The Herald Bulletin

June 16, 2013

'We cannot ignore this'

Health officials on suicide and why Madison County's rate is so high

By Baylee Pulliam
The Herald Bulletin

ANDERSON, Ind. — Emily Marshall was sinking.

Hours weren’t steady at work. Her post-traumatic stress, bipolar and other mental health disorders were difficult for others to understand. And, coupled with her medical problems, they added up to huge bills.

“I felt like nobody cared; like there was no hope,” said Marshall, of Muncie. “I wanted it all to go away.”

She thought about numbing the pain with pills — too many — then slipping into a deep sleep and never waking up. How easy it would be. How liberating. How simple.

But when she spoke with her husband, James, he pulled her back. “When she said she was thinking about it, I said, ‘We’re going to the hospital,’” he said. Emily was put on a 72-hour suicide hold.

Hers isn’t an uncommon story. In 2010, the most recent year for which statistics from the Centers for Disease Control and Prevention are available, nearly one million Americans attempted suicide — one every 32 seconds.

And they’re the lucky ones. Of those attempts, 38,364 were successful. That’s 105 people per day, and at least one by the time you’ve finished reading this story.

The statistics weigh heavier in Madison County, where 28 people committed suicide in 2010. The county’s rate was nearly double the national average — roughly 21 per capita.

“We cannot ignore this and go around with blindfolds on,” said Anthony Malone, president of the Madison County Community Health Center. “Many people, when they look at these numbers, just shake their heads because they don’t understand. The question is: Can we afford that?”

There’s no saying for sure why Madison County’s numbers are so high, but one factor could be an above-average unemployment rate. It soared as high as 12.7 percent in 2010, the same year the county’s suicide rate spiked.

“In this area, there’s a huge loss of income (and) people out of work,” said the Marshalls’ doctor, Sharon McNeany, an adjunct professor at Ball State University and director of behavioral health and psychological services at MCCHC. “That puts financial stress on the family, if their basic needs aren’t being met — clothes, home, food.”

Of course, money is only one possibility. Suicidal thoughts can be triggered by any number of things, such as a traumatic event, loneliness or feeling powerless. Thoughts like, “Can’t stop the pain, can’t think clearly, can’t make decisions, can’t see any way out,” according to the National Suicide Prevention Lifeline.

Emily said some of those were running through her head both times she considered killing herself — once with pills; the other by driving off a bridge.

The latter, ironically, is what led her to a new life with her husband. She went to a friend’s house where she met James, who was empathetic since he’d considered it, too.

“If you’re thinking about (suicide), pretty much all you’re dealing with is negative stuff,” he said. “It’s hopelessness. You need to reach out.”

That’s sometimes difficult, McNeany said, because there’s often a stigma associated with depression. “But it truly is a mental health issue,” she said. “There’s a chemical imbalance that takes place and multiple stressors can bring that on. It’s not shameful to be depressed.”

Both Marshalls were lucky to have a strong support system: each other, doctors, friends and family. After Emily’s hospital hold, “one grandma threatened to take me over her knee if I ever did it (thought about suicide) again,” she said, jokingly.

Whether or not you think the person is likely to actually commit suicide, it’s important to take them seriously, James said. Speak openly about how they’re feeling, offer alternatives and encourage them to get help.

At the Community Health Center, a behavioral health team offers psycho-educational programs and counseling for individuals, families, couples and groups, many of which are geared toward building coping skills.

“It’s all about mixing primary care with behavioral care,” Malone said, “because that’s one of the best safety nets, when you put the two together.”

They also screen to see if patients are considering suicide, an important fail safe, since loved ones don’t always recognize red flags, such as talking about being a burden to others, increased alcohol or drug intake or extreme mood swings.

The problem becomes even more serious when it involves kids, who unfortunately aren’t exempt. Young people are more difficult to read, Malone said, because adults “don’t understand them” or think the problem is hormonal.

While suicide was the 10th leading cause of death for adults in 2010, it was third for people 24 or younger, accounting for nearly 5,000 deaths in the U.S. that year. Of those, 274 were under the age of 15.

Kids and teens have stressors too, McNeany said. Many are in the school or home environments, such as “conflict with the parents, maybe their parents are getting separated or divorced,” she said.

Those things affect everyone in the household. But then again, so does suicide.

According to the CDC report, each one impacts an estimated six people, minimum. Considering the 796,672 suicides in the U.S. between 1986 and 2010, there are at least 4.78 million people — one in 65 Americans — whose friend or family member has taken his or her own life.

In an odd way, that might be reassuring. It means no one, no matter how isolated they feel, is ever truly alone, James said.

“It’s going to affect everybody, not just you,” he said. “There’s always somebody (who cares), whether you know it or not.”

Like Baylee Pulliam on Facebook and follow her @BayleeNPulliam on Twitter, or call 648-4250.