San Angelo Ranks Above State Average in Suicides

Suicide is a killer we don’t hear much about in the media. It’s one subject not many people like to talk about openly. It’s also a serious public health problem that takes its toll on families, friends, classmates, co-workers and communities, as well as on our military personnel and veterans. As a news organization, we hear about a response to a suicide almost every week. We do not cover these incidents because doing so will likely increase the incentive for someone else to do the same. The only exception is if the suicide is in a very public place, or the person involved is a public official. But even then, we are reluctant to provide coverage of an individual suicide.

This is the reason you don't hear much about suicides in San Angelo, but we found that the rate of suicides within the county is higher than the statewide average.

“According to the (Tom Green County)  justices of the peace and the people we have been in contact [with], there certainly has not been any significant drop in the suicide rate.” said Dusty McCoy, executive director for West Texas Counseling & Guidance in San Angelo. “We [San Angelo] have been above average every year, [and] above the Texas state average every year since 2000. Here in West Texas, we have a high rate in general."

McCoy added that other cities in Texas have had their ups and downs, but the San Angelo area's rate remains on a constant upward trend.

"They would go way up and then they would be below the average, but we have been the only ones since 2000 that have been above the state average every year,” said McCoy.

The Issue with Suicide Statistics

Suicide is the 12^th leading cause of death overall in Texas, and more than twice as many people die by suicide in the state annually than by homicide. On average, one person commits suicide every 16.2 minutes, and each suicide intimately affects at least six other people.

However, to determine the most up-to-date statistics in San Angelo isn't that easy.

Greg Hickey, M.S., QMHP-CS, with the MHMR Services for the Concho Valley and MCOT Coordinator & Continuity of Care Liaison, specified, “Unfortunately, we do not have any official data for 2014 and 2015 due to an approximate 15-month lapse at the state level for such data.”

Because of this lapse, Hickey said West Texas Counseling & Guidance and MHMR are teaming up with San Angelo and Tom Green County officials to correct this problem.

McCoy explained, “We are doing a partnership: MHMR, Tom Green Sheriff’s Office, San Angelo Police Department, County Judge and Tom Green County Crisis Intervention. We met a few months ago to address this 15-month lag in information. So we were wanting to work together to get real time numbers, when they occur, on a monthly basis to figure out where we need to target and take our education campaign. We are trying to put a program together where we don’t have to wait for 15 months and when suicide does occur; we are looking to be able to reach out to the families.”

San Angelo Police Department officials also said the numbers they have obtained for area suicides are an estimate because not all calls they receive come in as a suicide. However, based on the numbers they do have for 2015, a total of 31 people have attempted suicide and 16 have committed suicide.

The chart below shows San Angelo and surrounding cities' numbers compared to that of the Texas rate for suicides from 2013 to 2007. Texas ranks 9^th in the nation.

“West Texas in general does typically have a higher rate, and we have our guesses on why that is.” McCoy said, “I believe a lot of it has to do with the Bootstrap mentality of West Texas--the stigma of treatment. That is where we are trying to do some education and prevention, as far as spreading the word that treatment is effective and that there is nothing wrong with coming in. A lot of people believe that it means you are weak or that there is something wrong with treatment. [There are] negative beliefs that are associated with it. I think that is probably why our rates have been higher.”

McCoy also said the rates of suicide vary according to age, race, gender and other demographics.

“We see that suicide rates are highest in people age 85 and above, 19.3 in 2014," Hickey explained. "The second highest in the age range is 45-64 at 19.2 for 2014, with an average rate of suicide of 11.6 adolescents and young adults age 15-24. The overall rate of suicide has consistently remained four times higher in men than in women between 2005 and 2014. In 2014, of all those who died by suicide, 77.4 percent were male [and] 22.6 percent were female.”

The statewide statistics by race are as follows:

• White males comprised of 70 percent of all suicides in 2014
• Whites: 14.7 percent
• American Indians/Alaskan Native: 10.9 percent
• Hispanics: 6.3 percent
• Asian/Pacific Islanders: 5.9 percent
• Blacks: 5.5 percent

Nationally, for patients seen in an emergency room for suicide attempts, approximately 10 percent of those individuals will die by suicide within ten years. Other research shows that 7 percent of those individuals who had attempted suicide over a 22-year span die by suicide within that timeframe. Additionally, 80 percent of individuals who die by suicide have attempted at least once in the past.

Local Calls Related to Suicide and Help

The MHMR Services for the Concho Valley and West Texas Counseling & Guidance (WTCG) have a longstanding partnership with a common goal of improving access to mental health resources for those people who need help. The Mobile Crisis Outreach Team (MCOT) with the MHMR Services for the Concho Valley (not to be confused with the Crisis Intervention Unit with the Sheriff’s office) works with the local Mental Health Deputies to provide prompt crisis response in the community to individuals experiencing an acute mental health crisis, to include suicidal ideation, homicidal ideation, or an ability to care for themselves due to deteriorated mental status.

Hickey provided an insight into the calls his agency receives.

“They vary from month to month, but typically, we are dispatched between 30 to 55 times per month to valid calls to our crisis hotline," he stated. "We respond to a variety of settings, to include local emergency rooms, medical hospitals, psychiatric hospital intake departments, schools, the local jail, and law enforcement officers on scene with a person in crisis. I would say the mass majority of these calls involve individuals of severe psychosis as well. Approximately 75 percent to 85 percent of our calls involve an individual experiencing suicidal ideation or a recent suicide attempt.”

