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Suicidality in Rural Communities: A Scoping Review of Research in Canada

Publication: Canadian Journal of Community Mental Health
5 April 2023

Abstract

A scoping review of research about suicidality in rural and remote Canadian communities, published between 2009 and July 2020 was conducted by searching Embase, Medline, CINAHL, PsychInfo, SocIndex, Geobase, and PsycArticles databases. Included articles were reviewed and charted using data extraction. Thirty-nine Canadian, non-Indigenous articles met inclusion. Most publications were based on quantitative research (23). Apart from one intervention study, articles were prevention focused, with suicidality risk and protective factors noted to be of particular interests. The most frequently referenced suicidality risk factor was rural residence. It is anticipated that results of this review will inform future research, particularly the need to include qualitative and mixed methodologies, protocol, and evaluations of interventions as well as postvention research, with further consideration of different Canadian settings and populations.

Résumé

Un examen de la portée des recherches sur la suicidalité dans les communautés rurales et éloignées du Canada, publié entre 2009 et juillet 2020, a été mené en effectuant des recherches dans les bases de données Embase, Medline, CINAHL, PsychInfo, SocIndex, Geobase et PsycArticles. Les articles retenus ont été analysés et répertoriés à l’aide de l’extraction de données. Trente-neuf articles canadiens non autochtones ont satisfait aux critères d’inclusion. La plupart des publications étaient basées sur des recherches quantitatives (23). À l’exception d’une étude d’intervention, les articles étaient axés sur la prévention ; le risque de suicide et les facteurs de protection étaient considérés comme présentant un intérêt particulier. Le facteur de risque de suicide le plus fréquemment mentionné était la résidence rurale. Il est attendu que les résultats de cet examen éclaireront les recherches futures, particulièrement en ce qui a trait à la nécessité d’inclure des méthodologies qualitatives et mixtes, des protocoles et des évaluations d’interventions aussi bien que des recherches sur la postvention, avec un examen plus approfondi d’autres contextes et populations du Canada.

