“Suicide rates remain consistently higher in rural communities across all age groups when contrasted with their urban counterparts year after year,” writes medical student Briggs Miller.
Note to readers • This story discusses suicide. If you or people you know are at risk of self-harm, the 988 Suicide & Crisis Lifeline provides 24-hour support. Call or text 988.
For many, Utah has become the place to settle down, raise a family, pursue dreams and embrace all that life has to offer. This trend has only accelerated in the past decade. From 2010 to 2023, Utah was the fastest-growing state in the nation, driven largely by its high birth rate.
The state also ranks fourth overall in happiness, thanks to its first-place standing in both work environment and community/environment categories — two of the three major measures used by the World Population Review. With a thriving economy and countless opportunities to enjoy its breathtaking landscapes, it’s no wonder so many call Utah home.
Yet behind the glossy brochures highlighting skiing, hiking, and scenic views lies a reality many Utahns either fail to recognize or choose not to address: Utah has a mental health crisis. Despite ranking first in two out of three happiness categories, Utah slips to fourth overall due to its 27th ranking in emotional and physical well-being. More troubling, the state ranks 46th nationally in adult mental health prevalence and care access.
The consequences are glaring. In 2022, Utah recorded a suicide rate of 22.1 per 100,000 people, making it the seventh highest in the nation. Suicide is the second leading cause of death among Utahns ages 10–44. These statistics also fail to account for the far larger number of individuals who require hospitalization or medical care following suicide attempts. Utah thus faces a troubling paradox: how can one of the nation’s “happiest” states also struggle with one of the highest suicide rates?
The mental health challenges facing Utah are not distributed equally across its communities. As is true in most of the United States, health disparities are often more severe in rural and underserved populations. Utah is divided into 29 counties, 24 of which are classified as rural due to their population densities below 99 people per square mile. While these counties make up the vast majority of the state’s land, they account for only approximately 20.7% of Utah’s total population.
In Utah’s rural counties, the burden of mental health challenges is notably severe. In 2023, suicide mortality reached a decade-high of 26 deaths per 100,000 residents, compared with 18.6 per 100,000 in urban areas. The suicide rates remain consistently higher in rural communities across all age groups when contrasted with their urban counterparts year after year.
Multiple factors help explain the disparity in suicide mortality between rural and urban Utah. One important contributor is the higher prevalence of gun ownership in rural communities. This likely accounts for the higher proportion of suicide deaths involving firearms (63.3% in rural areas compared with 53.6% in urban areas). The favorability of more lethal means of suicide increases the likelihood of death.
However, the problem is far more complex. Accessing health care services is often a significant challenge for rural communities. They often face lower insurance coverage rates, fewer available providers, lower health literacy, and major geographic and transportation barriers.
The National Violent Death Reporting System (NVDRS) data indicate that individuals who died by suicide in rural Utah were more likely to have a physical health problem (27.8%) compared with their urban counterparts (21.8%). These disparities in health care access are likely a partial driver of the higher suicide mortality observed in rural settings.
Addressing this crisis requires a multifaceted approach. The most urgent need in rural Utah is to expand access to both general and behavioral health care. Long-term solutions must focus on increasing the physical presence of providers in rural and underserved communities. This is especially critical because three out of four people who die by suicide have seen their primary care provider within the year prior to their death. These visits are valuable opportunities to address mental health concerns and provide mental health resources early on — a resource not easily accessible in these communities.
In the short term, virtual options have emerged as an important tool for bridging the gap. Telehealth and telemedicine initiatives by the University of Utah and Intermountain Health now allow patients in remote areas to connect with specialists through video or telephone visits. Thus, they have effectively opened the clinic door to communities across the state.
Mental health should be a priority for all Utahns. The crisis is most acute in rural areas, where suicide mortality rates are significantly higher and compounded by limited access to care. Continuing and working to expand efforts is essential to address the silent but pressing mental health challenges facing rural Utah and its broader population.
To truly honor both its majestic landscapes and the people who call them home, Utah must transform happiness from beyond breathtaking landscapes to encompass a lived reality by guaranteeing access to mental health care.
Briggs Miller is a second-year medical student at the Spencer Fox Eccles School of Medicine at the University of Utah and was raised in Grantsville.
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Source: Utah News