Suicide - Oregon
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rise in youth suicides: Comprehensive training in all high
schools recommended Teen suicides came to the forefront for Deschutes County health and school officials in 2014, when at least five teens died by suicide. The local suicide deaths are still unverified by the state’s reporting system, but they could become part of a troubling statewide trend. Looking at data from 2003 to 2012, the Oregon Health Authority found a rise in suicides among people ages 10 to 17, . As a result, the OHA is recommending “complete statewide implementation of comprehensive suicide prevention in high schools,” according to a report, Suicides in Oregon: Trends and Associated Factors, 2003-2012, released on June 19. “Our behaviors start to solidify in adolescence,” said Jessica Jacks, supervisor of prevention programs at Deschutes County Health Services. “There is a need for prevention and intervention across the age spectrum. Doing more early is important.” Prevention programs are already underway in area high schools, and a five-year, $311,588 grant will further that work, Jacks said. The county wants to see at least two staff members at each school who’ve undergone a two-day training. With the new grant, every school in the county could be meeting that standard in the next five years, she said. The state is looking to expand training that’s been given at more than 200 high schools, said Lisa Millet, manager of the injury and violence prevention section at the Center for Prevention and Health Promotion. Under a federal Garrett Lee Smith Memorial grant, the state will expand that effort and offer a Web-based training to reach primary medical care providers, as well as school personnel. The state is also in the process of developing a new youth suicide prevention and intervention plan that would further its work to integrate behavioral health and primary medical care, Millet said. — Reporter:?541-617-7860,
kmclaughlin@bendbulletin.com Some key
findings about Oregon suicides • The age-adjusted rate among all Oregonians in 2012 was 17.7 per 100,000, 42 percent higher than the national average. • The rate has been increasing since 2000. • Among adolescents age 10 to age 17, the rate has increased since 2011 (after decreasing from 1990 to 2010). • Among adults age 45 to age 64, the rate rose more than 50 percent from 18.1 per 100,000 in 2000 to 28.7 per 100,000 in 2012. • Among men age 65 and older, the rate decreased approximately 18 percent from nearly 50 per 100,000 in 2000 to 42 per 100,000 in 2012. • Men were 3.6 times more likely to die by suicide than women, and the highest rate occurred among men age 85 and older. • About 25 percent of suicides occurred among veterans. • Psychological, behavioral and health problems all contribute to increased suicide risk. About 70 percent of victims had a diagnosed mental disorder, alcohol or substance abuse problems, or depressed mood at the time of their death. • Interpersonal conflicts were commonly reported circumstances. • Eviction or loss of home was associated with 199 suicide deaths, or 7 percent, between 2009 and 2012. • The number of suicides in each month varies, but there is no clear seasonal pattern. Source: Suicides in Oregon, Trends and
Associated Factors, 2003-2012, Oregon Health Authority,
Public Health Division, Oregon Violent Death Reporting
System Why Oregon's
suicide rate is among highest in the country Three months later, a tearful Stacy Punch still struggles to understand why. Married for 15 years, she saw no signs of the tempest that must have been raging inside her husband. Instead, she saw a father who drove his kids to track and wrestling meets. A husband who took their son, Derek, 13, hunting in Eastern Oregon. A sergeant for the Oregon State Police who caught drunk drivers and helped rescue a woman caught in the Japanese tsunami two years ago. A man who saved lives. A family man. "Nothing led up to it," Stacy Punch says on a rainy spring afternoon in Gold Beach. She speaks haltingly, pausing when the memories overwhelm her. "He never talked about it, never threatened to kill himself." Suicides are not uncommon in Curry County, which includes Gold Beach and Brookings. Between 2003 and 2010, 61 people killed themselves in the county, giving it the highest suicide rate in the state. Scott Punch handled five of those suicides in the past year alone, Stacy Punch says. Suicides higher in the West New figures show a sharp rise in suicides among middle-aged Americans, and an even bigger increase in Oregon. A Centers for Disease Control and Prevention report shows suicides among men and women aged 35-64 increased 49 percent in Oregon from 1999-2010, compared to 28 percent nationally. For years, Oregon has ranked between seventh and ninth in the country for suicides. In 2011, 685 Oregonians killed themselves, twice the number who died in vehicle crashes and six times the homicide rate. In 2012, the number climbed to 709 people who took their own lives, according to preliminary numbers. Oregon's suicide rate has been increasing since 2000. The financial cost is high. In 2010, self-inflicted injury hospitalization costs exceeded $41 million. "Are we doing enough to prevent suicides? I would say not," says Lisa Millet, a suicide expert who manages the Injury and Violence Prevention Section of the Oregon Health Authority's Public Health Division. "The whole field of prevention is so young, maybe 10, 15 years old," she says. "We haven't developed prevention strategies. One of the things that's sadly true, doctors, nurses, social workers, mental health practitioners, none of these people get adequate training." Oregon Public Health Division Suicide affects families for years, even generations, Millet says. "It's so disruptive because of all the shame and guilt. It carries across generations. It's horrific. If you think of all the communities affected -- we have thousands of people in Oregon who have died by suicide." Among efforts to stem the tide in the past 10 years, the state has trained suicide prevention specialists and introduced prevention programs in schools. But most Western states struggle with suicide rates higher than the national average, especially