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References

Armstrong L. L. 2011 The anatomy of rural-urban youth suicidal ideation–Who is at greatest risk? What factors to target? How to intervene? (Doctoral dissertation) ProQuest Information and Learning 74 1 -270
Armstrong L. L. and Manion I. G. 2015 Predictors of rural and urban youth suicidal ideation by gender: A case for targeted approaches to prevention Vulnerable Children and Youth Studies 10 3 206 -219
Avdimiretz N., Phillips L., and Bratu I. 2012 Focus on pediatric intentional trauma Journal of Trauma and Acute Care Surgery 72 4 1031 -1034
Barry R., Rehm J., de Oliveira C., Gozdyra P., and Kurdyak P. 2020 Rurality and risk of suicide attempts and death by suicide among people living in four English-speaking high-income countries: A systematic review and metaanalysis Canadian Journal of Psychiatry 65 7 441 -447
Bhatti J. A., Nathens A. B., Thiruchelvam D., Grantcharov T., Goldstein B. I., and Redelmeier D. A. 2016 Selfharm emergencies after bariatric surgery: A population-based cohort study JAMA surgery 151 3 226 -232
Burrows S., Auger N., Gamache P., and Hamel D. 2013a Leading causes of unintentional injury and suicide mortality in Canadian adults across the urban-rural continuum Public Health Reports 128 6 443 -453
Burrows S., Auger N., Tamambang L., and Barry A. D. 2013b Suicide mortality gap between Francophones and Anglophones of Quebec, Canada Social Psychiatry and Psychiatric Epidemiology 48 1125 -1132
Canadian Institute for Health Information. (n.d.). OECD Interactive Tool: International Comparisons - Peer Countries, Canada. CIHI. https://www.cihi.ca/en/oecd-interactive-tool-international-comparisons-peer-countries-canada
Carlisle C. E., Mamdani M., Schachar R., and To T. 2012 Predictors of psychiatric aftercare among formerly hospitalized adolescents The Canadian Journal of Psychiatry 57 11 666 -676
Collins A. and Leier B. 2017 Can medical assistance in dying harm rural and remote palliative care in Canada? Canadian Family Physician 63 3 186
Creighton G. M., Oliffe J. L., Lohan M., Ogrodniczuk J. S., and Palm E. 2017a “Things I did not know”: Retrospectives on a Canadian rural male youth suicide using an instrumental photovoice case study Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 21 6 616 -632 https://doi-org.berlioz.brandonu.ca/10.1177/1363459316638542
Creighton G., Oliffe J., Ogrodniczuk J., and Frank B. 2017b “You’ve gotta be that tough crust exterior man”: Depression and suicide in rural-based men Qualitative Health Research 27 12 1882 -1891
Daniels, S., Turecki, G., LeBlanc, A. & Joseph, M. E. (2018). Suicide and suicide prevention. Literature review. Commissioned by Public Health Agency of Canada and the Mental Health Commission of Canada.
Durant K. L. and Kortes-Miller K. 2020 Physician snapshot: The forming landscape of MAiD in northwestern Ontario Palliative Care & Social Practice 14 1 -14
Finkelstein Y., Macdonald E. M., Hollands S., Sivilotti M. L., Hutson J. R., Mamdani M. M., Koren G., Juurlink D. N., and Canadian Drug Safety and Effectiveness Research Network (CDSERN) 2016 Repetition of intentional drug overdose: A population-based study Clinical Toxicology 54 7 585 -589
Friesen E. 2019 The landscape of mental health services in rural Canada University of Toronto Medical Journal 96 2 47 -52
G20. 2022. Addressing territorial disparities in future infrastructure needs in the wake of the Covid-19 crisis: A G-20 perspective. https://www.g20.org/wp-content/uploads/2022/10/3.-OECD_G20_regional_disparities_August2022.pdf
Gomez D., Saunders N., Greene B., Santiago R., Ahmed N., and Baxter N. N. 2020 Firearm-related injuries and deaths in Ontario, Canada, 2002–2016: A population-based study CMAJ 192 42 E1253 -E1263
Grigoriadis S., Wilton A. S., Kurdyak P. A., Rhodes A. E., VonderPorten E. H., Levitt A., Cheung A., and Vigod S. N. 2017 Perinatal suicide in Ontario, Canada: Preliminary results Archives of Women’s Mental Health 18 2 E1085 -E1092
Hagen B. N., Albright A., Sargeant J., Winder C. B., Harper S. L., O’Sullivan T. L., and Jones-Bitton A. 2019 Research trends in farmers’ mental health: A scoping review of mental health outcomes and interventions among farming populations worldwide PLoS one 14 12 1 -20
Herath J. C., Kalikias S., Phillips S. M., and Del Bigio M. R. 2014 Traumatic and other non-natural childhood deaths in Manitoba, Canada: A retrospective autopsy analysis (1989–2010) Canadian Journal of Public Health 105 2 e103 -e108
Herron R., Ahmadu M., Allan J., Waddell C., and Roger K. 2020 “Talk about it:” Changing masculinities and mental health in rural places? Social Science and Medicine 258 113099
Herron, R. & Skinner, M. (2018) Rural places and spaces of health and health care. In V. Crooks, J. Pearce, and G. Andrews (Eds.), Handbook of Health Geography (pp. 267–272). New York: Routledge.
Hirsch J. K. 2006 A review of the literature on rural suicide: Risk and protective factors, incidence, and prevention Crisis: The Journal of Crisis Intervention and Suicide Prevention 27 4 189 -199 https://doi.org/10.1027/0227-5910.27.4.189
Hirsch J. K. and Cukrowicz K. C. 2014 Suicide in rural areas: An updated review of the literature Journal of Rural Mental Health 38 2 65 -78 https://doi.org/10.1037/rmh0000018
Kim K., Ozegovic D., and Voaklander D. C. 2012 Differences in incidence of injury between rural and urban children in Canada and the USA: A systematic review Injury Prevention 18 4 264 -271
Korczak D. J., Finkelstein Y., Barwick M., Chaim G., Cleverley K., Henderson J., Monga S., Moretti M.E., Willan A., and Szatmari P. 2020 A suicide prevention strategy for youth presenting to the emergency department with suicide related behaviour: Protocol for a randomized controlled trial BMC Psychiatry 20 1 20
Madge N., Hewitt A., Hawton K., Wilde E. J., Corcoran P., Fekete S., van Heeringen K., De Leo D., and Ystgaard M. 2008 Deliberate self-harm within an international community sample of young people: Comparative findings from the Child & Adolescent Self-harm in Europe (CASE) study Journal of Child Psychology and Psychiatry 49 6 667 -677
