You’ve got to have friends: the predictive value of social integration and support in suicidal ideation among rural communities

To explore the role of social integration and support in the longitudinal course of suicidal ideation (SI) in a rural population.

Baseline and 12-month data were obtained from participants within the Australian Rural Mental Health Study, a longitudinal
study of community residents within rural and remote New South Wales, Australia. SI was assessed using the Patient Health
Questionnaire. Individual psychological factors, family and community characteristics were examined alongside personal social
networks (Berkman Syme Social Network Index), availability of social support (Interview Schedule for Social Interaction) and
perception of local community (Sense of Community Index).

Thirteen hundred and fifty-six participants were included in the analysis (39% male, mean age 56.5 years). Sixty-one participants
reported recent SI at baseline, while 57 reported SI at follow-up. Baseline SI was a strong predictor of SI at 12 months [odds
ratio (OR) 19.0, 95% confidence interval (CI) 8.6–42.3); significant effects were also observed for baseline values of psychological
distress (OR 1.4, 95% CI 1.0–1.9) and availability of social support (OR 0.76, 95% 0.58–1.0) on 12-month SI. The emergence
of SI at 12-month follow-up was predicted by higher psychological distress (OR 1.8, 95% CI 1.3–2.4); there was a marginal
effect of lower availability of support (OR 0.74, 95% CI 0.55–1.0); neither of these variables predicted SI resolution.

This study investigated factors associated with SI over a 12-month period in a rural cohort. After controlling for known risk
factors for SI, low availability of social support at baseline was associated with greater likelihood of SI at 12-month follow-up.