Reduce the most preventable cause of death
Date posted: August 19, 2013
SHERIDAN — Last year, 163 Wyomingites committed suicide. That statistic puts the state at number one in the nation, and while rates are rising, Sheridan’s community prevention specialists are fighting what they consider to be the most preventable cause of death.
Community Prevention Specialist Thom Gabrukiewicz said Wyoming has been near the top of the list since the Department of Health started tracking suicide numbers. He said the state falls cleanly into what’s known among sociologists as the Intermountain Suicide Belt.
“What happens in Wyoming is the largest group of people trying to commit suicide are middle-aged men, and here, there are usually firearms in the house,” he said. “Attempting with a firearm more often leads to completion. However, women are actually three times more likely to attempt suicide.”
The American Association of Suicidology reports suicide is the 10th leading cause of death nationwide, but the third leading cause of death among the those aged 15-24 years. Rates are highest among those aged 45-54 and over 85. The rate decreases during times of war, and increases during an economic crisis. Mental illnesses, including depression and alcoholism, also multiply suicide risk.
Gabrukiewicz said women most often attempt to take their lives with drugs or poison, though women’s attempts with firearms are also on the rise, as are attempts across every demographic.
According to a 2011 report by the University of Las Vegas, the “Suicide Belt” also includes Colorado, Idaho, Montana, Nevada, New Mexico, Oregon and Utah.
Dr. Theresa Humphries-Wadsworth, state suicide prevention coordinator, says the geographical “Suicide Belt” refers primarily to the unique demographics of the Rocky Mountain Region.
“We find it has to do with being in a rural setting,” she said. “The people who settled these areas had a strong sense of self-reliance and independence that helped them have an advantage when they were settling the area. Today, those same traits of the independent pioneer spirit work against us.”
Humphries-Wadsworth’s explanation also accounts for Alaska’s high suicide rate, though the state is formally excluded from the list of states in the suicide belt due to its geographic disparity.
While a rural environment and access to firearms are factors high-risk states share, Humphries-Wadsworth said other environmental factors, including prevalence of wind and average amounts of sunlight, have not been proven to be risk factors. However, research is being done to determine whether altitude plays a role, as suicide rates also tend to climb along with elevation.
Humphries-Wadsworth said there are three main factors that can contribute to suicidal behaviors in people regardless of geography. The first is a mental disturbance, which can be a mental illness, sometimes undiagnosed, but could also be a stressful life situation for a healthy person like the loss of a job or bad ending of a relationship. The second is the involvement of drugs or alcohol, which clouds judgment. The third is a lack of feeling of community.
“We find it’s rural settings where people feel more disconnected if something is wrong,” she said.
Humphries-Wadsworth said while small town camaraderie is often considered to be a benefit, it can also backfire when someone needs space and understanding to deal with challenges.
“In a small town, everyone knows your business,” she said.
Within the state of Wyoming, Sheridan County suicides are among the highest in the state, possibly because of the location of the Veterans Affairs hospital, which attracts a demographic of people who may be more disposed to suicidal tendencies. In 2012, there were eight suicides. So far in 2013, there have been seven, according to the Sheridan County Cornoner’s Office.
Regardless of where it happens, Gabrukiewicz said suicidal inclinations are an odd phenomenon of the human psyche that can be completely prevented.
“Every cell in our body tells us to survive,” he said. “It’s just one of those things where everything piles on top of you that causes illness, and then that often gets compounded with drugs or alcohol, and judgment gets clouded.”
“What we’re trying to do is tell the public there is help available in our community, and they can get help to others,” he said.
Gabrukiewicz is working with a local and statewide team of prevention specialists within the Department of Health to empower Sheridan County citizens to develop a culture where at-risk people are identified, accepted and get the help they deserve.
The group offers “Gatekeeper” training, which is a 90-minute class targeted to educate everyday people about mental illnesses and enable them to initiate a dialog about suicide with someone they may be worried about. People who are Gatekeeper trained are taught how to ask someone if suicidal ideation is present, and if so, they know how to direct a person in crisis toward help.
“It’s a tough conversation to have,” he said. “That’s a problem with our society is we don’t deal well with depression issues and mental health issues right now. We have to get to a point where we can because so many people suffer in silence.”
Gabrukiewicz said it’s a common misconception that talking about suicide will push someone further into crisis. In fact, he said, it’s the opposite.
“If you ask the question, people are very honest, and it’s almost like a weight has been lifted off of them,” he said.
Applied Suicide Intervention Skills Training is also locally available, mostly to first responders, teachers and social workers. The two-day ASIST course takes the conversation on suicide a step further and addresses how to actually intervene in the midst of a suicidal crisis. ASIST training is also accredited continuing education for professionals in some professions.
Gabrukiewicz recently trained a group of 19 community leaders, mostly clergy and teachers, to conduct Gatekeeper training for their organizations. Furthermore, the prevention management team is hosting an ASIST session Sept. 9-10.
Gabrukiewicz said the recent push for education is a direct response to Wyoiming Governor Matt Mead’s call to address the state’s suicide problem. More importantly, he said, is that he knows education can change society and save lives.
“It’s just watching out for your fellow man is what it is,” he said.
“It’s a part of a lot of people’s make-up,” he said. “Everybody gets depressed. That’s a given,” he said.
The National Institute of Mental Health conducted a study in 2005 that concluded that more than half of Americans will experience mental instability at one point in their lives. The $20 million survey speaks to the reality that mental illnesses are common and treatable.
“There’s always been mental illness, and there’s always been the stigma that you can’t tell anybody you’re depressed or bipolar. Why not? It’s part of who you are,” he said. “Society functions better if we can have a truthful dialog about it. It shouldn’t be relegated to the shadows.”
Gabrukiewicz said it’s ironic that people openly discuss other health problems, like diabetes or cancer, but issues like depression, anxiety or bipolar disorder are taboo.
Community members interested in learning more about Gatekeeper or ASIST training can call the Sheridan County Suicide Preventional Coalition at 655-8263. People currently in crisis can call the National Suicide Prevention Hotline at 1-800-273-8255 or 911.
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