rather than evaluating program effectiveness in reducing suicidality. While a range of strategies/programs were used, few approaches focused on postvention strategies or reducing access to means.
Conclusion: Results highlight the dearth of literature on prevention programming in rural US settings, particularly for generalized populations. Community-academic partnerships should evaluate existing efforts. Future research should focus on additional at-risk populations. Our study offers investigators a guide to the existing evidence base and growing patterns in the field of suicide prevention in a much-needed yet overlooked area of study.