Montana, Wyoming, Nevada, New Mexico, Idaho and Alaska. There's even a name for the north-south swath of states: "Suicide Alley." Access to guns is one reason, studies show. Western states have more lax gun laws than other parts of the country. New York, with its more restrictive gun laws, ranks 50th in suicides in the country. A little more than half of all Oregonians who kill themselves use guns, according to the Oregon Public Health Division. In 2011, most Oregon firearm deaths were suicides (76 percent). Guns are used in suicides more than twice as often as the next two most popular methods: poison (20 percent) and hanging/suffocation (18 percent). Research shows 90 percent of suicides in rural America involve firearms. Geography is another reason Oregon's suicide rate is high. Suicide risk is higher in rural areas. Studies show that limited mental health care services, access to firearms and a rugged, individualistic culture that doesn't lend itself to seeking help are primary factors contributing to suicide. Age is also a factor. Suicide rates increase as people get older, peaking after 85. For reporting purposes, people who die under Oregon's Death With Dignity law are not listed as suicides. A change in health or the death of a spouse are triggers for suicide. Curry County has the highest number of older people, per capita, in the state, says Jan Kaplan, chief executive officer for Curry Community Health. "People retire here, many from California -- we're right on the California border -- and we don't have a college here, so we have few people between the ages of 20 and 40." Declines in the county's fishing and timber industry mean many residents don't have jobs, leading to depression and drug and alcohol use, says Kaplan's colleague, Carol Raper, a mental health program manager for the agency. "We're stretched pretty thin," she says. "We have nowhere near adequate services. I don't think people are aware a neighbor may be showing signs of behavior that is a concern." Men at risk What's even less known is the reason behind the high rate of men killing themselves, says Mark S. Kaplan, who has studied suicide for 19 years and has published widely on the subject. Kaplan works at the School of Community Health at Portland State University. Nationally, 80 percent of suicides are by men, his research shows. "Death by suicide is a strikingly male phenomenon," Kaplan writes in the International Journal of Men's Health. Reasons include losing a job, becoming ill, losing a spouse or partner, an embarrassing public disclosure or fearing loss of control. Men who lost their jobs are twice as likely to kill themselves, according to a Swedish study. Those factors can affect a man's image of himself, Kaplan says. Men, particularly in rural areas, view themselves as rugged individuals who prefer independence, he says. They may live far from mental health services so they don't ask for help. They often own a gun. If faced with a life crisis, they may not believe they have another choice. That's exactly how Leslie Storm's husband felt, she says. Twenty years ago, Fred Young, an attorney in Manzanita, took his boat out to sea and shot himself. They found his body a week later. Young had been facing financial problems, Storm says. "He didn't want to be a burden." She adds, "I think about it every single day." "The suicidal act is an effort to escape an intolerable view of self," Kaplan writes. Guns do the job. And the group that uses guns in suicides the most? Older men. More than 70 percent of older male suicides involve a firearm, according to the Centers for Disease Control. Suicide prevention may be a young field, but the state has begun to educate the public, says Millet, the Oregon Health Authority suicide expert. Federal and state-funded programs aimed at young people, Native Americans and veterans -- all high-risk groups -- seek to identify problems "upstream," before a crisis hits, she says. For example, 250 high schools have "Response" programs that train teachers and students in spotting someone in trouble. Suicide rates among youth have declined, but not among adults. Millet says she can't link the decline to any particular program. "But, we've made some big strides," she says. "We're preventing suicides every day. Some suicides we'll never be able to prevent. Some are a result of really impulsive behavior -- people with a firearm. We have to build healthier communities. Allow people to lead healthier lives. There are a lot of barriers to that. We're still not really good about talking about suicide as a health problem. Like mental health, there's still a lot of stigma." 'He had it all' Scott Punch was only 45, but in retrospect, he fit the profile of someone at risk for suicide. He was a veteran of Desert Storm and suffered post-traumatic stress syndrome, Stacy Punch says. Suicide rates for veterans exceed the national average. A shrine-like shelf in Stacy Punch's new home in Gold Beach holds Scott's ashes, flags, pictures and items from his career as a state trooper. Jamie Francis/The Oregonian "Scotty kept the military and what he witnessed to himself," she says. "He also shielded his police work and the violence he had seen from his family. He never talked about any details that would or could traumatize his family." It seemed as if everyone in Gold Beach, population 2,260, knew Scott. He had seen residents get into trouble and arrested some of them, yet 400 people came to his funeral. "He was well loved despite the badge," Stacy says. "He just didn't know it." "Pretty much everyone was in shock," says Curry County Sheriff John Bishop, who was Scott's friend for 19 years. They hunted together and boated with each others' families. "Everybody asked the question -- why? -- and there's no great answer to it. I think it was an impulse and it was stupid and doggone it, he shouldn'ta done it." After Scott's death Jan. 5, Stacy moved the family across town because she couldn't live in their old house. She feels abandoned, scared and mad. "He had it all -- a daughter, a son, a
wife who's in love with him. Nothing was more important to
him than his kids. I planned on spending 40 more years with
him. He left me to finish raising his son -- left me alone.
