Suicide crisis centers report increase in calls across Wisconsin. Is the economy to blame?
By Sara Jerving
Wisconsin Center for Investigative Journalism
On April 28, 2008, Raymond Eiden learned Janesville’s General Motors was eliminating the night shift he had worked for 27 years. That same day, he took his own life.
“After he heard the news about General Motors, he probably had an overwhelming flood of emotions and couldn’t think beyond that moment,” daughter Vickie Eiden said.
The elimination of the assembly plant’s night shift was followed by news the entire plant would close. Ultimately about 2,800 people lost their jobs.
Eiden was among 737 Wisconsin residents who took their lives in 2008, when suicides hit the highest level in at least 20 years.
Interviews with mental health experts and an analysis of Wisconsin suicide data by the Wisconsin Center for Investigative Journalism found:
- A total of 6,513 people took their lives in the 10 years from 1999 through 2008.
- The state’s suicide rate continues to rise, exceeds those of neighboring states and has remained higher than the national rate for about a decade.
- Suicide crisis centers in Wisconsin and across the nation report an increase in calls since the recession began.
- Stigma over discussing suicidal thoughts, lack of access to mental health care and insufficient funding are barriers to suicide prevention.
Experts say Wisconsin’s high suicide rate, relative to those of neighboring states, could be linked to a high rate of binge drinking, easy access to firearms and lack of available mental health care, especially in rural areas.
Suicide is the 10th leading cause of death in Wisconsin, behind influenza and pneumonia and surpassing deaths from breast and prostate cancer as well as motor vehicle accidents, according to state Department of Health Services data. Figures for 2009 aren’t yet available.
Increasing calls for help
Some suicide crisis center hotlines across the state have reported an increase in calls since the economy began to deteriorate. While it’s hard to pinpoint why these increases have occurred, officials speculate they could correlate with rising unemployment rates that contribute to losses of health insurance, financial security, a person’s daily routine and a community of colleagues workers rely on for companionship and support.
“We are very concerned about what the suicide rates for 2009 are going to look like,” said Shel Gross, director of public policy for Mental Health America of Wisconsin, a nonprofit outreach program. “Looking at some of the preliminary data, we think there will be increases in Wisconsin that will probably be more directly attributed to the economic situation — people losing jobs and homes and the effect that has on people.”
Wisconsin’s suicide rate has been higher than the national average since 1998 and has continued to rise, while the national rate has remained relatively consistent.
Wisconsin’s rate rose slightly in both 2007 and 2008 to just about 13 deaths per 100,000. Nationally, about 11 people per 100,000 take their lives each year, according to 2006 data, the most recent year available, with higher rates in the Western states. Wisconsin’s suicide rate is higher than that of all of its immediate neighbors — Minnesota, Iowa, Illinois and Michigan.
Suicide is the second leading cause of death among 15- to 24-year-olds in Wisconsin and the 10th leading cause for all ages. Men are more than three times as likely as women to kill themselves.
With a suicide rate two and a half times as high as the state average, Menominee County was hit harder than any other county over the past decade. Experts say the high rate is influenced by
“Each person has losses throughout their life, but some people are not equipped to deal with losses like others,” Derer said. “My son was one. He had lost his dad, his grandparents and at the end, he lost a major relationship with his fiancee. He just could not take one more loss.”
The loss of a job can cause feelings of humiliation and despair that in a person with underlying mental or emotional conditions, such as depression or bipolar disorder, can lead to suicide, according to the U.S. Substance Abuse & Mental Health Services Administration. And working-age men, such as Eiden, tend to be the most vulnerable to suicide during times of economic hardship, according to the federally funded Suicide Prevention Resource Center.
In Rock County, where the jobless rate was the state’s second-highest for much of the year, the Human Services Department in 2009 saw a nearly 20 percent increase in suicide crisis contacts such as phone calls and police interventions. Crisis intervention supervisor Brad Munger says the suicide rate for 2009 may be the worst Rock County has seen in more than a decade.
Racine County officials report a similar pattern. The unemployment rate in Racine doubled to 10.2 percent in February 2009 from what it had been five months earlier. One crisis line noticed a spike in suicide crisis calls in March and April of 2009, after layoffs and closings at Pioneer Products, Circuit City, Racine Residential Care Hoplite and elsewhere.
