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How an Appalachian county is working to lower its suicide rate

Colorful writing on a wall reads, "Help is just a phone call away."
Kendall Crawford
/
The Ohio Newsroom
The feathers on the wall at the Talbert House, a crisis call center in Cincinnati, are reminders of the lives they've saved. Across the state in Carroll County, community health workers are raising awareness about the suicide and crisis lifeline, 988.

Ohio’s suicide rate has risen sharply in the past two decades, from 9.3 deaths per 100,000 people in 2003 to 14.7 deaths in 2023.

That’s an increase of more than 50%.

Many of the highest suicide rates are in Ohio’s Appalachian communities, like Carroll County.

Eight people there died by suicide in 2024, the most recent year with available data. And while that number may sound small, it equates to a rate of almost 30 suicide deaths per 100,000 people — about double the state average.

“We're working really hard to decrease stigma,” said Natalie Bollon, executive director of the Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Tuscarawas and Carroll Counties. “How do we let people know that it's okay to admit if you're struggling?”

An ‘awful trifecta’

Carroll County is among the least populated places in the state. Its population of around 27,000 people is expected to drop by more than 15% in the next 25 years.

The aging demographic has given way to a specific challenge when it comes to suicide, Bollon said.

“We are seeing individuals mostly male, mostly over the age of 50. Many of them have been given what we're calling a life-altering diagnosis prior to suicide,” she said. “So we’re seeing our Baby Boomers age.”

A map shows Ohio's counties in varying shades of blue, representing local suicide rates.
2023 Ohio Suicide Report
/
Ohio Department of Health
A map shows the suicide rates in Ohio counties from 2020 to 2023. Many of the highest rates are in rural counties.

Bollon says some people in the rural community are isolated and live far from their neighbors. Plus, many are hunters, so they have easy access to firearms.

“So we have this awful trifecta of older men with a life altering diagnosis with a highly lethal method easily accessible,” she said.

Getting help in a rural community

The behavioral health system has been growing in Carroll County. Two nonprofit agencies now offer therapy and case management there.

“We have developed an addiction treatment program at one of our agencies,” Bollon said. “We have some open access drop-in hours at one of the agencies because we know that not every behavioral health need happens on a schedule.”

But she says getting help can still be a challenge. Carroll County is a health professional shortage area: The number of clinicians per capita is much lower than in other parts of the state.

“And the way that that impacts the community is if you call for a counseling appointment … and the person on the other end of the phone says, ‘Well, the earliest we can get you in is three weeks because we are just understaffed,’ you are very unlikely to continue down that path three weeks later. So the lack of having clinicians has really had an impact on people being able to get expedited treatment,” Bollon said.

Once people schedule an initial appointment, finding transportation to get there can be another challenge.

“It is probably one of the biggest barriers to having people continue to maintain mental health services,” said Leslie Korns, manager of community services for the ADAMHS board.

She’s been working to raise awareness about services like 988, the suicide and crisis lifeline.

“We're trying to put messaging out there that it's okay to share feelings and to try to curb some of that generational belief of ‘I just got to pull myself up by my bootstraps and keep going,’” she said.

To reach men, specifically, the organization is partnering with the sheriff to raise awareness about resources.

And Korns is working with the Department of Natural Resources and the Muskingum Watershed Conservancy District to plan a fishing event for men and share suicide prevention resources.

“Suicide prevention discussions don’t have to be somber,” she said.

She’s hoping events like this will decrease the stigma around mental health, so that fewer people die by suicide in 2026.

If you or someone you know may be considering suicide or is in crisis, call or text 988 to reach the Suicide & Crisis Lifeline.

Erin Gottsacker is a reporter for The Ohio Newsroom. She most recently reported for WXPR Public Radio in the Northwoods of Wisconsin.