Rural law enforcement officers often receive little or no support for frequent on-the-job mental trauma

Police answer calls to tragic events such as school shootings, family annihilation, severe child abuse cases and domestic violence crimes. During those calls, victim care is a primary focus but little attention is given to the psychological trauma law enforcement officers may experience as they manage crime scenes, reports Susan Szuch for the Springfield News-Leader, which covers Ozark news.

It's often hard for police to ask for help, particularly in rural communities where suicide rates are higher, but reaching out for care is stigmatized, according to Szuch. If officers ask for mental support or have psychological struggles, they can be deemed unfit for duty.

Michael Mason

The experiences of Michael Mason, a rural police officer and later Police Chief in Humansville, Missouri, a town with roughly 900 residents, serve as an example. Mason had a hard time processing many of the difficult scenes he had to work. In 2023, he attempted suicide. Afterward, he was "given a choice to get help but be fired and lose his Peace Officer Standards and Training certification, or to resign and keep his credentials," Szuch writes. "Mason chose to resign."

Although Mason moved on from his job loss and landed the police chief position in Humansville, he faced similar challenges and had learned not to ask for help. "He took his own life on Dec. 14, 2025," Szuch reports. "He was one of at least 27 law enforcement officers who died by suicide last year."

While laws and attitudes toward psychological care for law enforcement officers have been slow to shift, some changes have been made. "In 2020, the Law Enforcement Suicide Data Collection Act established a data collection program to 'help agencies understand and prevent suicides,'" Szuch explains. "In 2022, the federal Public Safety Officer Support Act changed its definition for line-of-duty deaths to include suicide, which can affect not only the way the death is discussed but how honors are conferred and what benefits survivors receive."

For officers who want someone to talk to, law enforcement leaders stress the "importance of talking to someone who understands a law enforcement officer’s unique situation and experiences," Szuch reports. "CopLine, a hotline for law enforcement officers run by retired law enforcement officers, offers a free, confidential way for them to talk with someone who understands the trauma and pressures of the job." The phone number for CopLine is 1-800-267-5463 (1-800-COPLINE).

Quick hits: No.1 favorite ice cream; ousting rogue drones; big find by NASA's Curiosity Rover; some good news

Farm Journal graphic, from IDFA National Ice Cream & Frozen Novelty Trends Survey

It's dark and rich and back in the top spot. "Chocolate is back at No. 1 among U.S. ice cream flavors, with butter pecan gaining ground and richer options continuing to rise in popularity, according to a new survey," reports Taylor Leach of Farm Journal. "After briefly ceding the No. 1 spot to vanilla in 2024, chocolate has reclaimed the lead in 2026." Michael Dykes, the International Dairy Foods Association president, told Leach, "Americans’ love for ice cream is as strong as ever." 

The Conversation graph, from Energy Information Administration data

After weeks of surging gasoline prices with no end in sight, some Americans might be wondering what all goes into the cost of a gallon of gas. Robert I. Harris, an energy economist, breaks down gas prices for The Conversation. "The price of a retail gallon of gas is the sum of four things: the cost of crude oil, refining, distribution and marketing, and taxes. . . . In nationwide figures from January 2026, crude oil accounted for about 51% of the pump price, refining roughly 20%, distribution and marketing about 11% and taxes about 18%." Harris adds that since crude oil is the biggest component of gasoline, when its price spikes on the global market, gas prices go up. 

Indiana farmers didn't appreciate drones hovering over
their livestock. (Photo by B. Dittrich, Unsplash)

In rural Indiana, some farming families are "leaning on the law" to keep unwanted drones off their lands, reports Greg Weaver of Indiana Capital Chronicle. "Hoosiers in rural Indiana say drones are unlawfully tracking deer for poachers, inexplicably flying around chicken coops, and increasingly making people uneasy." Although many Indiana farmers considered shooting down the snooping drones, they learned that wasn't legal. "So they’ve found other ways to combat the rascals. . . . Farmers fearful that drones might be spreading disease among livestock recently persuaded the Indiana General Assembly to pass a law that prohibits the devices from being used to harm or harass farm animals."

When it comes to serving up energy for hungry grids in rural Virginia, sometimes smaller is better. "The Blue Ridge Power Agency, which serves a string of nonprofit utilities in central and western Virginia, is set to go live this summer with a collection of five batteries of about 5 megawatts each," reports Elizabeth Ouzts of Canary Media. By comparison, larger batteries are typically at least 10 megawatts; however, both sizes aim to store energy when it's less expensive and plentiful. Blue Ridge Power's new batteries will "help two rural electric co-ops and the city of Salem’s utility save money" by releasing battery-stored energy "when high demand on the grid spikes prices." Unlike their larger cousins, smaller batteries are cheaper and faster to build.

NASA's Curiousity Rover spends its time exploring Mars and 
sending information back to Earthlings. (NASA image)

It's hard to be more remote than exploring for signs of life on Mars, which is what the Curiosity Rover spends its time doing. "New research published in Nature Communications details Curiosity’s latest find — never-before-seen organic compounds, including one with a structure similar to DNA precursors," reports Jake Currie for Nautilus. NASA geologist Amy Williams told Nautilus, "The same stuff that rained down on Mars from meteorites is what rained down on Earth, and it probably provided the building blocks for life as we know it on our planet." To send all those compounds back to Earth, Curiosity had to conduct a full orchestra of experiments. The Curiosity also goes by "the little robotic chemist that could."

Suicide deaths among younger Americans dipped by 11% from earlier projections. 
(Graph by Vishal R. Patel, MD,  Michael Liu, MD,  and Anupam B. Jena, MD)

And now, some really good news: "The rate of suicides among young people in the United States dropped 11% below projections, decreasing most sharply in states with a higher volume of answered 988 calls, a new study has found, reports Ellen Barry of The New York Times. The study's results, published in a research letter in The Journal of the American Medical Association (JAMA), found that 4,372 more adolescents and young adults, ages 15 to 34, are alive today than previously projected. The study's data suggests that the federal government’s 988 suicide prevention hotline rollout, which launched in 2022, is having a positive impact among younger Americans.

