Why are rural Westerners killing themselves?
Filed under: Government, Hot Health Headline, Public health
Writing for ABC News, Alan Farnham seeks to explain the jump in suicide rates in the rural American West, particularly in Intermountain states such as Idaho, Wyoming and New Mexico.
Historically the suicide rate in rural states has been higher than in urban ones. According to the most recent national data available, Alaska has the highest rate, at 24.6 suicides per 100,000 people. Next comes Wyoming (23.3), followed by New Mexico (21.1), Montana (21.0) and Nevada (20.2). Idaho ranks 6th, at 16.5. Suicide is the second-leading cause of death for Idahoans aged 15-34. Only accidents rank higher.
Farnham focuses on the Gem State, where suicide rates are rising alongside unemployment and related economic hardship. In addition to economic factors, including cuts to Medicaid funding, and a regional lack of resources for the initial diagnosis of mental illness, local experts point to demographic and cultural factors.
Kim Kane, executive director of Idaho’s Suicide Prevention Action Network in Idaho says other factors explain the high rate of suicide in western mountain states. One is the greater prevalence of guns: In 2010, 63 percent of Idaho suicides involved a firearm, compared with the national average of 50 percent.
She and Garrett also say the West’s pride in rugged individualism can prevent people from seeking help. Their feeling, says Kane, is that they ought to be able to pull themselves up by their mental bootstraps. Idaho is the only state not to have a suicide-prevention hotline.
Dallas Morning News explores effects of war on military families
For the paper’s series on military families, Dallas Morning News reporter Dave Tarrant has spent four months investigating what he calls the “relentless cycle of crisis and stress” that affects soldiers’ loved ones. The broad series touches on everything from the Fort Hood suicides to the Army’s preventative measures to Tarrant’s latest, “Wife faces life-or-death decision for her war-injured husband.”
Most of the content is behind the Morning News paywall, but there’s enough on the landing pages to, at the very least, help you understand where Tarrant’s investigation has taken him and just how wide-ranging the health effects of prolonged war can become.
Federal agency issues guide to covering suicides
Asserting that safe media reporting is one of the best ways to prevent suicide, the federal Substance Abuse and Mental Health Services Administration recently released recommendations for reporting on suicide.
The press release says the guidance was “developed by a group of suicide prevention experts, researchers and journalists and are based on more than 50 research studies.” It’s worth noting, however, that while the website lists a number of organizations that collaborated to develop the recommendations, none of those listed are journalism organizations.
Among its suggestions:
- Avoid sensational headlines and prominent placement
- Don’t use photos of grieving friends or family, memorials or funerals
- Don’t describe a suicide as inexplicable
- Don’t disclose the contents of suicide notes
- Avoid misinformation and offer hope
For some perspective from journalists about reporting on suicide, we recommend “Reporting Suicide and Finding a Balance,” by Meg Spratt of the Dart Center for Journalism & Trauma. The Dart Center has a collection of resources on the topic.
The “Minimize Harm” section of the Society of Professional Journalists’ Code of Ethics doesn’t specifically address suicide but does point out the need to show compassion and sensitivity, as well as realizing gathering and reporting the news can cause harm or discomfort.
The Radio Television Digital News Association has guidelines for reporting on suicide, from the American Association of Suicidology. The guidelines include minimizing reporting specific details and avoiding reporting simplistic reasons for suicide. It cautions against making suicide appear glamorous to someone who might be considering suicide and reporting on it in a straightforward manner.
Following the 9/11 terrorist attacks, Phil Nesbitt wrote an article for the American Press Institute about the ethical debates surrounding the publication of people jumping from the World Trade Center as well as an incident in Pennsylvania in which a state official committed suicide at a press conference.
Nesbitt reports that editors decide whether or not to publish photos on a case-by-case basis, often depending on the circumstances:
A picture of someone leaping from a high-rise fire would not necessarily merit publication. But someone jumping or falling from the World Trade Center tower as a direct result of the greatest terrorist attack on our soil, for most editors, would.
(Thanks to Charles Bingham and Gary Schwitzer for suggesting resources.)
DoD: No condolence letter if soldier committed suicide
Writing on the NPR health blog, Whitney Blair Wyckoff writes that while American soldiers who commit suicide receive full military honors, their families don’t receive a letter of condolence from the White House. It’s a substantial omission because, as Wyckoff notes, “the number of soldiers who committed suicide in the U.S. military rivaled those who were killed on the battlefield in Afghanistan this year.”
Suicide prevention and mental health advocates are circulating petitions to reverse the policy, which is gaining media attention at a time when the military’s attempting to destigmatize mental illness. The administration’s only reply was an e-mail from the Department of Defense stating that “Under the current program, the Secretary of Defense does not send condolence letters to next-of-kin of members who commit suicide.”
Stories focus on suicides of doctors, soldiers
New York Times columnist Pauline Chen, M.D., serves up a reminder that suicide prevention isn’t just a matter of access to counseling and resources, in the form of a story about high physician suicide rates. If there’s any sector of the population that should be able to recognize that they are suffering from mental illness, and that the condition is treatable, it should be doctors, Chen writes. Yet still they kill themselves at a rate above the American average.
For several decades now, studies have consistently shown that physicians have higher rates of suicide than the general population — 40 percent higher for male doctors and a staggering 130 percent higher for female doctors. While research has traced the beginning of this tragic difference to the years spent in medical school, the contributing factors remain murky. Students enter medical school with mental health profiles similar to those of their peers but end up experiencing depression, burnout and other mental illnesses at higher rates. Despite better access to health care, they are more likely to cope by resorting to dysfunctional behaviors like excessive drinking and are less likely to receive the right care or even recognize that they need some kind of intervention.
