January 10, 2015 - by Ed Stannard - New Haven Register
Death by suicide has been on the rise in Connecticut — nearly one a day — with experts pointing to the ease of acquiring deadly opioids such as heroin and the stresses of middle age.
"Here at our clinic, I do have to say that we are seeing more suicides, because we track them," said Barbara DiMauro, president and CEO of Bridges in Milford, which provides mental health services. "We had more suicides in 2012 and 2013 than we did in previous years."
In addition, DiMauro said, "Suicide is largely under-reported. I do believe there are many more (self-inflicted deaths) annually than the numbers we see documented" because of unexplained causes of death and other factors.
According to the Centers for Disease Control and Prevention, suicide was the 10th leading cause of death in U.S. and the only one that increased between 2011 and 2012, from 12.3 to 12.6 per 100,000. Nationally, suicide has been on the rise since 2001, according to the American Foundation for Suicide Prevention.
According to the state medical examiner's office, suicides in Connecticut rose from 262 in 2007 to 373 in 2012, before dropping to 333 in 2013, the latest date for which figures are available.
Increases occurred in several age groups in the last few years, especially teenagers and people from 40 to 79. The biggest spikes were found in the 15-19 age group, which at 18 in 2012 was the highest since 2001; and ages 40-49, which spiked to more than 90 in the last three years for the first time since 2004.
On the other hand, suicides in those over 80 actually dropped in 2012 to 10, the fewest since 1993.
DiMauro said baby boomers — those between 55 and 69 — "were probably more emotionally or psychologically impacted by the financial downturn," and are often caring for aging parents while also supporting adult children, bringing "heightened stress more so than any other age group."
She warned of copycat incidents among adolescents. "Death by suicide can inspire other deaths by suicide. ... They may be more prone, more impacted by those types of events."
"We worry a great deal about suicide in adolescents," said Dr. Frank Fortunati, a psychiatrist at the Yale-New Haven Psychiatric Hospital. "We tend to think of it as much more tragic when a teenager does it."
Fortunati said there has been a rise in teenagers' visits to hospital emergency departments. At Yale-New Haven, "we've also been aware of an increased incidence of completed suicides in the past few years ... that we've tried to understand the causes of."
He said increased substance abuse may be a factor.
"Heroin is more likely to be lethal," Fortunati said, but he said he couldn't be sure whether heroin itself contributes to more suicides.
Kate Mattias, executive director of the National Alliance on Mental Illness' Connecticut chapter, said that in Connecticut suicide is "a significant problem."
However, according to the American Foundation for Suicide Prevention, Connecticut has a below-average rate of 10.25 per 100,000 population
Suicide prevention is improving, however.
"I can tell you that there's been a lot of work in the last couple years in training folks in suicide awareness ... and I think that training is getting better," said Tom Steen, executive director of the Capital Area Substance Abuse Council in Hartford.
"That's the good news. We're really starting to get our hands around the data, creating an infrastructure of folks who are trained in suicide prevention. There is a very aggressive effort across the state to try to address the issue," he said.
A good collection of resources, he said, is at www.preventsuicidect.org, which includes ways to intervene before and after an attempt, lists risk factors and warning signs.
Those with "risk factors are people who have had a previous attempt, are prone to depression or are suffering from a co-addiction kind of scenario," Steen said.
Depression or other brain disorders, such as bipolar disorder or schizophrenia, are also risk factors, he said.
The signs that someone is suicidal may be pretty clear too: loss of weight, not working, withdrawing from society, disinterest or a sudden interest in religion, giving away prized possessions, Steen said.
Fortunati named "significant changes in daily behaviors, significant changes in interests, significant changes in someone's routine ... of family, living circumstances, where someone talks ... in a way where they have no hope for changing, for regaining ground.
"If someone starts to make efforts, planning how they would take their life, that significantly increases their risk," he said.
One thing several mental health experts agreed on is that if you suspect someone is considering suicide, you should ask.
Steen, who has lost a family member to suicide, said, "I'm very public about it, but there are people out there who don't want to share it" and would "just as soon forget it and push it back into their past, and that's OK, too."
"Someone dies by suicide every day in Connecticut," Steen pointed out. "It's probably one of the biggest public health issues we have today."
One positive trend would be if "folks don't feel such stigma and try to bring it into the forefront."
"The most important pieces of prevention is as a society to get much, much more comfortable just talking about it ... sort of busting the stigma about it," said DiMauro.
"If you see something that you're concerned about with someone, you should ask, and that asking doesn't put it in somebody's mind. ... It can be helpful," said Fortunati.
The current phrase for suicide prevention is "Question, Persuade, Refer."
"It's CPR for heart, it's QPR for suicide prevention," said Steen, who is a trainer in the techniques He has also recently formed the northern Connecticut chapter of the American Foundation for Suicide Prevention (there is also a southern Connecticut chapter; check www.afsp.org).
"In the state of Connecticut we have 211 (Infoline) and there's always a social worker/therapist on 24 hours a day."
One difficulty is having enough money to provide the supports necessary to help those who are on a downward mental slope.
"What we're hoping the legislature will do is continue to enhance those services and supports that are available," including the 211 line and efforts to reduce stigma against those who attempt to end their own life, Mattias said.
DiMauro said the legislature and governor "really have to understand what's at stake here when they're making decisions to cut budgets."
"I think in our current environment timely access to mental health services has really been a challenge," said DiMauro, citing waiting lists of two weeks to three months to see a counselor. "A lot of people who are calling for mental health services are not always going to tell you that on the phone. ... We may lose some of those people."
This story was edited as the result of new information. That data includes Connecticut's below-average suicide rate of 10.25 per 100,000 population and its total of suicides in 2013 (333).
Bridges is a community of dedicated caregivers committed to providing comprehensive and effective mental health services and addiction recovery programs for adults, children and families.