Suicide awareness in rural communities can help save lives

As we launch into Suicide Prevention Awareness Month, an outline focusing on how and why more rural residents die by suicide, paired with resources on how friends and family members can help, may save lives.

Due to unpredictability in everything from weather to political strife, farming is more financially stressful than most other professions. It also tends to be more solitary, which can make farmers more vulnerable to excessive worry, depression and despair.

"Signs of stress in the farm economy are everywhere you turn, and with corn futures hitting fresh lows, crumbling commodity prices are painting a dreary outlook for 2025, and the financial pressures are causing another bleak reality: farmer suicides are also on the rise," reports Tyne Morgan for Farm Journal.

If a farmer in your community looks like they need support, there are resources and approaches neighbors can take, including encouraging a call to the National Suicide Prevention Lifeline at 988, or chat on 988lifeline.org, or texting HOME to 741741 to connect with a crisis counselor.

Farm Journal provides a "toolbox" with what to look for and how to help here.

The availability of firearms in rural homes is a significant reason why more rural people commit suicide. "Rural gun deaths exceed urban rates by 28% because of increased suicide rates," reports Sarah Melotte for the Missouri Independent. Guns are considered the most lethal choice for a person contemplating suicide.

Graph by Sarah Melotte, from CDC data

Rural communities that support waiting periods for gun purchases and red flag laws may be able to  decrease suicide rates. Mellote explains, "Waiting periods could help rural communities in the American West that have some of the highest suicide rates in the country. . . . Red flag laws allow law enforcement or concerned family members to petition a court to remove firearms from individuals deemed to be a threat to themselves or others."

While the intention of a person's drug overdose can be unclear, some are determined to be suicides. Drug overdoses are not inherently unique to rural residents; however, awareness of those who may be more vulnerable may help prevent a suicide due to drugs.

In 2020 alone, nearly 92,000 people died from drug overdoses in the U.S. According to the CDC, about 5% to 7% of those overdose deaths were recorded as intentional. "Because it can be difficult to determine whether overdose deaths are intentional, the actual numbers are likely even higher."

To address the numerous reasons for suicide and interventions available for all communities, the federal Substance Abuse and Mental Health Services Administration provides a range of resources. Additionally, the Rural Health Information Hub has offers a program clearinghouse specifically curated for rural communities.

Finally, suicide is complicated for children and adolescents to understand. The University of Utah offers an age-by-age guide for talking to children about suicide.

Military doctors try to replace therapy for PTSD with 'combat cocktails.' The practice has been linked to suicide risk.

Veterans are 50% more likely to commit suicide than civilian 
adults. (Medication-Induced Suicide Prevention graphic)

Although there is no data to support the practice, many military doctors prescribe "combat cocktails" to veterans with Post- traumatic stress disorder. "The practice, known as 'polypharmacy,' can tranquilize patients to the point of numbness, cause weight gain and increase suicidal thoughts when it involves pharmaceuticals that target the central nervous system," report Shalini Ramachandran and Betsy McKay of The Wall Street Journal. Because roughly a third of military veterans live in rural areas, the post-combat treatment may have a disproportionate impact on rural families and communities.

Medical guidelines for the Department of Veterans Affairs don't recommend giving patients simultaneous mixes of psychiatric medications, and the Food and Drug Administration warns against the practice. And yet, "prescribing cocktails of such drugs is one of the VA’s most common treatments for veterans with PTSD (post-traumatic stress disorder)," the Journal reports. "And the number of veterans on multiple psychiatric drugs is a growing concern at the agency."

Polypharmacy definitions vary, but "the VA defines it as taking five or more medications at the same time," Ramachandran and McKay explain. A growing number of VA physicians and researchers believes such dosing can have disastrous results, because powerful drugs can interact with patients' nervous systems and each other in unpredictable ways.

While talk therapy is considered the best PTSD treatment, therapists are often in short supply, so medical providers have turned to medicine to treat PTSD symptoms. "Nearly 60% of VA patients with PTSD were taking two or more central nervous system drugs at the same time in 2019," the Journal reports. "The VA declined requests from The Wall Street Journal to provide more recent polypharmacy numbers for veterans in its care."

Given that suicide rates among veterans are much higher than those of civilian adults, how the VA treats PTSD is under scrutiny from Congress, advocacy groups and veterans. "Studies by VA researchers link the simultaneous use of multiple psychiatric drugs to suicide risk among veterans," Ramachandran and McKay write. "Yet the agency has been slow to mandate changes."

Quick hits: NASA needs farmers; 988 to use geolocation; opioid prescriptions required to have warnings; why child care needs national support

NASA's sub-agency, NASA Acres, would like to meet more farmers. (Graphic by Adam Dixon, Offrange)

If you're a farmer, NASA could use your help. The space agency has a growing sub-agency, known as NASA Acres, that is "designed to use satellite data to help U.S. farmers make sustainable decisions and be more profitable," reports Donavyn Coffey for Offrange. NASA Acres is recruiting farmers to participate in its Farmer Innovation Ambassador Team. The group will "weigh in on the problems that need solving, and to spread the word: NASA can help. The space agency is leveraging 50 years of satellite and data science to help any farmers willing to join in."

A change in location guidance aims to help 988 Suicide & Crisis Hotline counselors route help based on where callers or texters are calling from, instead of their cell's area code. "The Federal Communications Commission voted to require text messages to the 988 suicide and mental health crisis hotline to be georouted to local crisis centers based on where they are sent from," reports Chris Teale for Route Fifty. "Over the past three years, the crisis line service has received 11.1 million calls, 2.9 million texts and 2.4 million chats via instant message."

New labels come with direct warnings about long-term
use of opioids. (Graphic via MedPage Today)

The Food and Drug Administration will require opioid makers to update their labels to include details that "highlight the safety risks of long-term use," reports Nicole Lou of MedPage Today. "Now, opioid drug labels should clarify that patients should undergo periodic checks for signs of addiction, abuse, or misuse of these painkillers." The labels will include less common but possible health complications that longer-term opioid use can cause, such as esophageal dysfunction and negative interactions with other medications. Opioid makers have 30 days to submit their new labeling for FDA review.

