Youths who live in rural areas may be twice as likely to commit suicide compared with those who live in urban regions.

The recent findings highlight the need to improve the availability of mental health care in rural regions, Ohio State University reported.

To make their findings a team of researchers looked at nearly 67,000 cases of suicide in young male and female individuals from either urban or rural areas. The events occurred between the years of 1997 and 2010.  Along with the link between place of residence and suicide risk, the findings also revealed suicides by gun have decreased, and hanging has become a more common method for youth suicide.

"These kinds of surveillance studies can really help us identify areas to target our prevention efforts, and it's clear we need to target rural areas for primary prevention of suicide," said Cynthia Fontanella, clinical assistant professor of psychiatry and behavioral health at The Ohio State University Wexner Medical Center and lead author of the study.

The rural versus urban suicide rate among males was 19.93 and 10.31 per 100,000, respectively. The suicide rate for females living in urban areas was 2.39 per 100,000, and 4.40 per 100,000 for those living in rural regions. More than half of the study subjects suicide with a firearm, and 33.9 percent died by hanging. The researchers believe the disparity in suicide rates based on where young people reside is largely linked to a shortage of mental health practitioners in rural regions.

"If a rural child is depressed, it's much harder to get state-of-the-art care. And it's especially difficult to receive psychotherapy in a rural area," said John Campo, chair of psychiatry and behavioral health at Wexner Medical Center and senior author of the paper.

The researchers noted rural areas tend to practice a culture in which self-reliance is encouraged, which could cause a larger stigma to be placed on mental illnesses.

"There is a lot of pride around taking care of your own problems and turning to neighbors rather than professionals for help," Fontanella said.

The findings were published in a recent edition of the journal JAMA Pediatrics.