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County’s suicide rate above state, national average

Ten confirmed suicides in Archuleta County in 2009 place the county high above state and national averages.

Another possible suicide is under investigation, according to Archuleta County Coroner Carl Macht.

“For a town of our size, even 10 in a year ... is really outrageously high,” said Tom Bonde, vice president of Clinical Services of Southwest Colorado Mental Health.

According to Bonde, the average number of suicides in Colorado from 1999 to 2007 was 15.7 per 100,000 population, while the national average is 11.1 per 100,000 population.

Archuleta County has a population of 12,648, according to a 2008 U.S. Census Bureau estimate.

“Our suicide rates are astronomical,” said Bonde.

While the numbers are clear, the reasons for the suicides are not.

“The difficulty is finding out why,” Macht said, adding, “There’s no particular reason for them to occur.”

A consensus among local officials and experts is that economic hardships are a contributing factor, but to know if it was the only or primary cause is difficult.

Bonde pointed out that Pagosa Springs is unique in that it is a tourist town, with industries that do not pay well, and that was hit hard by the economic downturn of the last year.

Similarly, Carmen Hubbs, director of Archuleta County Victims Assistance, noted that when the world already looks bleak to an individual, hard economic times can add to the hopeless feeling.

Financial hardships can increase depression, anxiety, stress and other risk factors for suicide, Bonde said.

“A lot of people have been dealing with more and more mental health issues,” said Lt. Sean Curtis of the Archuleta County Sheriff’s Department, adding, “I think any time you have a suicide it’s got to be mental health-related.”

Bonde concurred, noting that for a person to get to the point of a “permanent solution to a temporary problem,” there has to be something psychologically wrong causing the depression and loss of hope.

While much of the speculation for cause concerns finances, the combination of stressors that ultimately cause the act is unknown in many cases.

“People will speculate about different factors, but we don’t know,” Macht said.

Generally, notes are left about 40 percent of the time in cases of suicide, though fewer than that average have left notes this year, Macht said, adding that many possible contributing factors are found by talking to friends and relatives after the fact.

The local victims have been predominately male and most have been between the ages of 35-50, which Macht notes as normal.

Where the numbers deviate from averages is in the use of firearms.

Macht said that “death by gun is at a higher rate than other small counties, including La Plata County.”

Nine of the 10 acts have involved firearms. One was an overdose, Macht stated.

The higher number of suicides here versus La Plata county is a fact that both concerns and baffles Josh Bramble, a local counselor who volunteers with the Archuleta County Sheriff’s Department.

“Why more here? I don’t know,” he said.

Bramble noted that most of the suicides occurred between January and June.

“We went quite a while without any,” said Curtis, but, most recently, about a month has passed without one.

“It seems to have slowed and I’m really happy about that,” he said.

Though there have been fewer incidents of late, Macht is cautious due to the traditional rise in mental health issues such as depression and suicides across the nation during the holidays.

“Having this many up to now, I’m concerned we’ll have more,” he said.

Bramble indicated that the number of people who reach out for mental health help also rises during the holidays.

Hubbs said county victim advocates have geared up for an expected increase in violence and suicide due to the hard economic times, and says they have seen an increase in some types of incidents. Advocates primarily work with those affected by domestic violence and sexual assault.

“There have always been ties” between hard times and violence, Hubbs said.

Similarly, Curtis pointed out that his department sees higher crime rates in times of financial trouble, but said that “the suicides were not something we counted on.”

Bonde said the Colorado Southwest Mental Health office has tracked the number of walk-in crisis contacts and has seen the number rise from four or five a month in September of 2008 to about 25 per month this fall. He noted that the number of walk-ins generally decreases from June to mid-September, when there is more work during the tourist season.

Warning signs

Professionals interviewed noted that the ultimate cause of suicide is a sense of hopelessness and helplessness leading an individual to make a decision they wouldn’t otherwise make.

