Alabamians are taking their own lives in greater numbers, and no one knows why
by Tim Lockette
tlockette@annistonstar.com
Jan 12, 2013 | 5995 views |  0 comments | 9 9 recommendations | email to a friend | print
There was a time, Shane Adrian remembers, when people who committed suicide would leave a note.

“I think it was helpful to the families,” said Adrian, assistant coroner for Calhoun County. “It gave them some closure. But at some point, they just stopped doing that. I don’t know why.”

Adrian has spent a lot of time asking why in the last year. The number of suicides in Calhoun County doubled last year. Twelve people took their own lives in Calhoun County in 2011, Adrian said, and 24 committed suicide in 2012.

It’s a problem most people don’t see. The Anniston Star and most other local news outlets don’t report a suicide unless it happens in a prominent place or is done by a well-known person.

But suicide in Alabama is on the rise. Ten years ago, just a little more than 500 Alabamians took their own lives every year. In 2011, 640 Alabamians committed suicide. That rise outpaces the overall growth in the population, state officials say, and Alabama’s suicide rate is above the national average, too.

Health experts say the nation’s economic troubles are to blame for the sudden jump in suicide after 2008. But they’re still mystified about the steady rise that was going on before the financial crash.

And mental health activists wonder why the state doesn’t spend more on the one thing that’s proven to help — mental health care.

“Depression is a very treatable disease,” said Lisa Dunn, of the Alabama branch of the American Society for Suicide Prevention. “That treatment should be available to more people.”

A classic case

Bobby Jack Travis fit the profile of an Alabama suicide victim.

The 77-year-old was reported missing last week, after no one could reach him at his home in Casey Estates at McClellan. His body was found a day later, in a wooded area nearby. Adrian, the assistant coroner, said Travis had killed himself.

“Suicide rates are much higher among white males than any other group, particularly for men over 65,” said Debra Hodges, director of suicide prevention for the Alabama Department of Public Health.

Hodges said suicide rates have climbed sharply across the country since the recession began, though Alabama’s problem has been worse than average. The state had about 13.4 suicides per 100,000 people in 2011, Hodges said. The most recent national numbers had the overall American suicide rate at 12.4 per 100.000, Hodges said.

But those numbers tell only part of the story. For white men in Alabama, the rate was around 22 per 100,000 — far above the number of any other demographic group.

“It’s a problem of rurality,” Hodges said. “One of the protective factors against suicide is a set of social connections, which is lacking for some people in rural areas. And they have guns, to protect their livestock and for other reasons.”

Hodges said lack of economic opportunity and less contact with other people may be among the reasons rural people are more likely to fall into depression. Unavailability of treatment — or an unwillingness to get it — exacerbates the problem. And the presence of handguns gives them means to act on impulse.

Sparsely populated northwestern states such as Alaska and Wyoming regularly post the highest suicide rates, Hodges said. As a region, the Deep South comes second to the Northwest. But rural populations are what both of those regions have in common.

It wasn’t always like this. In the 1980s, Alabama had fewer suicides than the national average, Hodges said. Then in 1987, it crossed over into above-average territory.

Hodges doesn’t know why. Maybe it was a big economic change in rural areas, such as the closure of textile mills.

“That may be, but I don’t really know,” she said.

‘Common sense’

Gun dealers across the state have reported a spike in sales since the Newtown, Conn., school shootings, a sign of the concern some Alabamians feel about the possibility of gun-control legislation.

Will the increase in sales — making guns still more accessible to in Alabama homes — lead to a future increase in suicides? The experts won’t make predictions.

“As clinicians, we assess the risk, and ready availability of the means to suicide is an indicator of high risk,” said Judith Harrington, a Birmingham psychologist. “So yes, I am concerned. Will the suicide rate increase? I don’t have a crystal ball.”

No one doubts that gun accessibility plays a role in Alabama’s suicide rate. Studies have shown that Alabamians are more likely to own guns than residents of most other states. One CDC study found that about half of Alabama adults reported having a firearm in the home, while only about one-third of adults nationwide said the same.

For the past 10 years, suicide by gun has accounted for about seven out of every 10 suicides in Alabama. Nationally, Hodges said, a little more than 50 percent of suicides are done with a gun.

And guns are clearly connected to the large incidence of suicide among men. Nationwide, women are three times more likely to attempt suicide than men, according to CDC numbers, but men are four times more likely to complete suicide. That’s because men, nationwide, are more likely to use a gun — a method that’s almost always fatal.

“It’s common sense that when the most efficient weapons to kill are available, they’ll kill more people,” said Samuel Preston, a University of Pennsylvania sociology professor and one of the authors of a recent National Research Council study on Americans’ life expectancy. That study found that the U.S. lags behind 16 other developed countries in health outcomes, with widespread gun ownership a key element in the country’s high rate of violent death.

Unreported

Hodges, like Harrington, said she can’t say that more gun sales today will lead to a higher suicide rate later. That’s in part because she’s not sure the state really knows the total number of people who kill themselves.

Only about one-fourth of suicide victims leave a note, she said.

In gun suicides, she said, the intent is pretty clear. But deaths by overdose may be underreported.

“Without a note, the coroner is likely to rule that an overdose is accidental rather than intentional,” she said. Any number of single-car accidents may actually be suicide attempts, she said, another number that’s hard to pin down.

Hodges believes that rural Alabama’s biggest problem may be a simple inability to talk about mental health issues. Even when people are worried about their friends, they don’t ask if they’re planning to hurt themselves.

“People seem to think that if you say the word ‘suicide,’ you’re putting the idea in their heads,” she said. “Believe me, they’ve thought about it already.”

Hodges said the Alabama Suicide Prevention and Resources Coalition, or ASPARC, is planning an ad campaign for this summer that would address the taboo against talking about the problem.

It’s new path for the group, which got its start as the Department of Public Health’s Suicide Prevention Task Force. It was a state task force for years, but never had any funding. Recently the task force decided to reorganize as a nonprofit organization, which allowed the group to apply for grants on its own. Harrington, the Birmingham counselor, will soon take the reins of the group.

Alabama’s Mental Health Department has seen its funding drop from about $136 million in 2009 to just over $100 million this year. Funding from earmarked sources and federal money has softened that blow, making the real impact only a few percent of the department’s total revenue. Still, the department last year announced plans to lay off 948 employees and close two hospitals.

Attempts to reach Mental Health Commissioner Jim Reddoch for this story were unsuccessful.

Hodges said ASPARC will fund its new ad campaign through a $1.47 million, three-year grant aimed at youth suicide prevention. Dunn, of the American Foundation of Suicide Prevention, said her organization works with the State Department of Education to present suicide-prevention programs in schools and to Air Force personnel.

Hodges and Dunn both said their programs can have a positive effect beyond their young target audience. But they acknowledge that those programs aren’t aimed primarily at the audience at greatest risk — older men.

Asked why there weren’t more grants available for suicide prevention for older people, Hodges said she had no idea.

“I often ask myself that very question,” she said.

Capitol & statewide correspondent: 256-294-4193. On Twitter @TLockette_Star.

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