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Rural communities have unique mental health needs and challenges which are often related to the uniqueness of the community itself. On a per‐capita basis, the investment in rural mental health research is far less than that in urban communities. Added to this, rural communities are often at risk of researchers, based in large urban universities, visiting, conducting the research with minimal engagement with local stakeholders and limited understanding of the community's social‐service‐environmental context. Often this research leaves no visible benefit to the community with respect to increased knowledge, resources or community capacity. This commentary is based on the insights of a panel of authors from 9 countries, each with extensive experience of rural mental health research and work. And it seeks to stimulate the discourse on responsible rural mental health practice. The aim of this commentary is to provide a reference on research practice for novice and experienced researchers on rural mental health research and practice, to assist policymakers, government and funding bodies to establish appropriate standards and guidelines for rural mental health research, and support rural communities to advocate for equity of funding and sustainable research as they engage with researchers, funders and governments. The 10 standards in this declaration will help guide researchers toward research that is beneficial to rural communities and also help develop the local community's research capability, which ultimately will serve to enhance the mental health and well‐being of rural communities. [ABSTRACT FROM AUTHOR]

Suicide is the second most common cause of death for medical students, after accidents. Once they have graduated, physicians have higher rates of suicide than the general population, and are consistently at the top of rankings for occupational groups at risk of suicide. However, we should be careful to avoid alarming medical students with these statistics. Suicide is the second leading cause of death for all young people, not just medical students, and the higher rate of suicide among physicians is substantially accounted for by their ready access to lethal means of suicide.

The association between thoughts of self-harm and help-seeking among youth with symptoms of depression was examined. Data were drawn from the Health Behavior of School-aged Children Study ("n" = 15, 686), a nationally representative sample of youth in the United States. Analyses focused on comparing help-seeking behaviors among youth with and without thoughts of deliberate self-harm (DSH) when depressed. Depressed youth with thoughts of DSH exhibited different patterns of help-seeking than those without. Both groups most frequently sought help from friends and parents. However, adolescents with thoughts of DSH were statistically more likely than youth without to seek help from friends (DSH: 69.9%; no DSH: 57.8%; AOR = 1.46), but less likely to seek help from parents (DSH: 53.7%; no DSH: 73.1%; AOR = 0.47). Youth with DSH were more likely to seek help from school officials (AOR = 1.05), health professionals (AOR: 1.83), or a counselor (AOR = 1.93) compared with those without thoughts of DSH who were more likely to seek help from a sibling (AOR: 0.77) or other relatives (AOR: 0.78). Results may help inform programs to improve identification of youth at risk of self-harm in community and school settings. (Contains 1 table.)

Investigation of land-use and management changes at regional scales require the linkage of farm-system models with land-resource information, which for pastoral systems includes forage supply. The New Zealand Land Resource Inventory (NZLRI) and associated Land Use Capability (LUC) database include estimates of the potential stock-carrying capacity across the country, which can be used to derive estimates of average annual pasture yields. Farm system models and decision support tools, however, require information on the seasonal patterns of pasture growth. To generate such pasture growth curves (PGCs), the Agricultural Production Systems Simulator (APSIM) was used, with generic soil profiles based on descriptions of LUC classes, to generate PGCs for three regions of New Zealand. Simulated annual pasture yields were similar to the estimates of annual potential pasture yield in the NZLRI spatial database, and they provided information on inter-annual variability. Simulated PGCs generally agreed well with measured long-term patterns of seasonal pasture growth. The approach can be used to obtain spatially discrete estimates of seasonal pasture growth patterns across New Zealand for use in farm system models and for assessing the impact of management practices and climate change on the regional sustainability. Additional keywords: cluster analysis, LUC soil profile descriptions, pasture growths curve., Introduction Pastoral agriculture is the major land use in New Zealand, covering -40% of the total land area. Of this land, -55% comprises improved pastures in flat to rolling terrain [...]

The psychological autopsy (PA) is a systematic method of assessing the psychological and contextual circumstances preceding suicide. The method requires interviews with one or more proxy respondents (i.e., informants) of suicide decedents. Procedural challenges that need to be addressed to conduct PA interviews are described in this article and recommendations for meeting these challenges in future PA investigations are made. Procedures addressed include determining the timing of PA interviews after suicide, designing the structure and flow of interviews, selection of proxy respondents, integrating interview data with information gathered from records, and selecting and training interviewers. This methodological article is the second in a two-part series--the first article focused on interview content. [For Part 1, see EJ966343.]

The psychological autopsy (PA) is a systematic method to understand the psychological and contextual circumstances preceding suicide. The method requires interviews with one or more proxy respondents (i.e., informants) of decedents. The methodological challenges that need to be addressed when determining the content of these research interviews for PA studies are described and recommendations are made for meeting these challenges in future PA investigations. Ways to improve the data collected about mental disorders and life events--domains that are assessed in almost all PA studies--are discussed at length. Other understudied content areas considered include the role of personality traits, medical illness and functional limitations, availability of lethal agents, medications, and select distal variables including child maltreatment and family history of mental disorders and suicide. The benefits and challenges to using common protocols across studies are also discussed.

An integrative suicide prevention program was implemented to tackle an outbreak of visitor charcoal burning suicides in Cheung Chau, an island in Hong Kong, in 2002. This study evaluated the effectiveness of the program. The numbers of visitor suicides reduced from 37 deaths in the 51 months prior to program implementation to 6 deaths in the 42 months post-implementation period. The number of visitor suicide pacts decreased from 7 pacts (15 individuals) to 1 pact (2 individuals). No statistically significant differences in the numbers of visitor suicide attempts and resident suicides were observed in the two time periods. No statistically significant changes in visitor suicides during the study period were observed on the comparison islands. The consistency and timing of reduction in visitor suicides correlated with the development and delivery of the integrative program on the intervention island, suggesting a causal association between program delivery and reduction of visitor suicides. The possibility of displacement seems small because there was no increase in visitor suicides on the comparison islands during the study period. This integrative approach in preventing target-specific suicides may serve as an example for other communities to develop suicide prevention programs that make use of the existing local resources.

Analysis of rates of further suicidal behavior among individuals making medically serious suicide attempts may help to predict suicide and suicide attempt from baseline characteristics of the individual and the index suicide attempt. Data are drawn from a 5-year study of 302 individuals making medically serious suicide attempts with information collected by personal interview at baseline, 6, 18, 30, and 60 months after the index attempt. Within 5 years, 6.7% died by suicide; 37% made at least one nonfatal suicide attempt. Although baseline characteristics permitted a modest prediction of suicide attempt, only a very limited prediction of suicide was possible. Almost half of those who made serious suicide attempts made a further fatal or nonfatal attempt within 5 years. These findings imply the need for enhanced follow-up, treatment, and surveillance of all patients making serious suicide attempts.