Is there a rural mental health crisis?

There is a silent mental health crisis in rural America that's costing the lives of young people, Democratic Montana Sen. Jon Tester says in an op-ed today in The Hill newspaper.

Six children have taken their own lives on the Fort Peck Indian Reservation in Montana in the past year, he writes. One of them was only 10 years old. In the same time frame, 20 more young people attempted suicide on the reservation.

Tester writes that Congress needs to reauthorize the bill that provides health services for Indian reservations, but that a mental health crisis afflicts all rural Americans because it's difficult to access mental health services in sparsely populated areas.

Interestingly enough, writer Dan Savage, who started the "It Gets Better" project to urge gay teens not to take their own lives, says he especially hopes his project will reach teens who live in rural areas, where tolerance for homosexuality is often much lower than in cities and suburban areas.

At least one teen who lived in a rural area (near Greensburg, Indiana) died by suicide in the past few months after bullies teased him and called him gay. His death partly inspired Savage's project.

Suicide prevention expert Ann Haas says being gay in rural America is "fraught with multiple problems."

"It's really pointing to a phenomenon that being gay in America differs widely by where you live," Haas says.

While there's no conclusive data on suicide rates among gay people, Native Americans aged 10 to 24 have by far the highest suicide rate of any ethnic group. But Native American young people who live in cities are even more at risk for mental health problems than those who live on rural reservations, Haas says — which complicates the view that suicide is a more pronounced "rural" problem.

It is true, however, that rural states have the highest suicide rates in the country. According to a recent study, Montana's suicide rate is the fourth highest in the nation; only New Mexico, Nevada and Alaska — also predominantly rural states — reported higher suicide rates. But some experts suggest that increasing mental health services, while a beneficial step in its own right, doesn't address some of the other prime risk factors for suicide in rural areas. Many rural states also have high rates of gun ownership, Haas points out — and people who try to kill themselves with firearms are more likely to succeed than those who use other methods, such as an overdose of pills. Meanwhile, Haas adds, some rural communities stigmatize people who seek help for mental health problems. "Depression and other mental health problems are seen as a sign of weakness," Haas says.

(A high school student and New Mexico Apache reservation resident testifies in Congress about the mental health crisis in March: AP)

Correction: This article earlier misidentified Anoka, Minnesota, as a rural area.