We'll never be able to make sense out of it. We'll just try
to go on." -- David Stabler Suicides
in Oregon: Trends and Risk Factors - 2012 Report (49
pages) Suicide is the second leading cause of death among Oregonians ages 15-34, and the 8th leading cause of death among all Oregonians in 2010. The financial and emotional impacts of suicide on family members and the broader community are devastating and long lasting. This report provides the most current suicide statistics in Oregon that can inform prevention programs, policy, and planning. We analyzed mortality data from 1981 to 2010 and 2003 to 2010 data of the Oregon Violent Death Reporting System (ORVDRS). This report presents findings of suicide trends and risk factors in Oregon. Key Findings In 2010, the age-adjusted suicide rate among Oregonians of 17.1 per 100,000 was 41 percent higher than the national average. The rate of suicide among Oregonians has been increasing since 2000. Suicide rates among adults ages 45-64 rose approximately 50 percent from 18.1 per 100,000 in 2000 to 27.1 per 100,000 in 2010. The rate increased more among women ages 45-64 than among men of the same age during the past 10 years. Suicide rates among men ages 65 and older decreased approximately 15 percent from nearly 50 per 100,000 in 2000 to 43 per 100,000 in 2010. Men were 3.7 times more likely to die by suicide than women. The highest suicide rate occurred among men ages 85 and over (76.1 per 100,000). Non-Hispanic white males had the highest suicide rate among all races / ethnicity (27.1 per 100,000). Firearms were the dominant mechanism of injury among men who died by suicide (62%). Approximately 26 percent of suicides occurred among veterans. Male veterans had a higher suicide rate than non-veteran males (44.6 vs. 31.5 per 100,000). Significantly higher suicide rates were identified among male veterans ages 18-24, 35-44 and 45-54 when compared to non-veteran males. Veteran suicide victims were reported to have more physical health problems than non-veteran males. Psychological, behavioral, and health problems co-occur and are known to increase suicide risk. Approximately 70 percent of suicide victims had a diagnosed mental disorder, alcohol and /or substance use problems, or depressed mood at time of death. Despite the high prevalence of mental health problems, less than one third of male victims and about 60 percent of female victims were receiving treatment for mental health problems at the time of death. Eviction/loss of home was a factor associated with 75 deaths by suicide in 2009-2010. 2 Investigators suspect that one in four suicide victims had used alcohol in the hours preceding their death. The number of suicides in each month varies; there was not a clear seasonal pattern. Baker, Coos, Curry, Douglas, Grant, Harney, Jackson, Josephine, Lincoln, Klamath and Tillamook counties had a higher than state average suicide rate; and Benton, Clackamas, Hood River, Washington, and Yamhill counties had a lower than state average suicide rate. Recommendations 1. Develop a new statewide suicide prevention strategy that prioritizes: a. A system of comprehensive primary prevention that implements evidencebased, upstream, primary prevention strategies that foster successful development and prevent psychological and behavioral problems (i.e. nurse family partnership, Paxis Good Behavior Game, Communities that Care, evidence-based parenting programs, mindfulness practice, and other evidence-based practices). b. Identify and implement evidence-based and culturally appropriate practices that address depression and suicidality among adult males to: i. enable men to identify depression as a manageable health condition, and ii. promote community, business, family and individual tools to support successful self management. c. Develop integrated behavioral health and primary care solutions to address depression and suicidal thoughts and behaviors among older adults. 2. Complete statewide implementation of comprehensive suicide prevention in high schools. 