Rural youth are more likely to land in an emergency room from self-harm, especially from gunshots, study finds

Rural youth are much more likely than their urban counterparts to visit a hospital emergency room after harming themselves, "and when it comes to self-inflicted firearm injuries, the difference is even more pronounced," reports Nara Schoenberg of the Chicago Tribune, citing new research.

"Rural youth in the study were three times more likely to be treated in the emergency room for self-inflicted gunshot wounds than their urban counterparts," Schoenberg reports, quoting Dr. Jennifer Hoffmann, a pediatric emergency medicine physician at Lurie Children’s Hospital in Chicago: “More attention needs to be given to youth mental health, including earlier diagnosis, and more resources need to be invested in rural areas. . . . It’s important that more messaging goes out about safe firearms storage.”

Hoffmann is a co-author of the study, published in the Journal of Pediatrics. It drew a representative sample of youth aged 5 to 19 from a database of 33 million ER visits in 37 states during 2016. It "didn’t examine the reasons for the higher rates of self-harm by firearms in rural America," Schoenberg writes, "but Hoffmann offered several potential explanations based on previous studies, among them that rural households are more likely to contain guns."

On the broader issue of self-harm, Hoffmann said earlier studies suggest that rural rates are higher because rural areas "tend to have greater shortages of mental health professionals and lower household incomes," Schoenberg writes. "Privacy may also be a concern when people in small communities consider seeking mental-health services. Hoffmann called for more mental-health training for pediatricians and school personnel. She also sees promise in telemedicine, which can allow families in rural emergency rooms to consult with psychiatrists from other regions."

Citing studies that show many children who die of suicide visit an ER in the months preceding, "Hoffmann said she would like to see more emergency rooms embrace suicide screenings for young patients ages 10 and up," Schoenberg reports, quoting Hoffmann: “The emergency department is a critical space for identification of suicidal thoughts.”