Rural and remote communities and suicide Fact Sheet

Suicide rates are higher in Canada’s rural areas (Hirsch & Cukrowicz, 2014; Barry et al., 2020). People there also experience poorer health, lower life expectancy, and are less likely to have their healthcare needs met (Eckert et al., 2004)

Why are people in rural and remote communities at risk?

Certain factors can place some people at a higher risk for suicide than others, and when multiple risk factors outweigh those that build resiliency, the likelihood that a person may think about suicide increases (Sharam et al., 2021).

• Issues of confidentiality: People living in rural and remote communities may be reluctant to seek help when it relates to their mental health, as they may have concerns about confidentiality in smaller rural settings, where a person’s neighbour could also be their counsellor.
• Easy access to firearms: Gun ownership is far more prevalent in rural areas compared to urban areas, and firearms are the most lethal suicide method (Arnautovska et al., 2014; Morgan et al., 2016; Jones-Bitton et al., 2020).
• Isolation: Rural and remote communities can be small and tight knit but also sparsely populated, which means fewer resources that can offer support and connection. The same wide-open spaces that many people enjoy may contribute to feelings of isolation or disconnection, depending on the circumstances. People feeling isolated or depressed need to know they don’t have to feel that way. Support is available.
• Access to mental health services: Smaller communities typically have fewer mental health professionals or limited access to other infrastructure like recovery centres and psychiatric wards. They may also have limited access to high-speed internet which is a barrier to accessing virtual services (Innovation, Science and Economic Development Canada, 2019). Services delivered by phone can be a helpful alternative.
• Being seen as less of a priority: Rural and remote communities may receive fewer resources from governments for mental health services. Many people feel that not enough has been done at the government level to acknowledge these populations as a priority for these services.
• Rugged individualism: People living in rural settings may have been socialized to be independent and self-reliant. These traits could possibly make some people reluctant to seek help, believing that their problems are their own to fix. Yet this is a tendency that may lead to negative coping mechanisms and ultimately result in suicide (Creighton et al., 2017; Hirsch & Cukrowicz, 2014).

Rural priority populations

As outlined below, certain rural and remote populations may be more likely to consider suicide due to additional factors not experienced by others. Governments need to address the mental and physical health needs of these priority populations, and make services for them accessible, i.e., easy to get to, easy to find, confidential, and inexpensive. People who work with these populations should also be trained in suicide prevention.

• Older adults: Older adults, especially men, have high rates of suicide in rural areas (and in general). They are also more likely to own firearms than those living in urban areas, something that increases their risk of suicide. The fact that they may have spent their working years in individualized, isolated, demanding careers, such as farming or ranching, makes it less likely that they will reach out for help. The chronic shortage of mental health professionals trained to help older adults in rural areas makes getting the right kind of support even more difficult (Gomez et al., 2020; Neufeld et al., 2015; Arbore, 2019).
• People in sexual and gender minorities: People living in rural and remote communities who identify as 2SLGBTQ+, especially those who are young, may be more likely to consider suicide, as they may struggle to feel a sense of belonging and community. They may also be more likely to face discrimination in their communities (including schools and the healthcare system). In addition, health and mental health services to meet their specific needs may be less accessible (Rhodes et al., 2018; Israel et al., 2017).
• Young people: Access to in-person mental health services is often limited in rural and remote communities, and for young people, who are generally less likely to access these services, getting professional help may be even harder. Since those willing to seek out these services may not have the financial means or transportation to access them, they may not be able to find help when they are struggling and considering suicide (Rhodes et al., 2018).
• Men: Men die by suicide three times as often as women, and much of this is due to their socialization. Because of it, men – especially those living in rural and remote communities – may be more likely to suppress their emotions and not seek help. Young men in rural communities are also more likely than those in urban centres to die by suicide due to the same kind of socialization (Creighton et al., 2017).