Chen mentions two recent studies published in the Journal of the American Medical Association that shed more light on the issue, one showing that in medical school depression and burnout are separate entities, and the other showing that depressed students believe others view them as incompetent. In the end, she calls for further long-term research, but does not take the next logical step and investigate comparative research and statistics. Is it just American medical students who are depressed? Do countries with low-cost, low-pressure med schools produce doctors with better mental health? There’s a lot of room for investigation.
Suicides in another high-access group
Chen’s New York Times colleague, James McKinley, writes that as many as 20 soldiers connected with the Army base at Ft. Hood have killed themselves this year, despite the Army’s suicide prevention efforts.
The spate of suicides in Texas reflects a chilling reality: nearly 20 months after the Army began strengthening its suicide prevention program and working to remove the stigma attached to seeking psychological counseling, the suicide rate among active service members remains high and shows little sign of improvement. Through August, at least 125 active members of the Army had ended their own lives, exceeding the morbid pace of last year, when there were a record 162 suicides.
As of July, the Army requires all returning soldiers to be evaluated by a mental health specialist, though veteran advocates still point to a shortage of psychiatrists and an emphasis on treatment through medication rather than through therapy. The system is taxed by record numbers of soldiers seeking help for psychological problems, and mental health was the leading reason for hospitalization in the Army last year, McKinley writes.
Each suicide is unique, McKinley writes, and it’s hard to find patterns.
Homemade poisonous gas may endanger EMTs
The Tampa Tribune’s Keith Morelli reports that homemade poisonous gases, which he says are growing in popularity among those who attempt suicide, are posing a new danger to first responders accustomed to charging in headfirst to prevent suicide attempts.
The lethal-gas-producing mixture of detergents was involved in 500 suicides in Japan last year, about a sixth of that country’s total, Morelli writes.
Now, thanks to the Internet, it’s becoming more common in the United States as well. In the St. Petersburg case Morelli chronicled (as in other similar incidents), the victim posted signs to warn first responders of the hazard, but Morelli implies that it’s easy to imagine a situation in which the victim is not so conscientious.
DoD campaigns against stigma of depression, PTSD
The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury’s new Real Warriors campaign is designed to aid soldiers with what they seem to see as the three r’s of military mental health: resilience, recovery and re-integration.
The RealWarriors.net site not only directs soldiers to additional resources, but also shares anecdotes from their peers and provides them with guidelines for good mental health, both in combat and out of it.
The effort, launched in May, even has a Twitter account.
(Hat tip to Arline Kaplan of the Psychiatric Times)
Related:
Bay Area panel on veterans’ health highlights untold stories
Lack of oversight contributes to Army suicides
Filed under: Government, Hot Health Headline, Studies
The Army reported that 143 active duty soldiers killed themselves in the last year, the highest number since the statistics started being kept in 1980. This year’s numbers are on track to break that unfortunate record. Gregg Zoroya of USA Today reports that an Army investigator blames at least part of this rise to a lack of day-to-day oversight by commanders accustomed to leading amidst the intensity of the battlefield rather than the less-obvious perils of the barracks.
The investigator’s solution is simple: commanders need to interact with their troops more, to keep in touch and keep their eyes out for risk factors.
Zoroya also noted another contributing factor to the climbing suicide rate:
Along with soldiers who engage in risky behaviors, McGuire says, the Army has a greater number of troops who entered the service with pre-existing anxiety or depression or who have stopped taking their behavioral medication in order to meet entrance requirements.
Soldiers concerned they may be at risk can try this online mental health self-assessment designed specifically for members of the armed services.
Advocacy group releases mental health media guide
The second edition of a media guide for reporting on suicide and mental illness, prepared by Wisconsin United for Mental Health, is now available. The guide, “Open Minds Open Doors: A guide for Media,” provides statistics, facts and background data as well as suggested terminology and guidelines for avoiding the stigma of suicide and mental illness. The guide recently won a Mental Health America 2009 Media Award in the advocacy category.
According to Wisconsin United for Mental Health’s Web site, its mission is to “educate and increase awareness about mental illnesses, to eliminate stigma and discrimination, and promote recovery.”
Army works to prevent soldier suicides
Teresa Snow of KRCG-Jefferson City, Mo., took a deeper look at suicides among active-duty military forces. Snow examined the factors that contribute to military suicide, spoke with a veteran who had attempted to take his own life and reviewed a two-hour suicide prevention video prepared by nearby Lincoln University at the Army’s behest.
Snow said the video, mandatory viewing last month for all 1.6 million members of the Army (both active duty and reserves), functions like a “choose-your-own-adventure” novel, with soldiers following along with characters and making decisions for them.
“It’s training on two levels,” says (LTC Gary) Gilmore. “What would I do as an individual when I just say all of these things, I feel like the world is dog piling on me what am I going to do about that? And the other piece is that OK, you’re the buddy who’s watching this happen, are you a real friend if you let him make a little secret with you and say don’t tell anybody? No, you have to say to him, I am being your friend, I’m not going to let this slide.”
Though the eyes of Wayne Dyle, Snow also took a raw firsthand look at the consequences of the Army’s failure to prevent suicides among active-duty forces and veterans.
Army Veteran Wayne Dyle doesn’t blame his time in the service but that last factor, drug and alcohol abuse for his suicide attempt. When he wanted to get off drugs and his wife did not, his third marriage began to break up. The break up and his $1500 a week drug habit were taking a toll. He describes how one day he loaded up, “When I ran out of the beer, the vodka, the meth, the crack, I ran out, I was out of money, said Doyle.”
Then he tried to slit his wrists.
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