Suicidality in rural and remote communities: A scoping review

By Kyrra Hunter Rauch, Donna Epp, Jesse Windsor, Jennifer Dauphinais, Rachel Herron, Stacey Lee, Sharran Mullins, Doug Ramsey, Kim Ryan, Andrea Thomson, and Candice Waddell-Henowitch
April 2021
Print Version

What you need to know

The Public Health Agency of Canada (PHAC), in association with the Mental Health Commission of Canada (MHCC), conducted a literature review and stakeholder consultations on suicide in 2018. Many priority populations did not have a voice in those discussions, one of those being rural and remote communities. The PHAC contracted the Centre for Critical Studies of Rural Mental Health (CCSRMH) to conduct an in-depth scoping review on suicide in rural/remote communities.

Why this research is important

This scoping review revealed a lack of research on the topic of suicide in rural Canada. This is concerning as the suicide rate has been found to be higher in rural and remote communities. The findings of this scoping review will inform future research on this topic.

How this research was conducted

The librarian researcher on the project developed the search string and identified seven databases as relevant to the project. Articles were included if: (1) they were published between 2009 and July 2020 and (2) examined suicide or suicide-related behaviour in rural communities.

After full-text screening was complete, 63 Canadian articles remained 39 of which were non-Indigenous. A separate focused analysis guided by Indigenous people and Indigenous ways of knowing will be required for further Indigenous study.

What the researchers found

As there is no universal definition of rural, the studies reviewed employed a variety of different definitions, including population density (<10,000 population) or relying on postal codes. A number of studies did not explicitly define rural.

Many of the studies reviewed sought to identify risk factors that influence suicide. Rural residence was the most prominent risk factor—regardless of age—and can be associated with additional risk factors including agricultural vocation, access to means, and limited access to mental health care; male sex was also a prominent risk factor. Urban residence, female sex (more likely to attempt suicide, but less likely to complete suicide), and social support, particularly family, were identified mitigating factors.

Interventions are aimed at individuals at risk for suicide/suicide-related behaviour, with the goal being prevention. Only one intervention was identified, and the results have not yet been published. No articles were found on postvention regarding support for individuals or families following a suicide attempt or death.

How this research can be used

This review identified gaps in the current literature published on rural suicide in Canada, including a lack of qualitative research and the need for more intervention and postvention research. Most importantly, this information will act as a base for stakeholder consultations across Canada, beginning March 2021. The input from these conversations will be shared with PHAC and will inform the next steps in research and assist in identifying the next steps for suicide prevention in rural communities.


Funding for this research was provided through the Public Health Agency of Canada.

About the Researchers

Kyrra Hunter Rauch

Kyrra Hunter Rauch, BA (Hons)

Kyrra Rauch is a recent graduate, BA (Hons) in psychology, and a research assistant for the CCSRMH at Brandon University.

Donna Epp

Donna Epp, RN, BScN, MScN, CDE

Donna Epp is the research facilitator for the CCSRMH.

Jesse Windsor

Jesse Windsor

Jesse Windsor is a research assistant for the CCSRMH at Brandon University.

Jennifer Dauphinais

Jennifer Dauphinais

Jennifer Dauphinais is a research assistant for the CCSRMH at Brandon University.

Rachel Herron

Rachel Herron, PhD

Rachel Herron is an associate professor in the Department of Geography and Environment and Director of the CCSRMH.

Stacey Lee

Stacey Lee, BA (Hons), MLIS

Stacey Lee is a cataloguing and metadata librarian at Brandon University.

Sharran Mullins

Sharran Mullins, RPN, BA, BScPN, MPN

Sharran Mullins is an assistant professor in the Department of Psychiatric Nursing at Brandon University.

Doug Ramsey

Doug Ramsey, PhD

Doug Ramsey is a professor in the Department of Rural Development at Brandon University.

Kim Ryan

Kim Ryan, RPN, RN, BScPN, MEd

Kim Ryan is an associate professor in the Department of Psychiatric Nursing at Brandon University.

Andrea Thomson

Andrea Thomson, RPN, BScPN, MPN

Andrea Thomson is an assistant professor in the Department of Psychiatric Nursing at Brandon University.

Candice Waddell-Henowitch

Candice Waddell-Henowitch, RPN, MPN, PhD (c)

Candice Waddell-Henowitch is an associate professor in the Department of Psychiatric Nursing at Brandon University.


  • Canada
  • remote
  • rural
  • suicide

Publications Based on the Research

Publication based on this research

Epp, D., Hunter Rauch, K., Windsor, J., Dauphinais, J., Herron, R., Mullins, S., Lee, S., Ramsey, D., Ryan, K., Thomson, A., & Waddell-Henowitch, C. (2021). Suicidality in rural and/or remote communities: A scoping literature review. Manuscript submitted for publication.

Editor: Christiane Ramsey

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