Searching for answers
Suicide experts point to risk factors, but say problem ‘knows no boundary’
Jerry Reed recalls clearly the day when Sen. Harry Reid turned to him at a congressional committee hearing in 1996 and asked why suicide rates in America were considerably higher in the nation’s Western mountain states.
The moment came not long after the Nevada Democrat had shared publicly at the hearing that his father had committed suicide years before, something he had discussed with few people in the 24 years since his father’s death.
As Reid, now the Senate majority leader, remembered in his 2008 book The Good Fight: “My colleagues didn’t know. My legislative aide at the time on aging issues, Jerry Reed, who—in helping me prepare for the hearing had contacted the National Institute of Mental Health and the Centers for Disease Control to get the latest data on depression, only to find that Nevada leads the nation in older suicide—didn’t know either. Telling the story of my father’s depression and death was liberating,” Reid writes.
As a result of the hearing, Reid introduced Senate Resolution 84 in May 1997, which recognized suicide—then the ninth leading cause of death in the U.S., claiming more than 31,000 lives annually—as a national public health problem. According to the most recent numbers from the Centers for Disease Control and Prevention, suicide is now the nation’s 11th leading cause of death, accounting for more than 33,300 deaths in 2007.
For Reed, a social worker who had worked on family violence, domestic abuse and youth services issues at the U.S. Defense Department, the senator’s question led to his research on why suicide rates are higher in certain regions of the country, a subject he analyzed for his dissertation, “Variation Among States in Older Adult Male Suicide,” at Virginia Commonwealth University in 2007. Today, Reed is director of the Suicide Prevention Resource Center, which is operated by HHS and funded by the Substance Abuse & Mental Health Services Administration. He also directs the Center for the Study and Prevention of Injury, Violence and Suicide at the Education Development Center in Newton, Mass.
“I looked at data from 2002 to 2004—certainly it was Nevada, Wyoming, Idaho and Oregon, but also New Mexico, Montana and Alaska—Western, rural, intermountain states,” Reed says. “The lowest were Rhode Island, New York, New Jersey and Massachusetts,” he says, adding that in Rhode Island the suicide rate was 11.6 per 100,000 people, while it was 67 per 100,000 people in Nevada, or nearly six times as high.
According to Reed and his dissertation abstract, the statistics on divorce rates, people per square mile, and the percentage of homes that owned a gun in these Western, rural states led him to identify three major themes in this region of the country: isolation, loneliness and access to lethal means.
“What works in a rural community in Montana with older adults might be very different from young, urban Latinas in New York City,” says Reed, who added that it’s important to focus on a wide range of risk and protective factors. These include those that are biological and psycho-social, such as mental disorders, depression, hopelessness, history of trauma or abuse, and exposure to suicide; environmental, such as relational or social (death of a spouse or friend), loss of job and financial losses; and socio-cultural factors, such as a lack of social support, isolation, barriers to accessing care and a stigma for seeking help.
“I was trying to find out if there was a way to explain variation,” Reed says. “If you look in the Northeast, even if you live in a city and don’t know a soul, you hear the sounds” of people and civilization, he adds, whereas in a mountain state, “You don’t hear that. You have to go out for it.” Some of the factors Reed described, namely isolation, history of trauma, socio-cultural losses, and domestic violence are the contributing factors that Rose Weahkee cites as problems plaguing American Indians and Alaska Natives, two
Reed: “I was trying to find out if there was a way to explain variation.”
Weahkee: Suicide prevention efforts are a “community responsibility.”