3. Expand suicide intervention skills efforts that will have an impact on adults, particularly men and veterans throughout Oregon. Introduction Suicide is an important public health problem in Oregon. Health surveys conducted in 2008 and 2009 show that approximately 15 percent of teens and four percent of adults ages 18 and older had serious thoughts of suicide during the past year; and about five percent of teens and 0.4 percent of adults made a suicide attempt in the past year1,2. In 2010, there were 685 Oregonians who died by suicide and more than 2,000 hospitalizations due to suicide attempts3,4. Suicide is the second leading cause of death among Oregonians ages 15-34, and the 8th leading cause of death among all ages in Oregon3. The cost of suicide is enormous. In 2010 alone, self-inflicted injury hospitalization charges exceeded 41 million dollars; and the estimate of total lifetime cost of suicide in Oregon was over 680 million dollars 3,4,5. The loss to families and communities broadens the impact of each death. “Suicide is a multidimensional, multi-determined, and multi-factorial behavior. The risk factors associated with suicidal behaviors include biological, psychological, and social factors”6. This report provides the most current suicide statistics in Oregon, provides suicide prevention programs and planners a detailed description of suicide, examines risk factors associated with suicide and generates public health information and prevention strategies. We analyzed mortality data from 1981 to 2010 and 2003 to 2010 data from the Oregon Violent Death Reporting System (ORVDRS). This report presents findings of suicide trends and risk factors in Oregon. 1 Oregon Healthy Teens 2009 -11th
Grade Results. public.health.oregon.gov/BirthDeathCertificates/Surveys/OregonHealthyTeens/results/2009/11/Documents/mental11.pdf
2 Crosby A.E., Han B., Ortega L.A.G., Park S.E., et al, Suicidal Thoughts and Behaviors Among Adults aged >= 18 Years – United States, 2008-2009. MMWR. 2011;60:13. 3 Oregon Vital Statistics Annual Report, Vol. 2, 2010. Oregon Heath Authority. 4 Wright D., Millet L., et al, Oregon Injury and Violence Prevention Program Report for 2011 Data year. Oregon Heath Authority. 5 Corso P.S., Mercy J.A., Simon T.R., et al, Medical Costs and Productivity Losses Due to Interpersonal and Self-Directed Violence in the United States. Am J Prev Med. 2007;32(6):474–482. 6 Maris R.W., Berman A.L., Silverman
A.M. (2000). Comprehensive Textbook of suicidology. New
York: The Guilford Press. (p378) State finds rise
in youth suicides Suicide remains one of Oregon’s most persistent public health problems, and the suicide rate among adolescents is increasing, according to the latest data and analysis by the Oregon Health Authority. Teen suicides came to the forefront for Deschutes County health and school officials in 2014, when at least five teens died by suicide. The local suicide deaths are still unverified by the state’s reporting system, but they could become part of a troubling statewide trend. Looking at data from 2003 to 2012, the Oregon Health Authority found a rise in suicides among people ages 10 to 17, . As a result, the OHA is recommending “complete statewide implementation of comprehensive suicide prevention in high schools,” according to a report, Suicides in Oregon: Trends and Associated Factors, 2003-2012, released on June 19. “Our behaviors start to solidify in adolescence,” said Jessica Jacks, supervisor of prevention programs at Deschutes County Health Services. “There is a need for prevention and intervention across the age spectrum. Doing more early is important.” Prevention programs are already underway in area high schools, and a five-year, $311,588 grant will further that work, Jacks said. The county wants to see at least two staff members at each school who’ve undergone a two-day training. With the new grant, every school in the county could be meeting that standard in the next five years, she said. The state is looking to expand training that’s been given at more than 200 high schools, said Lisa Millet, manager of the injury and violence prevention section at the Center for Prevention and Health Promotion. Under a federal Garrett Lee Smith Memorial grant, the state will expand that effort and offer a Web-based training to reach primary medical care providers, as well as school personnel. The state is also in the process of developing a new youth suicide prevention and intervention plan that would further its work to integrate behavioral health and primary medical care, Millet said. — Reporter:?541-617-7860, kmclaughlin@bendbulletin.com Some key findings about Oregon suicides:
Source: Suicides in Oregon, Trends and
Associated Factors, 2003-2012, Oregon Health Authority,
Public Health Division, Oregon Violent Death Reporting
System Suicide Oregon Ranked 10th Why Oregon's suicide rate is among highest in the country GOLD BEACH -- On the night of Jan. 5, Scott Punch grabbed his gun off the dresser and walked into the living room. He sat down four feet from his wife, put the gun to his head and pulled the trigger. On web diyr May 4, 2013 Soource: www.oregonlive.com/living/index.ssf/2013/05/why_oregons_suicide_rate_is_am.html Suicide Among Oregon Veterans 2008-2012 Leading causes of death by county of residence, Oregon, 2014 ------------------------------------
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