Haspel's book launches Aug. 11.

While the national conversation about child care is decades long, few changes have been made to address the dearth of providers, poor wages for child care teachers and the overall cost to families who are lucky enough to secure care. "Researcher Elliot Haspel suggests child care is a lost American value," writes Jackie Mader for The Hechinger Report, which reports on education. "Haspel's new book “Raising a Nation" presents 10 arguments — some of them well known and others less intuitive — for why child care needs to be a more supported part of American society."

In what could be a national first, energy company Holtec International looks to reopen the once-retired Palisades Nuclear Plant in Michigan by the end of this year. "The 800-MW Palisades plant received key federal approvals to open three years after shutting down," reports Eric Wesoff of Canary Media. "If Holtec succeeds, it would be the first nuclear plant in the U.S. to restart after being closed down. Remarkably, it would be just the second or third reactor to come back online in the global history of civilian nuclear power." 

Consumer enthusiasm helped inspire the  
combination. (Hershey/Mondelēz graphic)

Reese's peanut butter cups and Oreo cookies are slated for a mash-up, hitting grocery store shelves this fall. "Snack giants Hershey and Mondelēz are combining two of their top-selling products in a sugary marriage they say consumers have been begging for," reports Jesse Newman for The Wall Street Journal. The dynamic snack duo was partially inspired by "consumers’ own posts of their DIY combinations, such as a Reese’s peanut butter cup sandwiched between two Oreo wafers." 

Free online class on rural mental health is available at eCornell. It's designed for vets and agribusiness partners.

A new online course, “Mental Health and Suicide Prevention in Rural America” aims to help veterinarians, agriculture partners and veterinary students learn about mental health issues in rural communities and how to help, reports The Daily Yonder. The class is supported by Cornell University’s College of Veterinary Medicine and NY FarmNet, in partnership with Rural Minds, a nonprofit organization dedicated to promoting mental health in rural America. People interested in taking the course can access it at eCornell. The course is offered at no charge to participants.

The online course provides "practical tips to help with mental health challenges, including recognizing and responding to warning signs, as well as providing key information on resources such as crisis hotline numbers and local supports," the Yonder staff reports. "Rural communities have disproportionately higher rates of suicide in their population compared to urban areas. Farmers are twice as likely than those in other occupations to die by suicide, according to Rural Minds, and veterinarians also face higher risks of suicide when compared to the general population."

Jeff Winton, founder and chairman of Rural Minds, told the Yonder. "As a dairy farmer, I know firsthand that veterinarians are an integral part of all rural communities. And they may be among the first to see warning signs that a client is experiencing a mental health challenge but may not recognize those same signs in themselves."

With new technology, many 988 suicide and crisis hotlines will be able to use caller 'georouting' to help provide care

Many 988 crisis service calls will soon be aided by geolocation technology. (988lifeline photo)

Despite the 24/7 availability of the 988 suicide and crisis hotlines across the country, U.S. suicide rates have continued to climb, with rural states facing some of the highest losses. One of the 988 program's biggest shortcomings has been its lack of caller location services, but that's about to change, reports Deidre McPhillips of CNN. "Carriers have started to adopt a new technology that helps direct callers to 988 hotlines to help centers based on their physical location rather than their phone number’s area code."

Adding the new technology means 988 hotline counselors will be able to connect callers with services and follow-up support where they live. "Verizon and T-Mobile started rolling out the 'georouting' technology last week. . . . AT&T also plans to begin the process within the next couple months," McPhillips explains. "Next month, the Federal Communications Commission will vote on a rule that would require all wireless carriers in the U.S. to implement georouting for 988 calls."

Some mental health advocates have voiced concerns over caller privacy; however, georouting differs from geolocation in that "it does not provide a precise location for the caller," McPhillips adds. "Instead, it aggregates information about a caller’s location to help them reach local support while maintaining their privacy." 

The 988 lifeline began in July 2022, replacing the National Suicide Prevention Lifeline with "a broader focus and a simpler dial code," McPhillips reports. The lifeline now includes services such as "American sign language and Spanish. . . . a special veterans crisis line, and an LGBTQ+ youth and young adult line." 

American suicide rates continue to climb, with some rural states seeing double the number of deaths. Why?

When it comes to suicide prevention, what works where
hasn't been found. (Photo by A. Nath, Unsplash)

After decades of suicide prevention funding and plan roll-outs, the number of self-inflicted deaths in the United States has only increased, with some rural states shouldering double the number of deaths compared to their urban counterparts, reports Cheryl Platzman Weinstock of KFF Health News.

"From 2001 through 2021 suicide rates increased most years, according to the Centers for Disease Control and Prevention. Provisional data for 2022, the most recent numbers available, shows deaths by suicide grew an additional 3% over the previous year. CDC officials project the final number of suicides in 2022 will be higher," Weinstock adds. "Suicide rates in rural states such as Alaska, Montana, North Dakota, and Wyoming have been about double those in urban areas."

Meanwhile, mental health experts maintain that the ideas and educational programs aren't to blame for the results. Instead, they say, "the policies simply aren’t being funded, adopted, and used," Weinstock reports. "That slow uptake was compounded by the Covid-19 pandemic, which had a broad, negative impact on mental health. National experts and government officials agree the strategies simply haven’t been embraced widely."

How suicide data is determined and reported isn't uniform yet either. "Without accurate statistics, researchers can’t figure out who dies most often by suicide, what prevention strategies are working, and where prevention money is needed most," Weinstock writes. Without more clarity, deciding on the best preventative practices can become impossible. Interventions that work in sparsely populated Wyoming, may not work in the more populated farming towns of southern Indiana.

Other means to prevent or address suicide attempts also have gaps. "The fledgling 988 Suicide & Crisis Lifeline [also] faces serious problems," Weinstock reports. "Only 23% of Americans are familiar with 988 and there’s a significant knowledge gap about the situations people should call 988 for, according to a recent poll. . . . Most states, territories, and tribes have also not yet permanently funded 988, which was launched nationwide in July 2022."

