Journal of Rural Mental Health, Vol 47(2), Apr 2023, 65-80; doi:10.1037/rmh0000208
Suicide is an ongoing public health crisis among young people in the United States. Suicide rates in rural areas are often more than double rates in urban locales. Few reviews have examined the contextual place-based social, environmental, or economic factors that contribute to differences in mental health risks for young people. This scoping review aims to map the state of the evidence on socioenvironmental factors driving suicide risks in adolescents with a particular focus on rural America. A literature database search using PRISM guidelines identified 143 research studies meeting inclusion and review criteria. Descriptive and thematic analyses were conducted and presented in a narrative form for the following topics: (a) Adolescent suicide and vulnerable populations, (b) Mental health conditions in the pathway of suicide, (c) Rural versus urban, (d) Social determinants of mental health and access, and (e) Impact of physical environment on adolescent mental health. Findings highlight that hopelessness, particularly in minority populations, inadequate family and peer support, unaddressed traumatic experiences, and underdiagnosis and treatment for mood disorders or substance abuse, are essential contributory factors to rural adolescent suicide. Nearly all of the evidence focused on individual rather than community-level factors like school bullying and low screening. Improvements in school-based detection of mental disorders, particularly around critical transition periods, and more longitudinal research investigating causal links, rural populations, and the contextual socioenvironmental determinants of adolescent suicide are needed, emphasizing distinct challenges for rural areas in response to the pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)