Such suicides peak in the 20-24 year old age bracket, in which the suicide rate for urban areas is 15.9 per 100,000 and is five times greater in rural areas, at an alarming 78.3 per 100,000. Virtually all publicly-owned psychiatric hospitals are in urban or suburban areas, and there are serious questions about the quality of private psychiatric care, which sometimes consists of little more than confinement. In 1996 the magazine Rural Women Knowing All published a notice asking for information about the suicide of rural women. Within one year, the magazine received 344 letters about 260 suicides that occurred between 1995 and 1996. Despite the severity of this issue, and its impact on the health and survival of women, little attention is devoted to it.
Evidence indicates that women are less likely to receive psychiatric care.
According to a study of a long-term psychiatric hospital in China, twice as many men as women had their fees paid for by health insurance. This fact is salient in light of the strong correlation found between the length of stay in psychiatric hospitals and whether hospital costs were met by insurance or paid for out of pocket. Neither diagnosis nor severity of condition was as important for determining length of stay. At an acute psychiatric hospital, where treatments in addition to board and medication were charged for separately, men received significantly more treatment than women, which suggests that provision of care was based on ability to pay rather than need, and implies an indirect bias against women. But women are at special risk because they are often unable to exercise control in their sexual lives.