Suicide can cause significant distress in rural and remote communities. These communities are often small and interconnected which means that suicide can affect everyone. In rural areas that are less close-knit, suicide can cause trauma that is experienced in isolation, and without accessible or trusted support.
About suicide in rural and remote contexts
In recent years, the suicide rate among people living in rural, regional and remote communities has been 50% higher than in Australia’s major cities, and it has risen at a more rapid rate. This has been especially the case for Aboriginal and Torres Strait Islander peoples, as well as farmers, older people and younger men. Research has shown that, on average, remote Australians take their own lives at twice the rate of city people, yet are only able to access mental health services at a fifth of the rate of people living in cities.
While rural communities are diverse in terms of size, location, age and cultural makeup, a range of mental health, economic and service-related factors mean that rural-dwelling Australians are at greater risk of suicide and self-harm.
Importantly, residents of rural areas can face many adverse circumstances such as climate and economic factors that are largely beyond their control. The impact of drought, fire and floods can be traumatic and can affect both economic security and community wellbeing. For people who own or work on farms, the financial impact of adverse weather events can be very high, and it can have flow-on effects to local businesses and employment. When such events create long-term uncertainty, rural populations may decline and essential services may be progressively withdrawn. For those people who remain in rural areas, job insecurity and diminishing employment options can create significant stress for both individuals and families, increasing the risk of suicide and self-harm.
Isolation is also a key issue facing rural and remote communities. For farmers and farm workers, as well as those who drive or shear away from home, isolation from supports such as friends and family can be harmful to their mental health. When individuals do experience distress, a sense they should be ‘stoic’ and that time off would only ‘make matters worse’ can make seeking help difficult.
A strong sense of self-sufficiency amongst rural and remote communities can also discourage some people from seeking help. For people who do look for support, a lack of accessible services and trained medical specialists can be a big barrier, and they may be reluctant to access services that are not based in rural areas, because they may feel their experience is not understood. It has been suggested that this is a particular issue facing men in rural areas. However, recent research has shown that men will look for help, but who men ask for help and how that help is provided actually has the biggest impact on the effectiveness of the support they receive.
Poor access to support services can impact on all aspects of health and wellbeing, and this contributes to higher mortality rates, lower life expectancy and higher prevalence of mental health issues in rural communities. In young people, individual characteristics can combine with other factors including unrecognised or untreated depression, alcohol and other drug misuse and alienation due to issues around sexuality, identity and loneliness to make them particularly vulnerable.
For older people, a lack of easy access to services can contribute to feelings of stigma around seeking mental health support and so the identification and treatment of mental health concerns can be delayed or missed altogether. While the closeness of many rural communities can be a protective factor, a feeling that everyone ‘knows your business’ can, at times, serve as a barrier to crisis intervention and suicide prevention.
Grief after suicide in rural communities
Suicide can send shockwaves through families, workplaces and entire rural communities. When a person taking their own life appears to come out of the blue, a sense of shock and disbelief can add an additional layer of distress to rural communities that may already be facing significant economic or social issues. In cases where the mental health of an individual was a concern before their death, loved ones may feel frustrated at the lack of services that were there to support them, or angry that they may have had relatively easy access to the means of ending their life.
It is important to recognise that the social cohesion and informal support networks that often occur in rural and remote settings can mean that the impact of suicide may be far-reaching and complex. For health professionals supporting a community bereaved by suicide, it can be important to understand the effects of stigma that may exist, and to be proactive in providing information about accessing supports. It is also important to be aware of the networks and support services that are available in person or online in rural areas, and to work with employers, clergy and other community leaders to identify individuals whose grief may place them at increased risk of suicide or self-harm.
There are a number of local Suicide Prevention Networks in rural areas which may be able to provide support. To see if there is a Suicide Prevention Network in your area, you can check this list [link to pdf of a list of rural SPNs and their location, but no contact details]. To learn more about your local Suicide Prevention Network, contact the Office of the Chief Psychiatrist at [email protected] or by phone on 8226 1091.