State's suicide rate rising; tie to economy isn't clear

Minnesota's only statewide, 24-hour crisis hot line has seen a 20 percent jump so far this year in the number of first-time, middle-class callers plunged into despair by the slumping economy.

"We know anecdotally from the calls we're getting ... that the economic crisis is impacting people in ways that we haven't seen since the Depression," said Dr. Dan Reidenberg, executive director of the Bloomington-based Suicide Awareness Voices of Education (SAVE). "This is a tough time."

Although the increase in calls to suicide hot lines might strike some as predictable during a severe recession, those calls are coming during a more mysterious longer-term trend that has seen the number of suicides in the state rise steadily this entire decade, in good times and bad. Because it's widely accepted among experts that joblessness and suicide tend to rise in tandem (the highest suicide rates recorded nationwide coincided with the Great Depression), that has mental health professionals worried that the trend could gain further momentum.

After last peaking in 1986 at 13.8 deaths per 100,000 people, the state's suicide rate slowly decreased with some fluctuation for the rest of the 20th century. In 2000, the rate hit 8.9 -- the lowest on record from 1990 to 2008.

But in this decade, it has been climbing back up each year, hitting 11 deaths per 100,000 in 2008, a preliminary figure.

Numbers for the nation were available only up to 2006, when the national rate was 11.15 per 100,000 people. That year, the rate was 10.5 for Minnesota.

Experts aren't directly linking the poor economy to the growing suicide rate, because, they say, motives are usually far more complex than job loss, foreclosure or mounting bills. Coroners, state health officials and experts don't usually analyze suicide victims' life circumstances to determine what factors were at play.

Jon Roesler, an epidemiologist with the Minnesota Department of Health, said focusing on whether certain factors play a more prominent role misses the larger point -- for whatever reason, the state has been returning to the higher rates of suicide last seen more than 20 years ago.

"I don't have a very good explanation," he said. "The first thing people say is, 'Oh, it's the economy.' I'm not seeing a relationship. ... What's significant is the trend."

Calls for help

At the Crisis Connection hotline, there's no doubt that more and more callers are dealing with economic hardship.

"I don't know how many times I've heard, 'I've given to food shelves, I've never used one,'" said Jean, who has volunteered at the center for about six years. (The center requires that volunteers be identified only by their first names.)

Most of the center's callers aren't suicidal, although they may be in despair or mired in paralyzing loneliness, which can lead down a dangerous path. In an average year, the center receives about 45,000 calls from the general public, and about 20,000 calls through a second division that focuses on specific populations.

Call volume for the general line in the first quarter of 2009 was up about 20 percent, or 2,000 more calls on top of the average 10,000, said Linda Schmid, the center's director of clinical services.

"There's shame, reluctance to be put in that position," Jean said of many callers grappling with job loss, pay cuts, foreclosure and other economic strife.

Reidenberg's SAVE connects callers with resources to cope with suicidal thoughts. He said that over the past six months, the group's call volume has grown about 25 percent from the daily average of about 30 phone calls.

Search for answers

What could be the explanation for the rise in suicides?

Experts think part of the answer may lie in the reluctance of some people to take antidepressants. The drugs, which gained wide acceptance in the '90s, are credited with helping control what for some would be otherwise crippling depression. But after warning labels appeared in 2004 that cautioned of particular side effects among teens, some users abandoned the drugs.

In a 2007 article, researchers working under a National Institute of Mental Health grant wrote that the youth suicide rate in 2004 could possibly be linked to a drop in the use of antidepressants.

Another factor driving suicide rates higher is the growing number of vets who served in combat in Iraq and Afghanistan. Recently, the suicide rate among U.S. soldiers, some of whom were traumatized by their experiences, began exceeding that of their civilian counterparts of comparable age, said Dr. Paula Clayton, medical director of the American Foundation for Suicide Prevention in New York City.

Experts acknowledge that the current economic, job and housing slump are added stresses that could affect already vulnerable people.

"Anything that makes people more desperate or more hopeless is likely to lead to an increase in suicide risk," said Dr. Richard McKeon, lead public health adviser on suicide prevention for the Substance Abuse and Mental Health Services Administration in Maryland.

'How would it feel?'

Prevention efforts need to look at suicide as a continuous health risk throughout a person's life, such as cancer or heart disease, experts warn. This year, Crisis Connection began making follow-up calls to check on callers. The effect, said David Therkelsen, the center's executive director, is that many callers feel supported and accountable in seeking help for their problems.

On a recent morning, volunteers hunched over phones at Crisis Connection's unassuming suburban office. Black-and-white posters hung on walls listing dozens of phone numbers for psychiatric, sexual assault and financial assistance programs, among others.

One recent caller was a single man who'd lost his job, fallen behind on his utility bills and couldn't go live with his grown son because he'd been laid off, too. The caller had been "solidly middle-class," said Schmid. He asked Crisis Connection how different methods of suicide would feel.

"I anticipate our call volume will stay high," Schmid said.

Chao Xiong • 612-673-4391