When those contemplating suicide are asked if they want to end their lives or end the emotional pain, “Ninety-nine percent of the time, they want to be out of the emotional pain,” Bramble said.

“In the past 14 months, life has sucked for a lot of people, especially in this country. It’s not beyond the realm of reality to suggest there’s a lot of depressed people out there,” Bonde said.

Bonde and Erik Foss, a therapist at Pagosa Counseling Center (Colorado Southwest Mental Health), noted that it’s more normal to be depressed than not when depressing things are happening.

Warning signs to look for — concerning severe depression and possible suicidal thoughts — were listed by Bramble, Bonde, Foss and Robert Woods, also a therapist at Pagosa Counseling Center and include:

• A significant change in eating habits — either decreased or increased appetite.

• Significant weight gain or loss.

•?Withdrawing from family and friends.

• Increased substance abuse, including drugs and alcohol.

“People will often times act out their depression in destructive ways,” Bonde said, stating that depression can manifest in violence, domestic violence, overeating, substance abuse and more.

Foss and Bonde acknowledge that seeking help is seen by some as a sign of weakness, causing them to internalize their feelings — something that can lead to destructive behavior.

•?Statements about hurting themselves or committing suicide.

Foss indicated that one of the first things he looks for is if a person believes that the world would be a better place without them in it.

• A sense of hopelessness or that what one is doing is not enough.

• Sleeplessness.

•?In men especially, an increase in irritability, anger, frustration.

• Behavior that deviates from the norm.

• Loss of future orientation.

“If they’re talking about something they have coming up that they’re looking forward to, even just as simple as having an appointment they’re going to later in the week ... when there isn’t any of that future orientation, that’s a sign that stands out,” Woods said.

• An element of loss.

“It could be the loss of a job, of a dog, could be the loss of a home, could be the loss of a friendship or marriage ... any element of loss will put a person, typically, at a higher risk,” Woods said.

• The loss of a typical daily routine, which can follow events like retirement.

• Increased anxiety or stress.

“If there is evidence of anxiety on top of whatever else might be going on with their mental health, a person is three-to-four times more likely to have a serious attempt, if not to complete a suicide,” Bonde said.

What to do

If warning signs are present, individuals are encouraged to reach out to family, friends and professionals, and loved ones are encouraged to ask the hard questions — asking if the person is thinking of hurting themselves or committing suicide.

“One of the things we find as clinicians is that if the hard questions are asked, often times that, in and of itself, short circuits the process because what they end up doing is they start talking about it,” Bonde said. “And when they talk about just how miserable they feel, there’s kind of a cathartic release.”

“There’s a myth: people think that if you ask someone about suicide or talk about certain emotions and things, that it increases it and makes it worse. In my experience, I’ve never found that at all to be the case,” Woods said.

“What we actually find in the field is that just acknowledging an emotional response or an emotional state takes some of the power away from that emotional response,” Foss said.

“The key to health is not necessarily to change the outcome, but to acknowledge that your reality is accurate. Life does suck sometimes,” Bonde said.

The acknowledgment that those feelings are present “is the first step in preventing something that’s tragic,” Foss said.

Loved ones are encouraged to support the individual in seeking help, Bonde said.

Bonde acknowledged that reaching out can be a “Catch-22” situation of having to pay for treatment when financial difficulties are a primary cause of a depression, but he said some counseling centers have ways to aid in that case.

“There are options out there and there are a lot of people available to help,” Curtis said.

“On the bright side, this community is pretty well known for it’s supportive, faith-based community. That’s another option for people to reach out to folks in their church or start attending church,” Bonde said.

“Communication is the most important,” Woods said.

“When our members of our community are suffering, we’re suffering,” Hubbs said, adding that all it takes is some more effort on the part of the community members to reach out and help each other.

Indeed, reaching out has saved lives in the community, allowing for intervention.

“What we find is that they’re not following through when they reach out,” Bonde said.

“We’ve actually prevented a few, which is good,” Curtis said.

randi@pagosasun.com