The suicide rate in rural America is higher than in urban America.
Reasons include a lack of mental health care, financial stress, isolation, substance abuse and generally greater access to guns. It all adds up to a tragic — and growing — health disparity.
Washington State University is working on new approaches to address the issue, grounded in the university’s mission of service and tradition of outreach to rural communities.
For instance, WSU Extension, a trusted partner with offices in every county of the state and on the Colville Reservation, has offered workshops on mental health and suicide prevention; distributed gun locks; and trained its workforce in mental health first aid. That work led to a big U.S. Department of Agriculture grant to expand rural suicide prevention programs to 13 western states and four U.S. territories.
“My little county extension office is leading farm-stress suicide prevention outreach for the entire West; we’ve got amazing people working on it,” said Don McMoran, who led development of the program as director of the WSU Skagit County Extension office.
Elizabeth Weybright, associate professor and Extension specialist, is wrapping up a review of risk factors for rural/agricultural suicide. “Washington is a national leader when it comes to prevention, but this work historically has not focused on rural and agricultural communities,” she noted.
WSU Health Sciences, with its focus on reaching under-served communities, has many programs for rural health including suicide awareness and prevention.
Janessa Graves, an associate professor at the College of Nursing, participated in a project recently that offered telehealth counseling and therapy services in schools that are too small to have a full-time mental health therapist on staff. More than a third of young people who receive mental health care do so through schools.
The grant-funded pilot program “worked out really well,” Graves said, and offers a roadmap for future school services in rural areas. Graves is now working on community-based research to learn about barriers to accessing mental health care in rural northeastern Washington. “Hopefully that will inform development of an intervention that’s community grounded, not based on ideas from folks in Seattle or Spokane,” she said.
The WSU College of Pharmacy and Pharmaceutical Sciences trains student pharmacists in mental health first aid, which means learning how to assess whether someone is in crisis and learning how to ask questions about suicidal thoughts.
Pharmacists are often present in rural communities, even when a hospital or clinic is not, said Kathryn MacCamy, assistant professor. Pharmacists in such areas have taken on more aspects of primary care and may offer the lowest barrier to mental health care for rural residents.
“Washington is a national leader when it comes to prevention, but this work historically has not focused on rural and agricultural communities.”Elizabeth Weybright
Associate professor and Extension specialist, Washington State University
The College of Pharmacy and Pharmaceutical Sciences recently launched a specialized track for student pharmacists interested in practicing in rural areas and this fall has five students taking part. The “rural health initiative” also includes WSU establishing a residency program to train psychiatric pharmacists after they’ve received their doctorate of pharmacy.
“These programs directly respond to the community needs in rural Washington,” said MacCamy, who is also a board-certified psychiatric pharmacist.
Oladunni Oluwoye, assistant professor at the Elson S. Floyd College of Medicine, is leading one of two pilot projects in the state to offer early intervention services in rural areas and tribal communities for young people experiencing psychosis.
“The more I’ve engaged in this work, the more opportunities I’ve had to speak with families about their pathways to get into mental health services,” Oluwoye said. “But there’s so much more to do,” including creating consistent plans for follow-up after someone has disclosed suicidal thoughts.
McMoran, the Skagit County Extension director, said WSU is well-suited to address suicide awareness and prevention with its variety of colleges and programs and statewide reach.
“I don’t think there are many organizations as well-poised to take on that outreach,” he said.