Rural suicide--people or place effects?
OBJECTIVE
To examine factors that may contribute to elevated rates of suicide among rural communities in Australia.


METHODS
A wide-ranging literature search reviewed possible factors that may contribute to the geographical variation in suicide. Literature was organized to enable examination of compositional and contextual explanations, as well as collective social functioning and social practices.


RESULTS
A variety of factors may contribute to elevated rates of suicide in rural compared with urban areas. Collective and contextual (place) factors seem to be of particular importance as possible contributors to the elevated rate of suicide among rural males. These include rural socioeconomic decline; facilitators and barriers to service utilization such as service availability and accessibility, rural culture, community attitudes to mental illness and help seeking; and exposure to firearms.


CONCLUSIONS
Compositional, contextual and collective factors are hypothesized to influence the elevated rate of suicide in rural compared with urban areas. These factors need to be tested in empirical studies that consider both individual and community-based risk factors, and are designed to enable exploration of likely within-rural differences.
Centre for Rural Mental Health, Monash University School of Psychology, Psychiatry and Psychological Medicine and Bendigo Health Group, Victoria, Australia. fjudd@bendigohealth.org.au
Fiona
F
Judd
Anne-Marie
AM
Cooper
Caitlin
C
Fraser
Julian
J
Davis
D001315:Australia; D002423:Cause of Death; D006801:Humans; D007398:Interpersonal Relations; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012931:Social Environment; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data