Suicide rates have increased in recent years among rural residents, raising alarms about the accessibility of mental health services that could prevent actual suicide. This study will provide information about rural/urban disparities in 1) the receipt and sources of mental health treatment among adults with suicidal thoughts and attempts using data from the National Survey on Drug Use and Health (NSDUH); and 2) mental health follow-up visits among adults with a hospital admission or emergency department visit for self-inflicted harm using data from a national insurance claims dataset.

Specific aims of this study are to:

1. Using NSDUH data, estimate and compare the prevalence of any mental health treatment and the sources of treatment among rural and urban adults with past year suicidal thoughts and attempts.
2. Using NSDUH data, identify economic, social, and health care factors associated with the receipt of mental health treatment among rural and urban adults with past year suicidal thoughts and attempts.
3. Using MarketScan insurance data, estimate and compare the prevalence of the receipt of mental health follow-up care among rural and urban adults within 7 days and 30 days after a hospital admission or emergency department visit for suicidal attempt or self-inflicted injury.

The proposed study's findings will inform rural health policy makers, health system managers, and providers about mental health treatment access and unmet needs among adults at risk for suicide. In turn, the findings may contribute to funding allocation decisions for rural suicide prevention and mental health treatment services, changes in the training and education of health care professionals about the need for suicidal ideation screenings and mental health treatment in rural settings, and health systems' expansions of suicidal screenings and related mental health services.