By Randy Ihara
Suicide and mental illness, particularly depression, are inextricably linked.
Most suicides are brought on by unbearable psychological pain where the person ending his or her life is convinced that there is no other way out. This link was recently brought to the fore by an alarming article entitled, “Sweeping Pain as Suicides Hit a 30-Year High” published in The New York Times (April 22). The article was a report on the findings of a study released by the National Center for Health Statistics, which found that suicides in America have increased dramatically among “middle-aged Americans [45-64 years of age], sending a signal of deep anguish from a group whose suicide rates had been stable or falling since the 1950s.”
During the study period, 1999-2014, suicides for middle-aged women, 45-64, increased sharply by 63 percent, while men in the same age group exhibited a rise of 43 percent, “the sharpest increase for males of any age.” Over the study period, the Center reported, the overall suicide rate increased by 24 percent. Almost 43,000 people committed suicide in 2014; this is significantly more than the 33,000 Americans who died as a result of gun violence that year. At that level, suicide is the second leading cause of death after traffic fatalities. This is compared with just over 29,000 suicides in 1999. The increase in suicides was so broad, “affecting virtually every age group,” that the nation’s suicide rate increased to 13 per 100,000 people, the highest rate since 1986.
This data “provided fresh evidence of suffering among white Americans,” supplementing recently reported evidence of less-educated, lower-income whites who exhibit greater death rates from drug overdoses, suicide, liver disease and alcohol poisoning.
An analysis of the data by the Center and by health researchers at the Robert Wood Johnson Foundation “identified a link between suicides in middle age and rising rates of distress about jobs and personal finances.“ In addition, increases in social isolation as a result of rapidly rising divorce rates may play a role. According to one study “unmarried middle aged-men were 3.5 times more likely than married men to die from suicide,” while women were 2.8 times more likely to commit suicide. Finally, worsening economic conditions among lower-income whites have eroded the prospects of families, which may represent preconditions for suicide for this group. One study by the Centers for Disease Control and Prevention, found that suicide rates were highest during periods of economic downturn going back to the 1920s. During the Great Depression the national suicide rate was 22.1 per 100,000, about 70 percent higher than the rate in 2014.
In the face of these statistics, efforts to prevent suicide have been spotty at best. Funding for research into suicide prevention by The National Institute of Mental Health’s Suicide Research Consortium has been relatively flat, and represents “a small fraction for research of mental illnesses, including mood disorders like depression,” according to the study.
Against this national backdrop, Virginia is not immune.
According to a 2013 report of Virginia’s Chief Medical Examiner, suicide in the commonwealth is more common than homicide: For every homicide there were more than three suicides. Between 2000 and 2012, the suicide rate increased every year from 10.5 per 100,000 in 2000, to 12.9 per 100,000 in 2012. Eighty-five percent of those suicides were white men. In Loudoun County the suicide rate in that year was 9.2 per 100,000 population, higher than the rate of 3.7 for traffic deaths in the county.
Unfortunately, youth suicide in Virginia is a significant issue. According to the Virginia Violent Death Reporting System, suicide is the third leading cause of death for those in the 10-24-year age bracket, representing 13.4 percent of all Virginia suicides. Between 1996 and 2005, the Virginia youth suicide rate was 7.2 per 100,000, while in Loudoun County the Office of the Chief Medical Examiner reported a rate in 2013 of 9.2 per 100,000. According to the National Institute of Mental Health, 9 out of 10 who die by suicide have a treatable mental illness.
Yet resources for the treatment of mental illness in Virginia and Loudoun County have not kept up with the need. According to the National Alliance on Mental Illness, Virginia’s mental health system provides services to only 19 percent of adults with mental illness. Expansion of Medicaid in Virginia would increase access to health services, including mental health, for an estimated 400,000 Virginians. Modest improvements in funding were achieved in the General Assembly in Virginia this past session, but the need for additional resources remains, as evidenced by the growth of the state’s suicide rate and population. Per capita spending for mental health has fallen from about $105 per capita to $69. At the county level, funding for mental health services has remained level at around $32 million from FY12 to FY14 while the county’s population has grown significantly. As a result, on a per capita basis, funding has fallen from $94 in constant dollars, to $90 per capita.
The recent death of several of our young people reminds us of the cost of the insufficiency of resources available for mental health services. We can and must do better.
[Randy Ihara is a past president of Friends of Loudoun Mental Health.]