While some regions are introducing 988 awareness campaigns, several states, including Colorado, are trying something new. Weinstock explains, "State officials installed financial incentives for implementing suicide prevention efforts, among other patient safety measures, through the state’s Hospital Quality Incentive Payment Program. . . .The program hands out about $150 million a year to hospitals for good performance. . . . Experts hope other states will follow Colorado’s lead."

Opinion: 'Red flag' laws help prevent firearm suicides in the U.S., but they curb gun rights. It's a balancing act of risks.

ERPOs can prevent firearm suicides, but striking a
balance with gun rights is difficult to measure. (A.S. photo)

Access to a firearm can mean a person at the crossroads of ending their own life will succeed. Even though many other means of suicide exist, almost none are more predictably final. Psychiatry researcher Jeffrey W. Swanson looks at how extreme risk protection order laws prevent suicides and how they intersect with gun rights in his opinion for JAMA Network Open. Swanson first sees the topic through the lens of his 18-year-old cousin's suicide.

"The sound of my grandmother’s trembling voice lingers from that winter morning, almost 40 years ago now, when she called with awful news. My beautiful cousin Kristin had come home from college for the holidays and killed herself with a shotgun. . . . I was a new faculty member in a psychiatry department at the time, embarking on a career in which I would spend decades researching ways to prevent death and injury from guns.

"Aunt Helen asked me what could have saved their youngest child. I suggested Kristin had succumbed to a fatal illness; it was no one’s fault. . . .Today I would give a different answer. I would say Kristin died from a preventable injury with a firearm. I would add that a law prohibiting her access to a gun might have kept Kristin alive."

Extreme risk protection order laws, also known as red flag laws, "provide a civil court process designed to prevent firearm injuries by temporarily disarming individuals who pose an imminent risk of harm to themselves or others. An ERPO also prohibits a person from purchasing or possessing a firearm while the order is in effect, typically for up to a year," Swanson explains. "With the clarity of excruciating hindsight, it seems obvious that Kristin’s ability to acquire a firearm was a decisive factor in her death."

ERPOs have gained traction across the country as legislatures search for ways to reduce firearm deaths. At the same time, gun rights matter, so where is the balance? Swanson presents the paradox: "How do we know when someone poses enough danger to justify deploying police authority to remove their firearms? Risk means uncertainty, by definition, and risk assessment will always be an imperfect predictor of rare adverse events such as suicide; the significant risk factors all apply to many more people who will not die from suicide than those who will. Thus, for every hypothetical death averted by an ERPO, there will always be some ERPO respondents who would not actually have harmed themselves, or anyone else, had they been left (literally) to their own devices. We just do not know who they are in advance."

There are statistics to back up ERPO's effectiveness. "A widely cited statistic from our group’s research studies of suicide deaths among ERPO respondents in Connecticut and Indiana is that for every 10 to 20 ERPOs issued, 1 suicide was averted," Swanson adds. "In a nation where private gun ownership is commonplace, culturally entrenched, and constitutionally protected, feasible solutions to gun violence hang in the balance of risk and rights. . . . [Yet] in a country where more than 20, 000 people every year die of suicide with firearms, it is impossible to ignore that what is too late for Kristin could save many today."

Some rural attitudes toward mental health care are improving; access and stigma remain barriers

Ranching can be isolated, lonely work.
(Adobe Stock photo)

Farmers and ranchers must deal with mental and physical stresses that other professions don't demand. When it comes to mental health checks, both groups face isolation, social stigma that discourages asking for help, and a "frontier" legacy of being able to do it all. "This 'frontier' way symbolizes a rugged and independent way of life, characterized by the ability to survive and thrive in harsh and isolated conditions," reports Mike Watkins for Progressive Farming. "This also applies to dealing with mental health issues and the attitude that no outside help is needed."

Linnea Harvey, Rural Renewal Initiative coordinator in the Department of Agricultural Education at Oklahoma State University, explains "it's a complicated mix of barriers that play into the reluctance to seek mental health services," Watkins writes. "Harvey says many of the smaller farms she has worked with didn't have hired help. The more she got to know these farmers on a personal level, the more she saw the constant stress they were under. . . .No one talked about it, but there was a lot of loneliness, depression and anxiety."

Medical providers in more remote places often offer more integrated care that begins with a primary care doctor; however, referrals to more specialized care from psychiatrists can pose a challenge. "According to the National Alliance on Mental Illness, it's estimated that as many as 65% of rural counties do not have psychiatrists, and more than 25 million Americans living in rural areas are in a designated Mental Health Professional Shortage Area," Watkins reports. Getting to see a psychiatrist might mean traveling to another county or city, which some farmers or ranchers may not have the time to do.

The pandemic opened some opportunities for care that can specifically help rural individuals seeking mental health treatment, including telehealth. Watkins adds, "Still, in rural communities, which tend to be disproportionately older, people are often uncomfortable or unsure how to use the technology."

What are the signs that someone may need mental health support? Cate Jones-Hazledine, co-director of the Panhandle office of the Behavioral Health Education Center of Nebraska, "believes changes in someone's behavior is a big one, as is feeling or acting angry or irritable, and changes in sleep patterns and appetite, among others," Watkins explains. "Any thoughts of suicide or self-harm should be taken seriously, and help should be sought immediately."

Overcoming the mental health stigma that many rural residents have is a work in progress. Watkins writes, "Until there is a crisis, mental health care is often not a priority for most farmers and ranchers, although changes in attitude are happening." Jones-Hazledine told him: "Kids are growing up with services available at school, and this helps reduce stigma and normalize seeking help when needed. . . .Things are improving, and more resources are becoming available."

As the U.S. faces an ongoing mental health crisis, 988 call centers look to add geolocation services

In 2020, the Centers for Disease Control and Prevention verified 45,979 suicides; in 2021, the numbers increased to 48,183. Added together, the number of people lost to suicides could fill the Rose Bowl Stadium. When the CDC's provisional suicide counts from 2022 and 2023 are tacked on, the death toll reaches 172,520. 