Mahar A. L., Cramm H., Aiken A. B., Whitehead M., Tien H., Fear N. T., and Kurdyak P. 2019 A retrospective cohort study comparing non-fatal self-harm emergency department visits between Canadian veterans living in Ontario and matched civilians International Review of Psychiatry 31 1 25 -33
Mental Health Commission of Canada. (2020). National research agenda on suicide and its prevention survey FAQs and definitions. https://www.mentalhealthcommission.ca/English/national-research-agenda-suicide-and-its-prevention-survey-faqs-and-definitions
Narendran G. and Ratnapalan S. 2019 Mental health care for pediatric presentations to emergency departments: A scoping review Paediatrics & Child Health 24 Supplement 2 e39 -e40
Neufeld E., Hirdes J. P., Perlman C. M., and Rabinowitz T. 2015 A longitudinal examination of rural status and suicide risk Healthcare Management Forum 28 4 129 -133
Ngui A. N., Apparicio P., Moltchanova E., and Vasiliadis H. M. 2014 Spatial analysis of suicide mortality in Québec: Spatial clustering and area factor correlates Psychiatry Research 220 1–2 20 -30
Ostry A. 2009 The mortality gap between urban and rural Canadians: A gendered analysis Rural & Remote Health 9 4 1 -11
Pan S. W. and Carpiano R. M. 2013 Immigrant density, sense of community belonging, and suicidal ideation among racial minority and white immigrants in Canada Journal of Immigrant and Minority Health 15 1 34 -42
Peters, M. D. J., Godfrey. C., McInerney, P., Munn, Z., Tricco, A. C., & Khalil, H. (2020 version). Chapter 11: Scoping reviews. In E. Aromataris, & Z. Munn (Eds.) JBI Manual for Evidence Synthesis. JBI. https://synthesismanual.jbi.global. https://doi.org/10.46658/JBIMES-20-12
Pong R. W., DesMeules M., and Lagacé C. 2009 Rural–urban disparities in health: How does Canada fare and how does Canada compare with Australia? Australian Journal of Rural Health 17 1 58 -64
Poon C. S. and Saewyc E. M. 2009 Out yonder: Sexual-minority adolescents in rural communities in British Columbia American Journal of Public Health 99 1 118 -124
Public Health Agency of Canada. (2020, March 4). Suicide in Canada: Key statistics (infographics). Government of Canada. https://www.canada.ca/en/public-health/services/publications/healthy-living/suicide-canada-key-statistics-infographic.html
Ray J. G., Guttmann A., Silveira J., and Park A. L. 2020 Mortality in a cohort of 3.1 million children, adolescents and young adults Journal of Epidemiology and Community Health 74 3 260 -268
Rhodes A. E., Boyle M. H., Bridge J. A., Sinyor M., Katz L. Y., Bennett K., Newton A. S., Links P. S., Tonmyr L., Skinner R., Cheung A., Bethell J., and Carlisle C. 2018 Les soins médicaux de jeunes hommes et de jeunes femmes qui décèdent par suicide The Canadian Journal of Psychiatry 63 3 161 -169
Roy P. and Tremblay G. 2015 L’experience du stress chez les agriculteurs: Une analyse du genre masculin Nouvelles Practiques Sociales 27 2 236 -252
Roy P., Tremblay G., Oliffe J. L., Jbilou J., and Robertson S. 2013 Male farmers with mental health disorders: A scoping review Australian Journal of Rural Health 21 1 3 -7
Roy P., Tremblay G., and Robertson S. 2014 Help-seeking among male farmers: Connecting masculinities and mental health Sociologia Ruralis 54 4 460 -476 https://doi-org.berlioz.brandonu.ca/10.1111/soru.12045
Roy P., Tremblay G., Robertson S., and Houle J. 2017 “Do it all by myself”: A salutogenic approach of masculine health practice among farming men coping with stress American Journal of Men’s Health 11 5 1536 -1546
Schiller C. J. 2017 Medical assistance in dying in Canada: Focus on rural communities The Journal for Nurse Practitioners 13 9 628 -634
Sturgeon R. and Morrissette P. J. 2010 A qualitative analysis of suicide ideation among Manitoban farmers Canadian Journal of Counselling and Psychotherapy 44 2 191 -207
Subedi, R., Roshanafshar, S., & Greenberg, T. L. (2020). Developing meaningful categories for distinguishing levels of remoteness in Canada. Analytical Studies: Methods and References. Statistics Canada. https://epe.lac-bac.gc.ca/100/201/301/weekly_acquisitions_list-ef/2020/20-33/publications.gc.ca/collections/collection_2020/statcan/11-633-x/11-633-x2020002-eng.pdf
Tobias J. K., Richmond C. A., and Luginaah I. 2013 Community-based participatory research (CBPR) with Indigenous communities: Producing respectful and reciprocal research Journal of Empirical Research on Human Research Ethics 8 2 129 -140
UNCTAD. (2022). E-handbook of statistics 2021. https://hbs.unctad.org/total-and-urban-population/
Wang S., Xu H., Zhang S., Wan Y., and Tao F. 2020 Mediating effects of self-esteem in the relationship between childhood maltreatment and non-suicidal self-injury among adolescents: The roles of sex and only-child status Social Science & Medicine 249 1 -6 https://doi-org.berlioz.brandonu.ca/10.1016/j.socscimed.2020.112847
Yiannakoulias N., Sanchez-Ramirez D., Svenson L. W., and Voaklander D. C. 2016 A cohort study of regional migration and the risks of attempted suicide and violent assault injury Injury Prevention 22 6 407 -411
Zaheer J., Links P. S., Law S., Shera W., Hodges B., Tsang A. K. T., Huang X., and Liu P. 2011 Developing a matrix model of rural suicide prevention International Journal of Mental Health 40 4 28 -49

Information & Authors

Information

Published In

cover image Canadian Journal of Community Mental Health
Canadian Journal of Community Mental Health
Volume 42Number 1May 2023
Pages: 41 - 57

History

Version of record online: 5 April 2023

Key Words

  1. suicide
  2. rural
  3. Canada
  4. review

Mots-clés

  1. suicide
  2. rural
  3. Canada
  4. examen

Authors

Affiliations

Kyrra Rauch
Kim Ryan
Donna Epp
Stacey Lee
Rachel Herron
Sharran Mullins
Andrea E. Thomson
Candice Waddell-Henowitch

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