By Clarence Worly, NewWest.net Guest Writer, 9-22-10
Between 1999 and 2007 there were nearly as many suicides as
highway fatalities in the Mountain West states. In the case of
Colorado, Utah and Nevada there were more self-inflicted deaths than
traffic deaths. Am I the only person west of the Mississippi to see a
problem here?
I attended my first funeral at the age of 15. It was for my friend
and teammate who passed away in the spring of 1977 due to a
self-inflicted gunshot wound. He just turned 16.
This was my first experience dealing with the death of someone with
whom I was close. I couldn’t get my mind around the fact he was gone.
We wouldn’t be taking cheap shots at one another during football
practice the next fall. We wouldn’t be shot-gunning beers stolen out of
his dad’s garage fridge. We wouldn’t be grab-assing in the halls or
lying to each other about all the girls from other schools.
He was gone, stuck in time as a standout high school half-back and
all around good dude. After 33 years, I still feel the initial shock
and emotional devastation when I dwell on it too long.
There were no warning signs, no telltale
“I-should-have-seen-it-coming” behavior. I remember the last thing I
said to him as we walked out to the parking lot after school like it
was yesterday, “Let’s get shit-faced this weekend.” He yelled back over
his shoulder, “Sounds good, call me.”
He died that night.
I wish I could say this was an isolated incident: Chalk it up to
teenage angst and blame the mental health community for letting one
rare case fall through the cracks. But I know better.
I attended my next funeral at the age of 22. It was for my
friend and fellow musician who died the summer of 1983 due to a
self-inflicted gunshot wound. He was 21.
I saw my friend for the last time in Sun Valley. He had driven three
hours to lend some badly needed moral support for a crappy ‘80s cover
band I played in and he was ready to whoop it up. We had a blast and
before we went our separate ways I asked him if he needed a place to
stay that night. “Naw, I’m gonna camp out somewhere,” he replied. I
wish I’d gone with him. He was gone five days later. Again, I remember
that conversation like it was yesterday.
I managed to get through the rest of my 20s and 30s without losing
any more close friends. Oh, I went to more funerals, but they were held
for relatives who’d lived full lives. Contrary to popular belief,
there’s nothing terribly tragic or heartbreaking about a 72-year-old
heavy smoker dying of a stroke. It’s expected; losing someone who was
apparently healthy and had many years ahead is not.
I found myself standing next to another closed casket during the
winter of 2005. It held my friend and fellow fisherman, who died due to
a self-inflicted gunshot wound. He was 44. I always respected him as a
no-bullshit, take-charge Idahoan who proved himself to be a fine
outdoorsman and a good provider for his family.
Yet he left behind a wife of 20 years and a teenage daughter who
were counting on him. His death took me right back to the emotional
state I was in at 15. Once again, I just couldn’t get my mind around
the fact he was gone and had left his wife and daughter to fend for
themselves.
There is nothing more uncomfortable and unsettling than attending a
funeral for a victim of suicide. The clergy tactlessly expose the white
elephant in the room by referencing sin and damnation connected to the
circumstances surrounding the death. Oh yes, the officiate will pray
for their forgiveness, but it’s obvious mental illness is not
recognized as a legitimate disease by organized religion. At least, not
at the funeral.
If someone is killed in a car wreck or dies of leukemia that, too,
is tragic but, apparently, all is going to be wonderful in the
afterlife. Somehow, that message never comes across at the funerals of
people who take their own lives, at least not the ones I have attended.
During a time when family and friends are trying to make sense of what
went wrong, the last thing they need to hear are judgmental eulogies
based on biblical rhetoric and medical ignorance.
Thankfully, time has a way of softening the emotional blows received
and, years later, I find I can look back on the deaths of my old pals
with less anger and more logic. People in their right minds do not kill
themselves; they are sick, just as if they had cancer or diabetes. They
died because they suffered from a life-threatening disease called
depression that went undiagnosed.
DOES THIS HAPPEN ALL OVER THE WEST? YES
If you grew up in the Mountain West, you probably know someone who has
taken his or her own life. It’s really that common. Based on my
experience, depression isn’t truly taken seriously by the indigenous
population out here where the buffalo roam.
We live in a culture that requires a do-it-yourself—no pissing, no
moaning—cowboy-up mentality if you want to be accepted socially. The
public perception is that only the weak-minded and emotionally unstable
would ever consider getting professional treatment for depression. Most
Westerners don’t think of depression as a serious medical condition
caused by a chemical imbalance in the brain. The fact is we largely
don’t consider depression at all.
The image of John Wayne or Clint Eastwood lying on a couch, sobbing
like a schoolgirl and spilling their guts to a shrink because they’re
in mental anguish just doesn’t gel with the national persona of how the
West should be.
If you feel down, think happy thoughts. If you’re miserable, pray about
it. If all else fails, drown your sorrows around a campfire with your
buddies or uncork a few bottles of Merlot with your girlfriends. This
approach seems to work for the majority of folks living out here.
