Suicide and mental health in rural, remote and metropolitan areas in Australia.
To compare the prevalence of mental health disorders and the use of professional help by area of residence, age and sex; and to determine whether the differences parallel differences in suicide rates.



Retrospective cross-sectional analysis of Australian national mortality data (1997-2000) and the National Survey of Mental Health and Wellbeing (1997), using broad area-of-residence classifications based on the Rural, Remote and Metropolitan Area (RRMA) index.



(a) Suicide rates; (b) prevalence of depression, anxiety and substance-use disorders; and (c) use of health professionals for mental health problems - by age, sex and area of residence.



Higher suicide rates were evident for men, particularly young men in rural (40.4 per 100 000; z, 3.2) and remote (51.7 per 100 000; z, 7.2) populations compared with metropolitan (31.8 per 100 000) populations. Although the proportion of young men reporting mental health disorders did not differ significantly between rural (23.5%; z, -0.5) and remote (18.8%; z, -1.6) areas compared with metropolitan (25.6%) areas, young men with a mental health disorder from non-metropolitan areas were significantly less likely than those from metropolitan areas to seek professional help for a mental health disorder (11.4% v 25.2%; z, -2.2).



There is a need to investigate why young men in non-metropolitan areas, the population with the greatest suicide risk, do and do not engage with mental health services.
Caldwell
Tanya M
TM
Centre for Mental Health Research, Australian National University, Canberra, ACT. Tanya.Caldwell@sahs.nsw.gov.au.
Jorm
Anthony F
AF
Dear
Keith B G
KB
D000328:Adult; D017677:Age Distribution; D000368:Aged; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008507:Medically Underserved Area; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008603:Mental Health; D008875:Middle Aged; D009517:New South Wales; D012189:Retrospective Studies; D018570:Risk Assessment; D012424:Rural Population; D017678:Sex Distribution; D012931:Social Environment; D013405:Suicide / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D016019:Survival Analysis; D014505:Urban Population