Idaho’s latest numbers show suicides went up in 2017 compared to 2016.

In 2017, 393 Idahoans killed themselves, according to data from the Idaho Department of Health and Welfare, for a suicide rate of 22.9 per 100,000 people. In 2016, 351 people killed themselves in Idaho, for a suicide rate of 20.9 per 100,000, according to the state’s data.

The number of suicides in Idaho, when population is taken into account, dropped slightly in 2010, 2011 and 2016 but otherwise has been steadily climbing since 2008. In that year there were 251 suicides, for a rate of 16.5 per 100,000 residents.

Health and Welfare spokeswoman Niki Forbing-Orr said you shouldn’t read too much into the numbers from just one year, which can vary a lot.

“Nobody can really point to any one thing that’s responsible for a one-year increase,” she said.

She said you can learn from the trend over time. Both the suicide rate and the number of suicides has mostly increased in Idaho over the past decade.

“The rate of increase is still concerning to us, which is why we have established this program, to help people understand that there is help,” she said, referring to the suicide prevention programs the department has started over the past few years. “And most people recover from suicidality.”

Idaho has had one of the highest suicide rates in America for years, something it shares with Alaska and several other states in the Intermountain West. However, suicide rates have been going up in most of the country for the past 10 years or so. The Centers for Disease Control and Prevention released a report last week that said national suicide rates increased on average from 13.5 per 100,000 people in 2016 to 14 in 2017.

“We know that suicide is a lagging indicator (around) economic decline, as are many other indicators,” said Kim Kane, suicide prevention program manager for the Idaho Department of Health and Welfare. However, “as the economy has improved we have not seen suicide rates go down.”

Focusing on self-worth

John Landers, who manages the mental health department at Mountain View Hospital, said the perception that people with drug or mental health problems are weak discourages people from seeking help. He contrasted it with society’s attitude toward physical ailments — conditions such as heart disease can be the result of personal choices, but no one stigmatizes them.

“There are people in those numbers,” he said. “There are people in that 241 (who died of drug overdoses last year) and there are people in that 393 that didn’t have to die. Drug addiction and suicidal ideation are not terminal illnesses. (But) people don’t want to get help. They feel like there’s a burden they would impose on others if they got treatment. The crime in all this is the fact there is a stigma, and I think we continue to operate based on a consideration that mental health-slash-psychological concerns are a statement about someone’s worth.”

Matt Larsen, the head of the psychiatry department at Eastern Idaho Regional Medical Center, said a feeling of worthlessness or being a burden is common in his patients. People are more likely to work through difficulties if they still feel like they have value.

“The specific stressors always differ,” Larsen said. “The common links are usually, they’ve gotten to the point they feel like they’re a burden on the people around them. That’s one of the things that finally allows them to make a suicide attempt. They think everyone around them would be better off without them.”

Kane also said a sense of isolation and not feeling connected to other people are major risk factors.

“They believe that people around them would be better off with them gone,” she said. “And that’s never true, but their thinking is not rational.”

There are several theories about why there are so many more suicides in this part of the country. One, which Larsen personally finds the least plausible, is that the higher elevation plays a role in suicide rates. Other correlations, he said, include that suicide tends to be more common in rural areas rather than urban, in Republican areas rather than Democratic ones, and in areas where people have more access to guns.

If someone is suicidal, Larsen said the important thing is to get them somewhere safe, where they can’t access guns or any other “instant lethal means.” Then, mental health professionals can try to figure out whether someone is reacting to a new major stress in life or dealing with an ongoing mental problem.

“Sometimes it’s medication to treat mental illness,” Larsen said. “Sometimes it’s therapy. Sometimes it’s (learning to) handle stress better.”

State, school initiatives

The state has taken some notice of the problem, creating a suicide prevention program in 2016 that includes funding programs such as the school-based Idaho Lives Project. Lawmakers also passed a bill this year requiring suicide prevention training for school personnel.

