Lifting the veil over suicide

Editor’s note: This is the first in a three-part series about suicide.

A higher-than-average suicide rate in Grant County has mental health officials and community leaders looking for answers.

Representatives from the Grant County Education Service District, the Grant County School District, the district attorney’s office and the probation office met with staff from Community Counseling Solutions for a prevention and round-table meeting on Feb. 15 as members of Grant County’s Youth Suicide Response Team.

“It was a brainstorming session — what are we doing now, what more can we do,” CCS Clinical Director Thad Labhart said.

The team reached consensus that the community needs to do a better job of community screening, he said.

“One of the hardest problems is that, if we don’t know, we can’t help,” he said. “We can help them once they’re in the door.”

In 2014, the Oregon Legislature enacted a law calling for a five-year Youth Suicide Intervention and Prevention Plan to be in place by 2015. The goal was to improve access to mental health intervention, treatment and support for depressed and suicidal youths.

The plan mandated more training for medical and behavioral health providers, more collaboration among schools and school-based clinics, taking a look at laws governing confidentiality, developing responses by schools and communities following a youth suicide, using more social media and using best practices to identify and intervene with youths who are depressed, suicidal or at risk of self-injury.

According to the Oregon Health Authority, county governments acting as the local mental health authority would “take a leadership role in their communities to form collaborative partnerships for responding to youth suicides and reducing the risk of contagion.”

Information to be collected about a confirmed suicide could include whether a youth was in custody of the police, if the suicide occurred in a public place, whether a note was left, if there was evidence of bullying, if social media was involved, whether other suicides by children or adults had occurred in the past year and if any traumatic events had recently occurred.

Collection of that data raised privacy concerns, and the Oregon Health Authority encouraged counties to seek legal advice. Labhart drafted the plan for Grant County.

“Privacy issues have been fully vetted by the state,” he said.

In 2016, the suicide rate per 100,000 youths aged 10-24 was 12.97 in Oregon, compared to 9.6 nationwide. Suicide is the second leading cause of death among 10- to 24-year-olds in Oregon.

Oregon Healthy Teens Surveys from 2017 show that statewide 16.9 percent of eighth-graders and 18.2 percent of 11th-graders reported seriously considered attempting suicide in the past 12 months — and 8.7 percent of eighth-graders and 6.8 percent of 11th-graders actually attempted suicide.

In 2017 in Grant, Lake and Harney counties, 21.2 percent of eighth-graders and 18.9 percent of 11th-graders seriously considered suicide — and 9.4 percent of eighth-graders and 6.6 percent of 11th-graders actually attempted suicide.

For all age groups, about 70 percent of suicide victims in Oregon already suffered from a diagnosed mental disorder, an alcohol or substance-abuse problem or were in a depressed mood at the time of death.

Nearly three-quarters of the reported mental disorders were categorized as depression, while 15 percent were bipolar and another 15 percent were anxiety disorders. Diagnosed mental disorders for suicide victims were more common among women than men, while criminal legal problems were more common among men.

More than a third of suicide victims told others of their intentions, while another third left a note. About 20 percent had a history of suicide attempts. Nearly a quarter were believed to have consumed alcohol in the hours before their deaths.

If a suicide risk is determined to be serious, a person can be placed in custody under a mental health hold, Labhart said. A civil commitment hearing must be held within five business days, he said.

“We hold about four or five hearings a year in Grant County,” Labhart said.

If a CCS client makes suicidal statements, a safety plan could be implemented or medicine prescribed, but unless the client is under a civil commitment, it must be voluntary, he said.

“It’s a case-by-case basis,” he said.

CCS has about 250 active clients in Grant County. About 20 percent have alcohol- or drug-related issues. Of the remaining 200 or so clients, about 15 percent say something about suicide.

“It’s not that uncommon,” he said, noting that mental health providers need to recognize a specific intent as opposed to someone saying, “I just want to die.”

About 70 percent of Grant County suicide victims were not active mental health patients, although they may have been in the past, Labhart said. That’s why family members, friends or co-workers who hear something should contact CCS during business hours or call 911 if it’s an emergency or late at night.

“We receive referrals weekly,” Labhart said. “I guarantee you, we’ve saved lives.”

But some people, he noted, just don’t want anything to do with mental health providers.

“It’s that ‘mind your own business’ mentality,” he said.

The next installment, “Suicide by the numbers,” will be published next week.

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