Community-based Suicide Interventions in Rural United States: A Scoping Review

Area of Science:

• Public Health
• Mental Health Research
• Rural Health Disparities

Background:

• Rural communities in the US experience higher suicide rates compared to non-rural areas.
• Structural and cultural barriers impede access to care for individuals at risk of suicide in rural settings.
• Community-based interventions are needed to address the unique needs of rural populations.

Purpose of the Study:

• To conduct a scoping review of the literature on suicide prevention in rural US communities.
• To evaluate the current state-of-the-science regarding rural suicide prevention programming.
• To identify trends, gaps, and emergent themes in existing research.

Main Methods:

• Adherence to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines.
• Systematic literature search across four databases with dual screening and extraction.
• Extraction of data on article characteristics, program descriptions, and methodologies from 29 included articles.

Main Results:

• Studies predominantly focused on youth suicide prevention, particularly within Indigenous communities, medical settings, and among US veterans.
• A wide range of intervention and evaluation approaches were utilized, but few studies measured clinical outcomes or used theoretical frameworks.
• Limited use of official rural definitions and comprehensive prevention strategies was observed.
• A significant dearth of literature on prevention programming in rural US areas was identified.

Conclusions:

• The review provides a guide to the existing evidence base and patterns in rural US suicide prevention.
• There is a critical need for more research on suicide prevention programming tailored to rural contexts.
• Future research should incorporate context-specific rural classifications, measure relevant clinical outcomes, and employ comprehensive, theory-backed strategies.