The problem with the cowboy approach to mental wellness is the high
casualty rate it creates. The Center for Disease Control has been
tracking self-inflicted death statistics for 60 years. Guess which
states consistently carry the notorious distinction of having the
highest suicide rates in the nation? Montana, Nevada, Idaho, Wyoming,
Utah and Colorado jockey for pole position and do so every year.
By contrast, East Coast states like New Jersey, New York and
Massachusetts are ranked as having the lowest suicide rates. On a side
note, the 2009 CDC database shows Alaska had the nation’s highest rate,
followed closely by Montana. Washington, D.C., had the lowest. All of
the Mountain West states were at the top of the 2009 death rate data—as
usual.
Between 1999 and 2007 there were nearly as many suicides as highway
fatalities in the mountain west states. In the case of Colorado, Utah
and Nevada, there were more self-inflicted deaths than traffic deaths.
Am I the only person west of the Mississippi to see a problem here?
To put these data in better perspective, as of Sept. 17, 2010, there
have been a total of 6,816 coalition military fatalities during our
nine years supporting Operation Enduring Freedom in Afghanistan and
seven years supporting Operation Iraqi Freedom (source: casualty.org).
In our little six-state region, we have had roughly three times the
number of deaths due to suicide than both wars combined during the same
nine-year period.
I ran this search three separate times using different parameters for
each search to confirm these data because I did not believe it could be
correct. I assumed the WISQARSTM data base on the CDC website to be a
reliable source. For now, I argue the data I have presented is
accurate. I hope readers will find enough interest to do perform their
own investigations. The numbers presented here show a trend nothing
short of an epidemic.
WHAT CAN BE DONE?
The mental health community is aware of the problem we have in our
beloved Rocky Mountains. There have been many research studies
conducted in the past 30 years. The following four factors seem to be
the overall conclusions as to why our suicide rates are so high, based
on the half dozen studies I read in preparing this column.
From “Ranking America’s Mental Health: An Analysis of Depression Across the States” by Thomson Healthcare:
- Mental health resources: The more mental health
professionals in the state (specifically, the higher the number of
psychiatrists, psychologists or social workers per capita), the lower
the suicide rate. - Barriers to treatment: The analyses indicate that the
greater the percentage of the population reporting they could not
obtain healthcare because of costs, the higher the suicide rate. The
portion of the population reporting unmet mental healthcare need was
positively associated with suicide rates, although the connection did
not quite reach conventional levels of statistical significance. - Mental health utilization: Holding the baseline level of
depression in the state constant, the higher the number of
antidepressant prescriptions per capita, the lower the state’s
age-adjusted suicide rate. In addition, there was a trend showing that
the higher the percentage of the population receiving mental health
treatment, the lower the suicide rate. - Socioeconomic characteristics: The more educated the
population, the lower the suicide rate. The greater the percentage of
the population with health insurance, the lower the suicide rate.
Median household income was negatively associated with suicide rates
but, again, the connection did not quite reach conventional levels of
statistical significance.
The most important factor about depression and suicide in the Mountain
West seems to have been overlooked in these conclusions. It’s one I
mentioned earlier, essentially: We all have reputations to keep up and
no self-respecting Westerner is going to bellyache about having the
blues once in a while.
No one I know is going to seek professional help for depression,
regardless of how many psychiatrists, psychologists or social workers
we have per capita. No one I know is going to replace a campfire and a
bottle of whiskey with Prozac or Wellbutrin or Depakote. Above all, no
one I know will ever bear their soul to anyone and admit they’re
feeling suicidal. We grew up in the West; we just don’t do that.
To prove my point, the Idaho legislature dropped our suicide hotline
in 2007, due to budget cuts and lack of utilization. That move makes
Idaho the only state in the union without a similar service. Meanwhile,
Idaho was ranked No. 6 for self-inflicted death in 2007. But in our
state government’s defense, no one I know would ever pick up a phone
and call the hotline, especially now that we don’t have one.
When I began writing this piece I had planned to conclude by
offering links to mental healthcare sites, federal and state suicide
prevention programs and suicide hotlines. But on further reflection, I
realize those actions are futile, at least out here.
We spend our time and tax dollars squabbling over issues like wolf
reintroduction, grizzly habitat, public land use and Yellowstone
cutthroat populations instead of saving our citizens from
self-destruction. I’m not sure why, but our priorities seem to be
skewed.
As much as I dislike the cliché term “raising awareness,” I guess
that’s what I’m trying to accomplish here. I don’t see a solution at
the moment; I’m just sick of so many of us dying by our own hand and
having the deaths swept under a rug of shame by a culture entrenched.
Until we break down the Western stigma surrounding mental health and
start treating depression as a real life-threatening disease, nothing
is going to change and we can look forward to another 17,853 deaths
over the next nine years.
Clarence Worly blogs about life and other topics at Clarence Worly’s Southeast Idaho.
Originally posted at NewWest.net
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