With those tragic numbers in mind, in 2022 the Biden administration transitioned the country's 10-digit suicide hotline to the 988 Suicide and Crisis Lifeline, which provides an easy-to-remember three-digit number for 24/7 crisis care. But the 988 program has a gaping problem: It lacks geolocation service, reports Kery Murakami of Route 50, which "means callers are being sent to call centers thousands of miles away from where they actually are. . . People dialing into the hotline are sent to a call center based on their area code, not on where they are physically calling from."

The lack of geolocation means 988 counselors lack the capacity to connect a caller with services and follow-up support in another state. Murakami explains, "The issue, according to Rob MacDougall, director of emergency services for Johnson County, Kansas, is that a call center in Kansas isn't equipped, for instance, to connect someone in Florida to the services and help they need." The Substance Abuse and Mental Health Services Administration and the Federal Communications Commission are working with cellphone carriers to "test routing calls based on where a person in crisis is generally located." To ensure a level of privacy, call centers don't receive a caller's exact location.

While adding geolocation information will help 988 be more effective, some areas are still working to implement basic 988 services. "Many states are still working out technical kinks or struggling with staffing, which can lead to wait times or not reaching a counselor at all," Murakami reports. "In Florida, a distraught caller may have to sit on hold for 32 seconds, according to SAMHSA data. 

Despite struggles, the lifeline is making progress. "Before 988 was implemented, it might take several minutes to reach someone. Now the average response time has decreased from 2 minutes and 39 seconds to 41 seconds, according to SAMHSA," reports Christina Caron of The New York Times. 

In 1985-2014, suicide rates were highest among workers in lumber, wood and furniture; metal fabrication; and mining

Workers in several rural-oriented industries were found to have the highest suicide rates, in what the authors say is the first study of suicide rates by industry using nationally representative data.

The study looked at 1,943 suicides over 29 years, from 1985 to 2014. It found that age-adjusted suicide rates were highest in the furniture, lumber, and wood industry group (29.3 suicides per 100,000 population), the fabricated-metal industry (26.3 per 100,000), and mining (25.8). Railroading had the lowest rate (5.5), then education, banking, hospitals, and entertainment and recreation. 

Lines extending from numbers indicate possible maximum rates, due to
sample size. (Study graph, adapted by The Rural Blog; click to enlarge)

Most workers in the high-ranking industries are men, which may partially explain their rank. "Male-dominated industries often come with intense pressure, competition, and societal expectations that can significantly impact the mental health of individuals working within them," the authors write. "Male-dominated industries often involve high-stress jobs, long working hours, low pay, and limited work-life balance, all of which can contribute to chronic stress and mental-health problems."

The study, published in the Archives of Suicide Research, was conducted by Ahmed Arif and three other researchers at the University of North Carolina at Charlotte. They note, "Suicide rates in the working-age U.S. population have increased by over 40% in the last two decades," with the latest annual total 48,000. "Between 1999 and 2017, the age-adjusted suicide rate increased from 10.5 to 14.0 per 100,000 population. Although suicide may be linked with characteristics of workplaces and their industries, few studies have reported industry-level suicide rates."

Why study such rates? "Characteristics of the workplace may affect suicide risk," the authors write. "Researchers have identified job stress, low job satisfaction, bullying and harassment, lack of support and resources, poor management practices, and job insecurity as some of the risk factors for suicide linked with the workplace." Also, "There is evidence that workplace suicide prevention is effective."

Opinion: The number of U.S. suicides is unacceptable, so we need a new approach to address the problem

Suicide rates are at an 80-year high.
(MedPage Today photo)

In April, the Centers for Disease Control and Prevention shared this grim data: "In the past two decades, suicide rates have been consistently higher in rural America than in urban America." National suicide statistics are even more dire: Last week, the CDC reported that U.S. suicide deaths reached an 80-year high. While there was a "modest" improvement in youth data, the report pointed to a national suicide crisis. With that backdrop, Russell Copelan, a retired emergency department psychiatrist, suggests a new approach in his opinion for MedPage Today.

"Consider the American Foundation for Suicide Prevention's aspirational goal launched in 2016, to reduce the annual U.S. suicide toll by 20% by 2025. Since the initiative began, there has instead been a 10% increase in suicide deaths. We should be nothing short of appalled and dismayed by these numbers.

"Perhaps it is now best to consider the advice of Davy Crockett to young hunters: 'Whenever a fellow gets bad lost, the way home is just the way he don't think it is.' The field of suicidology is indeed 'bad lost.' We are in urgent need of a new 'way home.' So let's get out our compasses and make directions based on where we are standing, our present state.

"Here is a starting point. Saving life is difficult. If it were easy, everyone would be doing it. Well, in suicide prevention and research, everyone is trying to do it. And yet, the escalating press of self-directed death marches on. For foundations, alliances, and associations, the definitional issues, fragmentary data, ubiquitous risk training. . . and entrenched leadership make it difficult to determine a true North Star. . . . It is currently equivalent to the blind leading the blind -- and falling in a ditch.

"Ideation-centric assessments have continued to be promoted as 'best practices.' Under mounting evidence of insensitivity to risk, statistical inefficiencies, unreliable patient recruitment. . . confirmatory bias, should these assessments continue to serve as surrogates or the 'gold standard' in suicide risk evaluation? None of these instruments have been sufficiently accurate.

"Where is the proactive management to identify the root causes of our current and miserable predicament? Where is the preparatory understanding of the basic elements of the 'map' that could have empowered the field of suicidology to stay found?

"Let me ask again: Is conventional suicide prevention practice good enough? No. Unequivocally, no! What medical specialty would tolerate such a recurring -- indeed '80-year high' -- disaster?

"The topic of suicide is complex, complicated, and dark, and attempting to systemize and communicate improved risk probability stratification is considered by many either too difficult or a lost proposition.

"But you must fight with implacable doggedness, challenge old laws, and test new hypotheses. Demonstrate the miracles of good sense, connected observations, and strong convictions. Maximize your cause and seize your direction."

To read the theory and practice of Copelan's "new way home," click here.

