Suicide and Mental Health Inequities in the U.S.: Evidence from Policy, Place, and Practice

Session Submission Type: Panel

Abstract

Mental health is a pressing concern across the U.S., with variation in the causes and consequences across population subgroups and geographies. Among adolescents, suicide is the second leading cause of death. Among adults, reported rates of alcohol consumption are high, and past research has linked alcohol use with poor mental health. Across the country, increasingly frequent and severe natural disasters also introduce substantial emotional and psychological strain. This collection of research presents complementary insights into how alcohol policy, climate, and rurality each contribute to shaping these outcomes.

The first paper, “Examining Heterogeneity in Adolescent Suicide Trends to Inform Suicide Prevention Policy,” investigates long-term trends in active suicidal ideation, non-fatal suicide attempts, and suicide deaths among adolescents. The study reveals notable increases in all outcomes, with particularly substantial growth in ideation and attempts among females and in deaths among rural males. Rural adolescents across genders experienced steeper increases across all outcomes compared to urban counterparts. These patterns point to a growing crisis in youth mental health and emphasize the need for suicide prevention policies tailored to rural contexts and specific subpopulations.

“Putting School-Based Mental Health Services in Place: Evidence from Rural Tennessee” deepens the discussion of geographical differences by focusing on school-based mental health services in rural Tennessee, drawing on semi-structured interviews with Coordinated School Health Directors across nearly 50 counties. Their findings highlight challenges in rural districts, including persistent difficulties in recruiting and retaining qualified mental health personnel, often due to funding instability and geographic isolation. The study emphasizes the importance of stability, funding continuity, and community-based approaches to strengthen rural mental health school ecosystems.

The third paper, “Happy Hours Gone Wrong: The Impact of Alcohol Consumption on Suicide,” furthers the discussion of suicide trends by examining the relationship between alcohol consumption and suicide rates with a two-stage least squares approach using state-level happy hour restrictions as an instrument. This paper finds that increases in alcohol consumption lead to increases in suicide rates, especially for white males. These results suggest that policies restricting alcohol promotions can serve as an effective lever in suicide prevention, especially among high-risk demographic groups.

Finally, “Health Outcomes and Disparities Among Vulnerable Populations Following Natural Disasters and Climate-Related Extreme Weather Events,” explores the broader structural vulnerabilities that exacerbate mental and physical health disparities by providing an umbrella review on the effects of natural disasters and climate-related events. This review finds consistent evidence of disproportionate health impacts among women, racial and ethnic minorities, rural communities, and economically disadvantaged populations. Key issues include depression, anxiety, and trauma. The review calls for equity-oriented disaster response policies and greater attention to intersectional and structural factors in future research.

Together, these studies underscore the multidimensional nature of mental health disparities in the U.S., driven by policy, place, and access to services. Each paper contributes unique insights into the challenges facing vulnerable populations and points toward targeted solutions to improve outcomes and promote equity in mental health care and suicide prevention.

Policy Area

• Health Policy

Chair

• Mason M Shero

Discussants

• Calaia Samara Ellice Jackson, University of Delaware

• Harneet Kaur, University of Arkansas

Organizer

• Sharmistha Chakrabarti, New York University

Individual Presentations

• Examining Heterogeneity in Adolescent Suicide Trends to Inform Suicide Prevention Policy - Presenting Author: Sharmistha Chakrabarti, New York University

• Putting School-Based Mental Health Services in Place: Evidence from Rural Tennessee - Presenting Author: Liliane Nienstedt, Vanderbilt University

• Happy Hours Gone Wrong: The Impact of Alcohol Consumption on Suicide - Presenting Author: Archi Arnob, University of Kansas

• Health Outcomes and Disparities Among Vulnerable Populations Following Natural Disasters and Climate-Related Extreme Weather Events - Presenting Author: Jim P Stimpson, University of Texas Southwestern Medical Center