"No one knows" exactly what leads up to any person committing suicide, says John McIntosh, a psychology professor at Indiana University South Bend who has studied 50 years of nationwide statistics. But he's one of the experts who've noticed that, collectively, Westerners lead the nation in suicide rates.
No other measurement of mental illness distinguishes the West so clearly - not rates of depression and "serious psychological distress," not the shortages of money for treatment. In public spending on mental-health care, for instance, some Western states are below average, with New Mexico and Idaho nearly last, while some Western states are above average.
For suicide, nine of the top 11 states are in the West, a trend that holds year after year and decade after decade. And the degree of the lethal regional difference is stunning: Nevada, Montana, New Mexico, Wyoming, Idaho, Utah, Colorado, Arizona and Oregon range from 19 to 15 suicides per 100,000 people - more than twice as high as New York and Washington, D.C., the healthy end of the scale. The rate in Washington state is nearly as high as its neighbors in the region, and even mellow California ranks 50 percent higher than New York and D.C.
Some 8,000 Westerners will kill themselves this year, a hefty portion of the national total of more than 30,000 suicides. Much of the cause, McIntosh suspects, is embedded in our Western culture. "Potential contributors," he says carefully, "include the personality or attitudinal or world-view differences across the country." Patty Limerick, a prominent Western historian at the University of Colorado, frames it more frankly: In the West, "we won't admit our sorrows until they become cataclysmic."
Wallace Stegner is considered the Shakespeare of the West, one of our most important writers and thinkers. He wrote of the region's "geography of hope," and the inevitable poisonous disappointments that blossom from that hope. His life fits the pattern. "Stegner experienced a hardscrabble childhood. His father, George, a failed farmer and career bootlegger, dragged long-suffering wife Hilda and their two boys to remote locations," says Carlin Romano, in a review of a new biography of Stegner. "The Stegners lived in 20 different residences over 10 years to avoid raids on George's bootlegging. ... At one point, Hilda deposited Stegner and his brother in a Seattle orphanage, one of the writer's most painful memories. ... He came to hate his abusive father ..."
Wallace Stegner's father committed suicide (and killed his mistress) in a Salt Lake City hotel in 1939. Four years later, Stegner published an autobiographical novel, Big Rock Candy Mountain, which "yields insights into the origins of the most important themes of his life and writings - how man relates to his family and to his surrounding environment," according to Patricia Rowe Willrich, a literary critic who profiled Stegner shortly before his death in 1993. In Big Rock Candy Mountain, Stegner described a character, Bo Mason, based on his father:
"He was born with the itch in his bones. ... He was always telling stories of men who had gone over the hills to some new place and found a land of Canaan, made their pile, got to be big men in the communities they fathered. But the Canaans toward which Bo's feet had turned had not lived up to their promise. People had been before him. The cream, he said, was gone. He should have lived a hundred years earlier.
"Yet he would never quite grant that all the good places were filled up. There was somewhere, if you knew where to find it, some place where money could be made like drawing water from a well, some Big Rock Candy Mountain where life was effortless and rich and unrestricted and full of adventure and action, where something could be had for nothing."
Stegner's themes echo. Westerners by nature tend towards transience. The early white settlers came here to escape or find something new and better - that Big Rock Candy Mountain - and the same urge continues today. Waves of migration come from other regions. People bounce from California to Montana to Arizona, thinking nicer scenery will somehow solve their problems, or that they'll find a fresh start in a booming city, or forge deep connections in some small rural town. When nothing is solved, the beautiful mountains or rivers or deserts become a taunt. And guns - the most popular method of suicide - are easily available.
"We encourage people to move here and lie to them about it being paradise," says Arnold, the Arizona mental-health lawyer. Western states, exploding with population growth, have flimsy communities. Families are strained or fragmented by the churning. Our frontier mentality makes us suspicious of government and public services. We expect people to tough it out on their own. "The dream of a freer life, independence, that kind of individualism, works against community and familiar structure," says Bill Handley, an associate professor at the University of Southern California who studies how Western writers deal with these themes. "There's a whole literature of loneliness in the West."
Among the other cultural factors linked to suicide: Westerners are the least likely to attend church. We're more likely to abuse alcohol and prescription drugs. We have high rates of divorce. A 1992 study even found that country music, with its refrains of loneliness and failure, could contribute to suicide rates.
Sheila Linwood, who runs a suicide-prevention group in Grand Junction, Colo., sees high rates of suicide among the young men who work far from their families in the booming construction and oil and gas fields. "It's huge isolation," she says. When they suffer depression and other mental illness, she says, "They really do feel like no one else in the world can understand, no one is going to help them out. It's not a healthy atmosphere." Some suicides never make it into the statistics, she says. "If you're putting up an oil derrick, it's dangerous work, and if you have a mental-health condition, you may not take the precautions you need to take."
I don't know whether my brother would've fared better if he'd stayed in the Illinois system. I do know that when he moved back to the West, his chances worsened. But he was a Westerner, in his origin, his conclusion and his transience. He lived in at least six states, two countries, and more than a dozen apartments and houses in Tucson alone, not including hospitals. Sometimes he was willing to seek help, but often he was reluctant. He was also a victim. All the very crazy ones are born into it, or hit with it, regardless of the choices they make or how they try to live their lives.
I go around with thoughts that I should've done more for John. In Tucson, I saw him roughly once a week. On holidays and other special occasions, he came over to the house where I lived with my wife and kids. He tried to interact, but sometimes was too far gone. The kids called him Uncle John, and he was sweet to them, but generally he wasn't good in groups. So most of the times I was with John in the desert, it was just the two of us (my younger brother took his own path, to New Mexico, Europe and California). We had our routines: I took John out for burritos, or we went to a bar to shoot pool. We went to movies, where he could lose himself in the big screen. He helped me work on my cars.
The hikes were the best times we shared. We liked to go at sunset. One trail meandered through washes in the Tucson Mountains to a pioneer's homestead that had fallen into decay. The roof and windows were gone, and just stone walls remained on a concrete pad. Sometimes we hiked up the canyons of a bigger range, the Santa Catalinas, where we often found the magic of water flowing in the desert. Or I would drive us up to the summit of that range for hikes in the cool pines. John would sit on the passenger seat next to me, refusing to look at the panoramic views out his side window. He just stared straight ahead, but I know the scenes outside registered in him and helped him.
Our favorite hike was Tanque Verde, a canyon between two ranges, where we almost always found water. I would take off my shoes and persuade him to take off his, and we would wade on the sandy bottoms as the sunset flared into dusk and bats emerged on fluttering wings.
I always said goodbye to John with a hug. He liked that, too. He rarely felt the touch of other people. Over the years he had a few girlfriends who valued his intellect, his intensity and his struggle, but they all ultimately gave up on him. At least one was a fellow crazy, and two were counselors with their own troubles. Counselors aren't supposed to lie down with people like John because it's considered unprofessional and unhealthy. But I saw them as heroic.
He was so alone that sometimes he would call me and say nothing, just looking for a voice. Sometimes I got angry at the long pauses, when his calls interrupted my life. I felt I was expected to carry him, but I had competing duties to my wife, my kids, and myself. "Family members feel badgered," says Clarke Romans, director of the National Alliance on Mental Illness's Tucson chapter. "The mentally ill person sucks the attention of most of the family. Others in the family feel shortchanged. Families walk around with this aggravated sense of rage, because they're not getting the services they deserve."