Suicide isn't just a cause of death for teenagers and adults; younger children also commit suicide

Children ages 5-11 also commit suicide.
(Photo by Lukas Metz, Unsplash)

As children enter their new classrooms and routines this fall, it's an excellent time to remember to monitor their mental health. And while many people might not realize it, young children are also at risk to commit suicide. "Suicide ranks as either the seventh- or eighth-leading cause of death among children ages 5 to 11, according to the Centers for Disease Control and Prevention and recent studies," reports Cheryl Platzman Weinstock of CBS News. "And numbers show the rates among younger kids appear to have increased in the past decade, especially among Black boys."

Paul Lipkin, a pediatrician at the Kennedy Krieger Institute, told Weinstock, "Historically, we thought that suicide is a problem of teens and adults, but younger children are expressing similar thoughts that may have been ignored before." Weinstock reports, "This has many experts calling for lowering the screening age for suicide ideation in children and moving to develop more effective early suicide risk detection and targeted prevention strategies. The broad approach includes pediatricians, teachers, and parents working with children at a young age to build their resilience and identify and manage their stress."

Weinstock writes, "Studies have found that young children gain an understanding about death and killing oneself from TV or other media, discussions with other children, or exposure to death from a family or community loss. . . . It is quite likely the 136 reported suicides from 2001 to 2021 among 5- to 9-year-olds were an undercount." Margaret Warner, a CDC epidemiologist, told Weinstock: "If we are missing deaths or don't have all the information leading to them, we can't properly develop programs to prevent future deaths." Weinstock adds, "That's why there's also an ongoing national effort by coroners and medical examiners to improve the quality and consistency of pediatric death investigations."

What parents can do now is be aware and observant. Lisa Horowitz, a pediatric psychologist and staff scientist at the National Institute of Mental Health, told Weinstock: "It's never too early to start a conversation with kids about recognizing mental health distress and doing what we can do to help them have better coping strategies and foster resilience. . . . I don't want people to panic but just want them to be vigilant about their children."

988 Suicide & Crisis Lifeline has been up and running for a year, but few Americans know about it; here are details

Suicide is the 12th leading cause of death in the United States, but it doesn't have to be. Getting the word out about the national 988 Suicide & Crisis Lifeline is one way to change that sobering statistic. Launched in July 2022, the Lifeline operates 200 call centers, but many people don't know about it. Dr. Emmy Betz, a professor of emergency medicine at the University of Colorado, "discusses the critical need to raise awareness about 988," with details on how the resource works. SciLine's Q & A with Dr. Betz for The Conversation, a journalistic platform for academics, is edited below.

Who should call 988, and when? 988 is the suicide and crisis lifeline. I want to really emphasize it's not just for suicide. It's for anyone who's experiencing substance abuse, mental health crisis, emotional distress or suicidal thoughts. You can call for yourself. You can call for someone in your family or a friend. It's available 24/7, and it's free and confidential.

What are some prevention strategies for firearm suicides? In Colorado, 73% of our gun deaths are by suicide. It's a critical problem in our state. And these deaths are preventable. Suicide typically occurs in the context of some kind of crisis, whether it's related to a job, a recent breakup with a romantic partner, or something else. Prevention is all about getting people through that high-risk period to get the treatment or resources they need.

We know that if a person uses a firearm in a suicide attempt, about 90% of the time, they die. So my work and the work of our initiative really focuses on how we can reduce firearm access when someone is in that high-risk period.

It's not about confiscation. It's not about legislation. It's about engaging with communities, educating communities and educating health care providers about what we can do to reduce firearm access – specifically, encouraging people to take steps to lock up guns differently, such as changing the locks or changing the password so the at-risk person can't access the gun.

There are things we can do that don't conflict with views on Second Amendment rights. . . . . When someone has a suicide risk, it can be a good idea to move firearms out of the home temporarily. We've been working with gun ranges, retailers and other locations that offer voluntary and temporary firearm storage as a solution for people – to make the home safer while someone's getting better.

What is suicide contagion, and what should journalists know about covering suicide without contributing to it? Suicide contagion is the phenomenon whereby hearing about one suicide – in particular, the methods – leads to additional individuals attempting or dying by suicide using the same methods. . . . It's really important that journalists talk about suicide, and that we raise awareness, and we get these messages out. . . . There are guidelines from the American Foundation for Suicide Prevention and other large organizations that really spell out best practices for journalists.

What are warning signs that a person is thinking about suicide? The main thing to look out for is if someone says that they've lost hope or that they aren't looking towards the future anymore. . . . It's OK to ask. If you're ever worried that someone might be having thoughts of suicide, it's fine to ask them directly. You're not going to prompt suicidal thoughts by asking that question.

Can you share some statistics about suicide in the U.S.? What about youth suicide?
Suicide is the 12th-leading cause of death among all ages. . . . In 2021, there were 48,000 suicide deaths in the U.S., about one every 11 minutes. Suicide rates among youth have increased. Between 2011 and 2021, suicide rates for youth rose 60%. Particularly concerning are increases in suicide rates among young individuals of color, where there have traditionally been lower suicide rates.

Watch the full interview to hear more about the 988 hotline and suicide prevention. SciLine is a free service at the American Association for the Advancement of Science, a nonprofit that helps journalists include scientific evidence and experts in their news stories.

Farm Bill may offer more mental-health help for farmers, who are showing more stress from extreme weather

Ali Aas graphic forAmbrook Research, from AP photo 

Extreme weather is hard on everyone, but farmers may be some of the most vulnerable to its often brutal impact, which can affect their mental health. This year's Farm Bill could bring additional funding and resources for mental-health care for farm families and workers. "Experts say they have witnessed a rise in farmers struggling with anxiety and depression as climate impacts have worsened in recent years," reports Mélissa Godin of Ambrook Research. "The farmer crisis hotline run by Farm Aid, for instance, has seen a significant increase of calls from farmers during natural disasters linked to climate change." Caitlin Arnold-Stephano, a farmer and a Farm Aid program manager, told Godin, "When climate disaster strikes, or an ongoing disaster such as drought is occurring, the toll on farmer mental health is high. Often a disaster can push a farmer over the already-thin margin or edge that existed."

