Content area
Full Text
Living in a rural area has been linked to poorer mental health outcomes and higher rates of suicide, particularly among adolescents, as reported in the 2014 study by Kann and colleagues for the Centers for Disease Control and Prevention. Research suggests that the prevalence of mental illness and death by suicide in rural areas may be a result of limited mental health literacy-a problem that is compounded by stigma, geographic isolation, and limited access to service providers. To address the problem of limited mental health literacy in rural areas, the Better Todays training was developed to educate adult gatekeepers in rural communities on how to identify and respond to adolescents at risk for suicide. The present study evaluated Better Todays using a paired sample t-test. Results showed that individuals who participated in Better Todays reported improved mental health literacy. Data from this study suggest that trainings and customized program content may be an effective way to improve mental health literacy in rural communities.
Key words: disparities; mental health literacy; mental illness; rural; stigma; suicide prevention
Introduction
Living in a rural area often has a negative impact on mental health outcomes, sometimes leading to higher rates of suicide (Kann et al., 2014). Indeed, states with large rural and frontier areas such as Idaho, Oregon, and Utah have the highest percentages of people experiencing mental illness in the United States (19 to 22 percent) compared to 14 to 17 percent in Texas, Illinois, and Florida (Substance Abuse and Mental Health Services Administration [SAMHSA], 2014c). This is particularly significant because high suicide rates are strongly associated with mental illness: more than 80 percent of people who die by suicide were also reported to have a documented mental illness (Harris & Barraclough, 1997; Hawton, Saunders, Topiwala, & Haw, 2013). The link between suicide and mental illness is exemplified in Idaho, where death by suicide is particularly high for adolescents, with a suicide rate of 18.4 per 100,000 as compared to an average of 12.3 per 100,000 for the United States (Idaho Department of Health and Welfare, 2014). Certain racial and ethnic subgroups are at higher risk for mental illness and suicide. The rate of suicide for Native Americans is 11.00 per 100,000 compared to 5.1 per 100,000 for...