Suicide in American Cities

Purpose of Review Suicide rates have risen over the past two decades in the United States of America (USA). Rates are higher in rural settings, but more total suicides occur in urban areas. Understanding risk and protective factors prevalent in urban areas is essential in reducing the individual and public health impact of suicide. Recent Findings Lower rates of suicide in urban settings derive less from underlying differences in mental distress than from variation in access to care and to highly lethal means of suicide. Culturally appropriate interventions incorporating intersectional perspectives are needed to prevent and reduce suicide among people of color, particularly Native American and Black youth, and among lesbian, gay, bisexual, and transgender (LGBT) populations. The Zero Suicide Initiative aims to coordinate multi-level suicide prevention interventions across sites of healthcare, and may be particularly well-suited to urban areas, where sources of care are more densely available and healthcare contacts may be more frequent.