Rural suicide rate in state at crisis level
RENO -- Officials hope technology, newly licensed counselors, partnerships with higher education and community education about suicide will reduce deaths and improve the quality of life for rural Nevadans.
Nevadans in the 15 rural counties, excluding Washoe and Clark, commit suicide at a rate more than double the national rate. In 2004, the most recent year for which data are available, 27 out of every 100,000 people in the state's rural counties killed themselves. The rate for the state and Washoe County was 19 per 100,000. The national rate was 11 per 100,000.
Officials said a precise reason for the high rate is unknown, but lack of mental health professionals, distance between communities, and the stigma of seeking treatment all contribute to the problem.
As the state faces its worst budget crisis in decades, health officials are hoping rural mental health clinics can be spared drastic cuts.
Rural clinics already are understaffed and cannot recruit for vacant positions, creating a waiting list of up to a year for patients who need to see a mental health counselor, officials said.
Nevada is trying to address mental health needs in rural areas with an Internet-based program called telemedicine, which connects patients to a psychiatrist through a Web camera, the Reno Gazette-Journal reported.
Last year legislators enacted a law to license new mental health counselors and partnered with state colleges and universities to create academic programs specific to rural mental health.
Officials said the problems of rural mental health extend throughout the country, and other states have addressed them in a variety of ways.
The Sowing the Seeds of Hope program established in 1999 in seven Midwest states works to make citizens comfortable seeking help in privacy. In Iowa, Kansas, Nebraska, Wisconsin, Minnesota and North and South Dakota, statewide hot lines are staffed by mental health professionals trained on agricultural issues faced by the citizens. The professionals then direct callers to resources.
Sowing the Seeds of Hope includes outreach workers who go to homes, assess needs and refer residents to services, coordinator Michael Rosmann said.
"Historically, the problem with behavioral health in rural areas has been attributed to its few providers, but the culture is one of reluctance to reach out," Rosmann said. "They think if they ask for help, it's a sign of weakness or their neighbor will find out.
"What we've done is try to present behavior health treatment in a way that people are comfortable with accessing help."
Alaska, the national leader in suicides, is mostly rural communities. Many parts of Alaska are accessible only by boat or aircraft.
Ron Adler, chief executive officer and executive director of the Alaska Psychiatric Institute, said the state also has a shortage of professionals, especially to treat children.
Adler said the state has used telemedicine for about 20 years. In the last five years, video-conferencing was added for assessments and patient sessions with psychiatrists at eight rural clinic hubs throughout the state.
"We find that children and adolescents are adaptable to the technology while adults are initially apprehensive, but are grateful after the services are rendered," Adler said. "Without a question this is the next step in providing greater access to treatment to people in rural and frontier communities."
