Personality and Place

The Geography of Mental Health

By Mary Kearl

Have you ever stopped to think that maybe the place you live is to blame for your bad mood? Or, if you're of a more chipper disposition, then perhaps the reason you're so sunny is because of your environment? A slew of recent studies that delve into mental health suggest that there's more of an association between your setting and how you feel than you might expect. Plus, if you live in or visit Las Vegas, these stark statistics may startle you.

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City with the Highest Risk of Suicide

Las Vegas: Home of legalized gambling and perhaps something even darker than that. According to a study conducted by Temple University published in the December 2008 issue of "Social Science and Medicine," residents of Las Vegas face a suicide risk that is significantly higher than other parts of the country, based on analysis of data from the National Center for Health Statistics. Even more startling: People who die while visiting Las Vegas are twice as likely to die by suicide versus those who die traveling someplace else.

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Why Las Vegas?

The authors suggest several reasons for the high suicide risk found in Las Vegas. Among them: Something about the city may be "suicidogenic" -- meaning some unknown aspect of the urban lifestyle promotes suicide. Some other potential scenarios are that a certain kind of person, who carries with them a high suicide risk, may be attracted to Las Vegas or that Las Vegas creates a social contagion in which the suicides of vacationers and residents attract more suicide-prone people and, in turn, yields more suicides.

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Urban Versus Rural Dwelling

Aside from the case of Las Vegas, living in an urban area reduces your risk of suicide, says Wray, who co-authored the "Leaving Las Vegas" study. If you live in an urban area, you're much closer to a hospital, increasing the effectiveness of an intervention, but if you live in a rural area the distance to trauma care can diminish the chances of care.

Fast-growing urban areas, like Las Vegas, however, have a very hard time building the "social safety net that one would want -- things like adequate mental health facilities, enough practicing psychiatrists, psychologists, social workers -- basic mental health infrastructure that is better established in other urban areas that have more resources," says Wray.

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The Gambler's Life

Another study cited by the December 2008 article found that the large number of hotel rooms in Las Vegas may attract both residents and vacationers intent on self-harm who don't want to be found or rescued. The study found that Las Vegas residents who check into hotels are more likely to commit suicide than visitors. Various studies have found an increased risk for residents and visitors in gambling environments.

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Miserable Cities

In 2008, Forbes undertook their own list of "worst" cities, which they determined using a modified version of the "Misery Index." The Misery Index is based on inflation rate and unemployment rate. In addition to these, Forbes factored also factored commute times, income tax rates, number of superfund sites, violent crimes and weather into their city rankings. They found that top 10 worst cities were Detroit, MI coming in first place, followed by Stockton, CA; Flint, MI; New York, NY; Philadelphia, PA; Chicago, IL; Los Angeles, CA; Modesto, CA; Charlotte, N.C.; and Providence, RI.

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Are There Inherently Depressing Places?

"The science is mixed," says Matt Wray, Ph.D., professor of sociology at Temple University. "There are some studies from the U.K. that show that areas of social deprivation -- high poverty, [with] low social services -- correlate positively with suicide, so that it appears that where one lives shapes one's access to resources that might in effect be a buffer from going through with suicide. But even if you could prove that an area has these characteristics -- that it's poor, it's lacking resources -- it's hard to know if the individuals in that area who kill themselves were affected by those exposures to those factors."

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Suicide Tourism

Yes, there are destinations -- typically cities with bridges and/or tall buildings -- that consistently draw people who are contemplating self-harm, says Wray. A 2007 study published in the "Journal of Urban Health" looked at this phenomenon in New York City. They found that over 10 percent of suicides in Manhattan were committed by non-residents of New York City, unlike most suicides, which take place at home. Of the non-residential suicides that occurred, nearly half were the result of a long fall; another 10 percent were death by drowning, often caused by falling from a bridge into a waterway. Studies have found that jumping from a height is more common in New York than in the rest of the United States.

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The Golden Gate Bridge

San Francisco's Golden Gate Bridge is well-documented as being the "hottest hot spot for suicide," says Wray. Sometimes people have to travel across two or three bridges which could have produced just as lethal results, but the Golden Gate Bridge has become a magnet for those who are serious about self-harm. To that end, activists are calling for the city to put in place a barrier or net to prevent suicides, which could be an effective preventative measure. "It's something about a specific place, people attach meaning to it. When you put up a barrier around that place, you don't see substitution effects where people choose another means," Wray says.

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If You're Emotional, You'll Move:

Anywhere but where you grew up, according to a September 2008 study from a group of European researchers, published in "Psychological Science." Their research, which focused on migratory habits by personality type, found that people who are very emotional are more likely to move away from home, but typically do not go very far and do not move very often. Because they are simply moving away from where they were not comfortable -- their homes -- these types do not have a preference between urban and rural environments. They also move shorter distances in the hope that these moves will be less stressful.

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