Many rural states face high suicide rates; Montana governor bucks his party to expand student mental-health screening

Montana Department of Health and Human Services map highlights states with 10 highest suicide rates. (CDC data)

Preventing child and young-adult suicide is a national, uphill battle; in rural states such as Montana, the climb is particularly arduous, reports Keely Larson of Kaiser Health News. "According to the Centers for Disease Control, in 2020, 581 children ages 10 to 14 completed suicide in the U.S.  Suicide rates for those between the ages of 5-14 increased 60% between 1981 and 2010." In Montana in 2011-20 the youth suicide (ages 11-17) rate was 11.9/100,000, "more than double the national rate for the same age group (4.98).," Larson writes. "In 2020, 62% of the youth suicides were by firearms."

Montana has the country's third highest suicide rate, and advocates are working for change. Larson writes, "Beth Nyman works with the Rural Behavioral Health Institute, a Montana-based organization that aims to reduce youth suicides by improving mental health care in rural places. She recently testified for a bill that has been twice rejected this legislative session by the Montana House to use state money to fund free mental health screenings in schools, like those that Rural Behavioral Health Institute provides."

Youth are particularly vulnerable, "One in 5 students will develop a significant mental health problem during their school years, and roughly 7 in 10 students who need mental health treatment will not get appropriate care, according to the Substance Abuse and Mental Health Services Administration," Larson reports. "Screening for behavioral and mental health issues has become more prevalent in schools and can help identify students at risk or in need of intervention, according to SAMHSA."

Suicide continues to be more frequent in Western states where isolation, vitamin D deficiency and firearms all play a part. Rural dwellers face mental health stigmas and a lack of providers. Funding for programs can stall help. Recently, Montana's legislature rejected additional funding sponsored by a Democrat, but "Republican Gov. Greg Gianforte announced a $2.1 million grant to the Rural Behavioral Health Institute to essentially fund free optional mental health and substance abuse screenings for all schools statewide and same-day care for students flagged as being at high risk for suicide," Larson writes. "Republican Rep. Bob Keenan said suicide prevention has developed into an industry with no results to show for it."

Janet Lindow, executive director of the institute, told Larson that screenings are a key component in identifying students who may be at risk of dying by suicide. “This is a way to find those kids who are basically suffering in silence,” Lindow told Larson. Shawna Hite-Jones, a suicide prevention specialist with the Suicide Prevention Resource Center at the University of Oklahoma, told Larson, it’s important to use screenings as part of a comprehensive approach that includes training teachers to recognize suicide risk." Hite-Jones told Larson, "Screenings are a tool that can be helpful for schools if they have the capacity and relationships with mental health providers to make them useful."