SUICIDE

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West battles to stem high suicide rates

By Chryss Cada, Boston Globe, 1/2/2001

ORT COLLINS, Colo. - Ever since her fiance drove his pickup truck to a lonely stretch of Arizona desert and shot himself with his rabbit-hunting rifle, Maxine French has asked why.

''There are answers,'' French says, ''but none of them are enough.''

It's a question that echoes incessantly along the Rocky Mountains and across the open plains of the West. For almost a century, the suicide rate in the Mountain States has been the highest in the country, as the region's isolation and a tradition of rugged individualism make a lethal combination.

The suicide rate of 17.2 per 100,000 people in the states of New Mexico, Arizona, Colorado, Utah, Nevada, Idaho, Wyoming, and Montana is nearly double the 9.6 rate in New England. And it puts the Mountain States on par with Russia, China, and Kazakhstan, which have the world's highest suicide rates.

The period after the holidays is a particularly deadly time.

''We usually see a spike after the holidays,'' said Bev Thurber, director of the suicide prevention center in Colorado's Larimer County, which has one of the highest teen suicide rates in the country. ''People tend to hold on for the holidays.''

But factors leading to suicides are present year-round, nowhere more so than in the West, where health specialists say the problem has reached ''epidemic'' levels.

''That one geographic area has such a dramatically higher rate tells us there are common denominators to investigate,'' said Dr. John Fildes of the Las Vegas-based Suicide Prevention Research Center, which is funded by a grant from the Centers for Disease Control. ''Each provides hints to solving this riddle.''

''Suicide is what happens when people think they are out of options. And in the West, there are fewer options,'' Fildes added.

The vast majority of people who commit suicide suffer from mental illness, often major depression, according to the American Foundation for Suicide Prevention, a research organization. But in the West, there is less access to mental health professionals and other support.

Other barriers to getting help are self-imposed.

''He was a country boy, who wasn't going to ask for help,'' French said of her fiance. ''He believed a man should pull himself up by his bootstraps.''

It's a story Stephanie Finley has heard again and again as she traveled through Colorado this summer talking to those touched by suicide.

''There is definitely a rugged individualism out West,'' said Finley, who organized the Colorado Office of Suicide Prevention last summer. ''We still have that pioneer mentality, that we can do it ourselves. Add to that the stigma associated with mental health, and you have people deciding not to go in for help.''

To try to destigmatize suicide, Finley's office is operated under the state's public health, rather than mental health, department.

In Wyoming, the bulk of the state's draft suicide prevention plan focuses on reducing the stigma of seeking help for mental illness.

''If you live in a rural area and seek out help for mental illness, you are more likely to be `found out,' and once you are found out it is more likely that your entire social network will know,'' said Robert Beeson, president of the Rural Mental Health Association, a national organization for mental health professionals.

Even those who want professional help might not get it.

''Untreated mental illness is the number one cause for suicide,'' Beeson said. ''And in rural areas, there is a low availability of professional help.''

The American Association of Suicidology, a nonprofit group with members ranging from researchers to therapists to survivors, has also made this connection. In a recent study, the states with the highest suicide rates also had the lowest number of mental health professionals per capita.

Another factor may be the lack of people in general. The Mountain States, six of them among the country's 20 least-populated, are strung together by long stretches of wind-battered highways where signs of inhabitance can be hundreds of miles apart.

Isolation can be especially difficult for teenagers, for whom suicide is the third-leading cause of death nationwide (compared with the eighth-leading cause for adults). A 1984 article in the Western Journal of Medicine noted that ''youthful suicides are most prominent in the western United States and particularly in the intermountain region.''

''She was different,'' Dennis Bogett said of his daughter Sonja, who committed suicide at age 15. ''In more rural areas, people value conformity. I think it was hard for her to find other kids like herself.''

Bogett added, ''My daughter had a lot of anger; she was a perfectionist who was always very hard on herself.... All her life we felt like we were fighting to keep her alive. Eventually, we lost.''

Though traditionally more sparsely populated, the population of the Mountain States has been surging. A Census report last week showed that five of the six fastest-growing states are in the region. Immigrants may find themselves isolated.

''In high-migration areas like the West, people are at more of a risk,'' said Finley. ''When they move, they leave behind their safety net. The people who might recognize the warning signs in a loved one aren't there to notice.''

French said she and her fiance had moved to Arizona just before his suicide because ''he wanted to get away.'' French now lives in Colorado and is a volunteer with the Larimer County Suicide Prevention Center.

In Nevada, which has the nation's highest suicide rate, one unique factor may be gambling. Suicide rates are up to four times higher in cities with legalized gambling than in comparably sized cities without it, according to a 1997 study by David Phillips, a professor of sociology at the University of California in San Diego.

The rate of visitors who kill themselves in Nevada is also four times the national rate.

Work on reducing suicide continues, with no single answer or solution in sight, or even expected.

But government agencies' approach to the problem has made a marked shift in recent years. For the first time, the surgeon general is approaching the issue as a health concern, holding meetings across the country last fall to devise a national suicide prevention strategy.

And researchers are about to embark on the heart of their study - extensive interviews with suicide survivors.

''Suicide is not an irrational or inevitable act,'' said Fildes. ''It is a public health problem of ever-growing proportion, which requires the same level of commitment that has been provided to cancer and cardiac disease.''

''It took 200 years to eradicate small pox, which is a single organism,'' said Dr. Alan Berman, executive director of the American Association of Suicidology. ''Suicide is infinitely more complex, and quality research on it is only in its infancy. It's not something we will ever fully eradicate.''

As a veteran of the search for answers, French says he knows the road ahead is a long one, but one that must be taken.

''No matter how frustrating and painful, we have to keep asking, `Why?''' French said. ''Answering the question means fewer families will find themselves having to ask it.''

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This story ran on page A01 of the Boston Globe on 1/2/2001. © Copyright 2000 Globe Newspaper Company.

-- Lars (larsguy@yahoo.com), January 03, 2001

Answers

I'd be more inclined to believe this if there were references given for the statistics. Suicide statistics are notoriously suspect anyhow. For years there have been stories of high suicide rates in San Francisco, Seattle, Sweden and among dentists.

The endless pressure to fill a newspaper with "something" probably causes that profession to have high rates of suicide, alcoholism, divorce, etc. Still, the article does sound plausible.

-- Lars (larsguy@yahoo.com), January 03, 2001.

Didn't Bush win in 7 of those 8 states?

-- FutureShock (gray@matter.think), January 03, 2001.

The suicide rate in the midwest is also higher than usual. And here in the Northwest is a common occurrance. Before the anti-gun crowd jumps on this one. Let me tell ya right off that a third of them are carbon -monoxide caused. I know many that happen in farm country in the last fifteen years have been in large part related to the farm economy. Poor prices for most commidities, increasing bankruptcies, farm sales and the inability to control your fate has some at the end of their rope. Also many retired people move into rural areas and Western states to live their last years and along with that follows cases of terminal illness. Many elect to end their suffering instead of dragging it out. Think about it, if you are going to do yourself in, wouldn't it be far better on a country road at the start of a beautiful morning with the smell of new mown alfalfa taken as your last breath instead of the alternative?

-- Boswell (fundown@thefarm.net), January 03, 2001.

Future Shock, are you suggesting that Hawk's idiotic Bush conspiracy posts have something to do with these suicides?

-- Dr. Pibb (dr_pibb@zdnetonebox.com), January 03, 2001.