The Department of Health and Welfare also plans to start implementing the Zero Suicide initiative, a program to train health care providers to spot and help people who are considering suicide. About 45 percent of people who commit suicide saw their primary care doctor within the month before, Kane said. The number is even higher for older people who kill themselves.

“It closes all of the loopholes and little cracks through which suicidal people can fall,” Kane said.

The Legislature also has been funding crisis centers where people who are suffering from mental health or addiction problems can go for 24 hours to get some help and then be referred to further services. The crisis center in Idaho Falls, which opened in 2014, was the first. There are also crisis centers in Boise, Twin Falls and Coeur d’Alene, and more are expected to open soon in Pocatello, Lewiston and Canyon County.

Some Idaho schools have been implementing their own prevention programs. One such program is the Hope Squad in Bonneville Joint School District 93. It is modeled off Hope4Utah, which was founded by Greg Hudnall, a former administrator in the Provo (Utah) City School District. Chuck Shackett, who is District 93’s superintendent now, said he helped implement it when he was principal of Provo High School, and Bonneville started its version last year.

The “hope squads” consist of students at every school, from elementary through high school, who are chosen by their peers as students they trust and feel comfortable talking to, said Gordon Howard, the district’s director of technology and safe schools.

Howard said the students are given age-appropriate training — with the younger students, for example, they emphasize things like being kind. At the higher levels, though, part of their training is recognizing the signs that someone is having suicidal thoughts. Gordon stressed that the students aren’t counselors themselves, but they are the “eyes and ears,” trained to listen to their peers who are struggling and, when appropriate, bring them to a counselor or other adult who can help.

“It’s been a very positive program,” Howard said. “We saw the benefits in year one with the referrals that were coming in and students we were able to help.”

‘Recovery is the norm’

Kane said that while many people who attempt suicide have mental health issues, improving mental health treatment isn’t the whole answer. She said this is more of a contributor than a cause — most people with mental health problems don’t attempt suicide. A big part of it, she said, is addressing “upstream factors” such as jobs and housing, and teaching children better coping skills so they don’t turn to risky behaviors when they run into problems.

People, she said, should be aware of the warning signs and willing to reach out to people they know who might be struggling. She also said the media should highlight stories of recovery. Most people who have suicidal thoughts, she said, get better.

“Recovery is the norm,” Kane said.

Larsen said that while awareness and education have been improving, suicide rates have yet to decline. He said it’s hard to know what will make a difference in different communities, since suicide has so many causes, but there are things society can do.

“One is making it easier for people to discuss when they’re stressed and reach out for help,” he said. “As a community, it’s increasing things that bring people together and show them their value. As far as specific things, the only specific things you can do is, when someone is doing worse or in crisis, decrease their access to lethal means. Lock up meds and lock up guns. Get them to a friend’s house, have a friend keep them safe or something.”

Larsen has been working with youth at the hospital and speaking at schools and churches. For example, he’ll be speaking at Hillcrest High School in two weeks.

“What I’m currently working on is trying to help people get better at failing and working through failure,” Larsen said. “So it’s more an expected part of life. We’re going to fail, we’re going to mess up, and that’s just expected, and we work through it and move on to what’s next.”

Landers said changing people’s attitudes toward mental illness starts at the family level. The schools also play a role. He pointed to drug and sex education programs, which can spur parents to talk about difficult issues with their children.

Landers pointed to other examples of how attitudes change over time. His grandparents, he said, grew up with racist views that he didn’t. Meanwhile, his children grew up hearing more inclusive messages about gay people and people with other differences than what he grew up with.

“If we were to start educating at an elemental level with families and children in school, we could start getting rid of the stigma in a generation,” Landers said. “It’s not a quick fix. It’s a cultural change and therefore it’s going to take a generation, but it’s worth doing.”

Editor's note: This article has been updated to remove an error in the description of the Idaho Suicide Prevention Hotline.

Reporter Nathan Brown can be reached at 208-542-6757. Follow him on Twitter: @NateBrownNews.

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