The 2018 Farm Bill was the first with contained "direct funding toward farmers' mental health, by providing grants for the Farm and Ranch Stress Assistance Network, which connects farmers, ranchers and agricultural workers with mental-health-assistance programs and resources," Godin notes. "Advocates hope that the 2023 Farm Bill will offer even more support. Bipartisan legislation, led by Sens. Joni Ernst (R-Iowa) and Tammy Baldwin (D-Wis.), would reauthorize the FRSAN to establish helplines, provide suicide prevention training for farm advocates and create support groups for farmers and farm workers. The bill would increase funding for the program, authorizing $15 million per year for the program for the next five years, up from $10 million allocated in the last Farm Bill."

Farmers have long faced unrecognized and untreated mental-health problems. "The rate of suicide among farmers has historically been three and a half times higher compared to the general population, according to the National Rural Health Association," Godin reports. "Many farmers, however, struggle to access mental health services, often not readily accessible in rural areas. And when services are available, they are not always tailored to farmers' needs. Traditional mental health services can be alienating to farmers, who sometimes come from communities where mental health is highly stigmatized. . . . Unless the federal government takes action to address the root causes of farmers' distress — the economic precarity, the lack of support, the increasingly unpredictable weather — many experts are concerned farmers will continue to struggle."

Greg Mruk, executive director of New York FarmNet, an organization that offers financial and emotional counseling to farmers, told Godin: "More than anything, farmers want to be given a chance to be part of the solution, a chance to figure it out. Let's not be of the 'sky is falling' mindset. We need to take a proactive approach."

Dept. of Agriculture offers 5 virtual mental-health workshops for rural residents on five Tuesdays starting May 9

The U.S. Department of Agriculture will highlight mental health in a series of weekly workshops May 9 through June 6, from 2 to 3:30 p.m. ET each Tuesday. The series will gather farmers, ranchers, faith leaders, rural health providers, USDA employees, and federal, state and university partners to discuss mental-health challenges, stressors, and the resources and services available to address them. These meetings will be conducted virtually using Zoom.gov. A link to the workshop will be provided upon registration; contact center@usda.gov with any questions. Click here and see below for more information and to register.

May 9: Farm Stress and Suicide Prevention: Data, Challenges, and Opportunities: This session provides context for the issue of farm stress and suicide by focusing on available data, challenges, and opportunities for farm stress researchers, practitioners, and service providers. Panelists include the National Association of State Departments of Agriculture, the American Farm Bureau Federation, Farm Aid, and others to discuss the state of the field and offer insights into their respective partner programs, resources, and emergent needs. Register

May 16: Veterans Mental Health and Suicide Prevention Workshop: Rural veterans experience a significantly increased risk of suicide. In this workshop, you will learn how to act with care and compassion if you encounter a veteran who is in crisis or experiencing suicidal thoughts. Register

May 23; Rural Mental Health Matters: Challenges, Opportunities and Resources for Communities: This session focuses on the resources and tools that are available in rural places, where over 60% of Americans live in mental-health provider shortage areas. Speakers will examine programs focused on giving rural and frontier communities the tools they need to thrive through creative problem solving. With perspectives rooted in rural services, behavioral health, and technology, the presentations and follow-on conversation will explore the importance of increasing the efficiency of providers in rural areas and other solutions, to challenges that rural communities face to ensure community wellbeing and economic prosperity. Register

May 30: Farm Stress and Suicide: Faith, Place, and Community Health: This session provides an overview of the USDA Center for Faith Based and Neighborhood Partnerships and highlights the challenges faced by many Americans during Mental Health Awareness Month. A training on farm stress, health and well-being will be provided by The Well Church Initiative of Texas A&M Extension to discuss and highlight tools and resources available to faith and community-based organizations as they support their congregants and communities. Register

June 6: LGBTQ+ Mental Health in Rural Communities: This session will focus on the lived experienced of LGBTQ+ identifying folks in rural communities across the country. Discussion and dialogue will focus on mental health, the relationship to stress, and more. Register

'People think that it's just a city problem, while it's not;' death by gunfire is more likely in rural America, study shows

Map by Joe Murphy, NBC News, from Centers for Disease Conrol and Prevention data

It's perhaps an unexpected truth: If you're an urban dweller, you are less likely to die from a gun-inflicted wound than someone living in small-town America. "Gun death rates are consistently higher in rural areas than in big cities, two decades of data show," report Aria Bendix and Joe Murphy of NBC News. "From 2011 to 2020, the most rural counties in the U.S. had a 37% higher rate of gun deaths per capita than the most urban counties, according to research published in the Journal of the American Medical Association, Surgery. That's up from a 25% difference from 2000 to 2010. . . . Findings are based on an analysis of data from the Centers for Disease Control and Prevention. The authors attributed the trend to a rise in gun suicides, which outnumbered gun homicides in 2021 by more than 5,300 and are more likely to occur in rural counties."

Paul Reeping, who conducted the research at Columbia University, told NBC, "Rural areas are sort of ignored when we pass firearm laws because people think that it's just a city problem, while it's not. Suicides were always the highest in rural areas. That hasn't changed. It's just that the gun deaths overall have gone up, including firearm suicides, in those areas." NBC reports, "From 2011 to 2020, the most rural counties had a 46% lower rate of gun homicide deaths than the most urban counties but a 76% higher rate of gun suicide deaths, according to Reeping's analysis."

Gun ownership and the number of firearm deaths rates may trend together. "CDC data suggests firearm death rates tend to be highest in mountain Arizona, Idaho, Nevada and Wyoming. Research from the Rand Corp., a nonpartisan think tank, found a similar trend for gun suicides in 2020." Andrew Morral, a senior behavioral scientist at Rand, told NBC, "These are also states that, not coincidentally, have particularly high firearm ownership rates at the population level. . . . The urban areas have a little bit higher rate of firearm homicides, but it's not huge."

Digging into the data gets sticky, "Because there is no comprehensive national firearm registry and very few state registries, it is difficult to track gun ownership in the U.S., so estimates of gun ownership rely on survey data or measures closely related to gun ownership–such as the number of firearm laws," reports Heather Saunders of the Kaiser Family Foundation. But given the date that's available, "More than twice as many suicides by firearm occur in states with the fewest gun laws, relative to states with the most laws."

