Suicidal risk remains high in both Taiwanese psychiatric
inpatients (Chiou et al. 2006, Lee et al. 2007) and outpatients
after hospital discharge (Thong et al. 2008). Similarly,
45% of 60 Turkish patients with schizophrenia (30 inpatients
and 30 stable outpatients) had a history of suicide attempts
(Evren & Evren 2004). Although the prevalence of psychiatric
disorders in the Netherlands was higher in urban than
rural areas (Peen et al. 2007), patients with schizophrenia in
rural areas of China were reported to have a greater risk of
suicide than those in urban areas (Phillips et al. 2004).
However, evidence indicates that patients in rural areas of
China (Phillips et al. 2004) and Taiwan (Huang et al. 2005)
are at higher risk than urban patients of inadequate health
care services. Similarly, patients with serious mental illness in
the USA who lived far from the health service system had a
greater risk of low health service use than those who lived
close to health services (McCarthy et al. 2007). Thus,
community-based health care providers need to pay more
attention to the issue of suicide attempts in rural patients with
schizophrenia.