These “valid calls” mean that the individual in crisis meets the criteria for some kind of service with MHMR or MCOT, which ranges between a referral for counseling services, all the way to inpatient psychiatric treatment. Safety in this case is paramount and MHMR, MCOT and WTCG make every effort to ensure that. MHMR has standing contracts and valuable partnerships with River Crest Hospital and Shannon Behavioral Health both in San Angelo and Abilene for those who need that level of care.

“Any call to our team that involves an individual with persistent suicidal ideation, a plan for suicide, or a suicide attempt will more than likely result in a successful referral to an inpatient program.” Hickey elaborated. “It is difficult to define what ‘successful’ means in this regard. Each individual is going to define what ‘success’ is in their recovery differently. For many, being able to wake-up, shower, and care for their activities of daily living is a huge stride when struggling with debilitating depression or anxiety. For others, success may mean becoming functional in the workplace again, attending school, maintaining social relationships, etc. If we are talking about success in terms of successful referrals, we always connect those 75 percent to 85 percent of individuals we are called-out to see, who are a danger to themselves by way of suicidal thoughts/attempts, to some kind of service to keep them safe. To fail to do so would be, by law, neglectful.”

Contributing Factors of Suicide

“It is okay to ask someone if they are suicidal or want to do harm to themselves.” McCoy stated, “Some people believe that, by asking, it somehow puts it in their mind, which is not the case. We always want to ask somebody, and we want to be very direct because, if they are, we want to get them the help they need.”

Hickey further stated that sparking a conversation with a friend or loved one can often put the person at ease and open the door to get them help. Many people feel there are no warning signs, but this is simply not true. There are signs, and though they can be subtle, spotting them can mean the difference between life and death, Hickey added.

McCoy said there are target indicators people can look for.

“One indicator of suicide is when someone has had a family member that has committed suicide. It is a red flag,” McCoy noted. “It makes someone more likely to commit suicide, which is one of the things we look for. Another indicator of suicide is the belief that that they are a burden to others and hopelessness. Those two are the ones where we really need them to get assistance.”

Other indicators include:

• Talking about suicide (Contrary to popular belief/myth, most people who attempt/die by suicide have spoken about attempting at least once before.)
• Seeking access to means
• Talking about death to the point of preoccupation
• Social and emotional withdrawal
• Giving away prized possessions
• Self-destructive behaviors
• Self-loathing/Self-hating statements
• Getting affairs in order
• Sudden sense of calm after a period of great emotional turmoil
• Psychiatric history/history of mental illness
• A history of suicide attempts
• Has a plan for suicide/access to means
• Depression symptoms
• Multiple environmental stressors
• Lack of family/social support
• Recent psychiatric hospitalization
• Family history of suicide
• Chronic physical illness/pain
• History of childhood trauma
• History of physical/sexual abuse
• Alcohol/substance abuse

There are a variety of reasons why people consider suicide and Mr. Hickey enlightened us on these reasons.

He said, “Some experience symptoms related to an underlying psychiatric illness, such as major depression, bipolar disorder, anxiety, or schizophrenia. Some may experience a variety of environmental stressors, which lead the person to feel overwhelmed, emotionally pained, and hopeless/helpless in their personal struggle. The good news is, most people in a state of suicidality are ‘suicide ambivalent’, meaning that at least a part of them wants to live; they just feel that they cannot overcome their burdens. We want to help the individual in crisis to seek out both something worth striving for and a means to overcome their situational stressors, while treating the underlying mental illness is applicable.”

Programs for Those in Need

There are many resources for help locally, including financial aid for treatment. WTCG is a non-profit organization that works to ensure that individuals and families seeking mental health treatment have access to counseling services, regardless of their socioeconomic status and ability to pay. They have a sliding scale based on income and, in some cases that qualify, can provide free counseling as well.

MHMR also has funding available to help people without insurance get inpatient services. The local crisis hotline can be reached at 325-653-5933 (1-800-375-8965). If anyone needs help for themselves or a loved one, this is a great place to begin.

“Those who work calls at the hotline have the ability to request welfare checks via SAPD and the local Sheriff’s office," Hickey explained. "If you are concerned for yourself or a loved one, welfare checks can be requested via the non-emergency line with SAPD if the person is located within city limits. Outside the city limits, the Tom Green County Sheriff’s Office can be contacted for the same.”

McCoy informed, “We are putting a program together called LOSS, which stands for Local Outreach for Suicide Survivors. Basically, we are going to have support groups, offer individual therapy, but have somebody who is a survivor, someone who has been there, reach out to the families. When someone has experienced the loss of someone by suicide, typically it takes four years for someone to get into counseling and services. With the LOSS program, the research shows that decreases to 30-45 days. The whole idea is “Postvention” and the postvention is basically prevention because they are dealing with such a significant loss.”

It is not wrong to seek help, no judges or shames those who seek help. There are many resources available, and there is a network of caring organizations who have recognized and addressed this problem. They can help anyone who needs help.

Other Sites and Resources

For individuals who have more questions about this topic, here are some additional resources to look into.

1-800-273-TALK (8255) National Suicide Prevention Lifeline

www.texassuicideprevention.org

www.dshs.state.tx.us/mhsa/suicide/Suicide-Prevention.aspx

Center for Disease Control and Prevention www.cdc.gov/violenceprevention

National Institute for Mental Health www.nimh.nih.gov

Substance Abuse and Mental Health Services Admin www.samhsa.gov

Suicide Prevention Resource Center www.sprc.org

Also, if you would like to become an Advocate for American Foundation for Suicide Prevention in Texas, please contact Nicole Gibson, AFSP Senior Manager of State Advocacy at [email protected].