More relaxed gun laws, combined with a higher number of gun owners could explain some of the increase. NBC reports, "Researchers suspect that higher rates of firearm ownership in rural counties could drive up gun suicide rates. A 2020 study found that owning a handgun was associated with a greatly elevated risk of firearm suicide among both men and women." Saunders reports, "Firearms are the most lethal method of suicide attempts, and about half of suicide attempts take place within 10 minutes of the current suicide thought, so having access to firearms is a suicide risk factor."

What could lower the number of gun deaths in rural America? "Reeping said safe storage laws — which require guns at home to be unloaded, locked and stored when people who can't legally possess guns are present — might help," NBC reports. "Reeping also noted that doctors at hospitals can assess whether people at risk for suicide have access to firearms, then work with the patient's families to limit that access — a process known as 'lethal means counseling.'. . . Morral, meanwhile, highlighted the effectiveness of red flag laws —which allow state courts to order the temporary removal of firearms from people's possession if they pose significant threats to themselves or others — at preventing both suicides and homicides. . . . He also pointed to a Harvard-led initiative called the Gun Shop Project, which helps gun retailers display and distribute suicide prevention materials and teaches them how to avoid selling or renting firearms to customers at risk of suicide."

Teen suicide statistics show deaths increased in tandem with social-media launches; rates higher in rural areas

Teen suicide can be a "tip-toe around it" discussion topic, but dire statistics are overcoming the stigma.

The CDC's latest Youth Risk Behavior Survey found that "The number of male students who said they had considered, planned or attempted suicide was stable between 2019 and 2021 [but] female students reported a sharp increase in all three, with 30 percent having seriously considered suicide in the last year, 24 percent having made a suicide plan, and 13.3 percent having attempted suicide," Politico reports.

Other new statistics tell a loud story about increased deaths combined with social media's influence -- and the loss of rural young men, related to firearm access. "In the United States, suicide has become the second leading cause of premature death among those ages 10 to 24; it is the leading cause of death among teens ages 13 to 14," Florida Atlantic University reports on recent research. "In the U.S. suicide has become the second leading cause of premature death among those ages 10 to 24; it is the leading cause of death among teens ages 13 to 14."

Researchers looked at U.S. suicide trends in 13- and 14 year-olds from 1999 to 2018 as well as isolating sex, race, level of urbanization, census region, month of the year and day of the week. The rural results were startling. Dr. Charles H. Hennekens, a study co-author, said, "Our data show that non-metropolitan areas have higher rates of teen suicide, regardless of method, and rural areas have higher rates due to firearms. . . . During the years immediately preceding the onset of increases in rates of suicide among 13 and 14 year olds, several prominent social media platforms used by teens, including Reddit, YouTube, Twitter, Facebook, Myspace and Tumblr were launched."

Study results showed that suicide rates among 13- and 14-year-olds "more than doubled from 2008 to 2018, following a rise in social media and despite significant declines in suicide mortality in this age group previously from 1999 to 2007. These trends were similar in urban and rural areas but were more common in boys in rural areas where firearms are more prevalent," the university reports. "In rural areas, firearms were used in 46.7 percent of suicides in boys and 34.7 percent in metropolitan areas. Suicides occurred significantly more often between September and May and were highest on Monday followed by the rest of the weekdays, suggesting school stress as a contributor. These statistically significant increasing trends were similar by sex, race, urbanization and census regions."

Dr. Sarah K. Wood, the study's senior author, said the data show correlations "with social media, school stress, and firearms, which require further research. In the meanwhile, there are clinical and public health initiatives for those at highest risks." The study results were released online, ahead of print in the peer-reviewed journal Annals of Pediatrics and Child Health.

Higher religious participation linked to fewer deaths of despair; research suggests it's the social ties that matter

National Bureau of Economic Research working-paper graph
shows underlying cultural trends that preceded the opioid edpidemic

In 2000, the label "death of despair" did not exist. The phrase is now common and often attached to the opioid epidemic, but a deeper understanding of its root causes is still being explored. "A new paper by Tyler Giles of Wellesley, Daniel Hungerman of Notre Dame and Tamar Oostrom of Ohio State bolsters the case that deaths of despair stem in part from weakening social ties. It shows that mortality from these causes among middle-aged whites stopped falling around 1990—well before the rise in opioid use," The Economist reports. "What changed at that time? The authors studied attendance at religious services. They found that states with more participation had fewer deaths of despair and that the faster religious attendance fell in a state, the more such deaths rose. A paper in the Journal of American Medical Association in 2020 also showed that of 110,000 health workers, those who went to services were less likely to die from these causes."

To study the relationship between deaths of despair and religious participation, "The authors tried to isolate the impact of religion by studying blue laws, which banned commerce on Sundays to encourage churchgoing," The Economist reports. "Whenever a state repealed a blue law, religious attendance tended to plummet, creating a natural experiment. And sure enough, deaths of despair rose unusually quickly in the few years following these repeals. Although legalizing alcohol sales on Sundays may account for some of this trend, the biggest increase in mortality came from suicides."

A Google search of "Why go to church if I can pray at home?" yields pages of responses. And yet, this study "strikingly found that private prayer was not linked to lower deaths of despair," The Economist notes. "This suggests that the risk reduction stems not from belief, but rather from the interpersonal connections that organized religion provides. Although secular groups like charities or labor unions also produce such 'social capital,' the JAMA authors say that faith-based networks provide unusually potent protection."

The phrase "death of despair" comes from a 2015 milestone paper published by Anne Case and Angus Deaton that analyzed death rates in America and found deaths of despair to be disproportionately rural. "The economists found that mortality had been rising among middle-aged whites, thanks to a surge in drug overdoses, alcohol-related illness, and suicides—causes they deemed 'deaths of despair,'" reports The Economist. Since 2015, academics have sought tease out the root cause of these deaths -- are they caused by mental anguish or opioid abuse -- the answer is yet to come.