Youth suicide rates are higher where mental-health providers are scarce, study of all U.S. counties says; all but 3 in Ky. rated short

Counties that have shortages of mental-health providers tend to have seen their rates of youth suicide increase in recent years, a study has found.

The study, published in JAMA Pediatrics, found that after adjusting for demographic and socioeconomic characteristics, counties with a mental-health workforce shortage were associated with an increased youth suicide rate, and an increased youth firearm suicide rate, when compared to counties with no or partial mental health shortage designations.

Suicide is the second leading cause of death among U.S. adolescents, with rates rising over the last decade. This is also true in Kentucky. Every county in Kentucky is officially designated as a Mental Health Professional Shortage Area, except Boone, Campbell and Grant counties in Northern Kentucky.

“Our results underscore the critical need to expand the mental health professional workforce in counties across the country,” lead author Dr. Jennifer Hoffmann, an emergency medicine physician at Ann & Robert H. Lurie Children’s Hospital of Chicago, said in a news release. “In addition, policies that restrict firearm access to young people may be considered as a suicide-prevention strategy.”

Using youth suicide data from every U.S. county, the researchers found there were 5,034 suicides by youth between the ages of 5 and 19 from 2015 to 2016, with an annual suicide rate of 3.99 per 100,000 youth in that age group. The study found that among all the counties where a youth suicide occurred, more than two-thirds, or 67.6%, were designated as mental-health workforce-shortage areas.

The designation is made by the U.S. Health Resources and Services Administration, which assigns a score between 0 and 25, with higher scores indicating greater shortages. The study found that the adjusted youth-suicide rate increased 4% for every 1-point increase in the score.

It also found that there were geographic disparities, with higher suicide rates in rural and high-poverty areas, where mental-health professionals are scarce.

“Counties with mental-health HPSA designation had more uninsured children, lower educational attainment, higher unemployment, higher poverty, higher percentages of non-Hispanic White residents, and were more often rural, compared with counties with partial/no HPSA designation,” the researchers write.

Hoffmann offered several ways to improve access to mental-health care for youth.

“Mental-health workforce capacity can be increased through integration of mental-health care into primary-care settings and schools, and through expansion of telehealth services,” Hoffmann said in a news release. “Improving reimbursement rates for mental-health services may further aid in recruitment and retention of mental health professionals, and hopefully reduce suicide rates among young people.”

Dr. Aaron Carroll of the Indiana University School of Medicine and Denise Hayes of the university’s School of Public Health, argued in an accompanying editorial that money directed at hiring more mental-health care professionals alone will not solve this problem.