The crisis line at Milwaukee County’s Behavioral Health Division also experienced a 15 percent increase in calls from 2008 to 2009. Similarly, the Outagamie County Crisis Center, which includes the city of Appleton, saw an increase in suicide crisis calls during 2009. Appleton saw its unemployment rate more than double between October 2008 and March 2009, and it remains high at 10 percent.
“A lot of the calls we get are about finances and loss of jobs,” Outagamie crisis phone supervisor Lisa Anderson said. “Some of the suicide attempts have been due directly to loss of jobs and not being able to maintain a certain lifestyle.”
In 2009, the U.S. Substance Abuse & Mental Health Services Administration conducted a study in which it recorded the number of suicide crisis calls to the national hotline that were related to economic stress. In the first six months, it found 27 percent reported financial distress as one of the reasons callers were feeling suicidal.
Overall, calls over the past two years to the National Suicide Prevention Lifeline also are up, which project director John Draper attributes to the economy. The national hotline saw a 36 percent increase in calls from 2007 to 2008 and an estimated 14 percent increase in 2009 — a jump of about 220,000 calls from 2007 to 2009.
“We have an increase in calls every year, but we never have seen increases in volumes that have been as consistently large as the last two years, without any other clear explanation than the
economy,” Draper said. ”The routine and structure that having a job once provided has been removed, and a sense of purpose and way in which to organize the day is now a void. Coming to work is a way to be with people. You have not only lost the structure in your life, but a community of people that you have shared daily experiences with.”
An increase in calls to crisis centers does not necessarily mean that the suicide rate will rise; it could just mean more people are seeking help, American Association of Suicidology Executive Director Lanny Berman said.
In response to a national need for data on suicidal thoughts and behavior, questions on suicide were included on the 2008 National Survey on Drug Use and Health. It found in 2008, an estimated 8.3 million people had serious thoughts of suicide in the past year, and 1.1 million reported attempting suicide.
A variety of reasons beyond financial problems can trigger suicidal thoughts. In Wisconsin, about 15 percent of suicides are reported to be associated with recent legal problems, according to the Wisconsin Violent Death Reporting System. For example, on Jan. 29, a Reedsburg man took his own life the same day he was charged in Sauk County Circuit Court with possession of child pornography. Mental health experts say that an otherwise respected individual accused of something considered shameful, such as child sexual abuse or embezzlement, may have a heightened suicide risk.
Many don’t seek help
According to the American Foundation for Suicide Prevention, 90 percent of people who die by suicide have treatable mental illnesses such as depression or substance abuse disorder. These are often undiagnosed or untreated.
Vickie Eiden said her father may have suffered from bipolar disorder, but never sought treatment because he thought he could handle problems on his own. Years ago, Eiden would spend days in bed, getting up only to go to work. But in the days before his death, he seemed all right, said his wife, Carrie Eiden.
That’s why the suicide of the 60-year-old came as to a shock to family, friends and co-workers — some of whom recalled sharing jokes and laughs with him at his nephew’s birthday party the day before.
Eiden’s family began attending Survivors of Suicide (SOS) support group meetings in Madison two weeks after his death.
“It helped us to make some sense of a tragedy we never imagined would occur within our family; to understand a little more about something that seemed incomprehensible, and to find some comfort and peace through learning and sharing with a community of others who have also experienced the complex grief associated with suicide,” his daughter said. “Too many people are isolated, embarrassed and afraid; there is just too much stigma around suicide.”
David de Felice believes an important first step in suicide prevention is for people to recognize that most such deaths stem from treatable mental illnesses. De Felice is a Dane County supervisor who lost his wife to suicide in 2006.
“Mental illness is not a personal failing or a character flaw, it can be treated and people can recover from it,” de Felice said. “Until we realize that, we can throw as much money as we want at suicide prevention, and there is still going to be resistance.”
The passage of the federal Mental Health Parity and Addiction Equity Acts could have an important role in the prevention of suicide, said state Rep. Sandy Pasch, D-Whitefish Bay. The federal law, which took effect at the beginning of 2009, requires coverage of mental health and substance abuse disorders be equal to medical and surgical benefits offered by businesses of 51 or more employees. Under this law, employers aren’t obligated to provide coverage, but if they do, mental-health coverage must be on par with other medical benefits.
A bill for Wisconsin mental health and substance abuse parity sponsored by Pasch awaits consideration by the full Assembly. The measure could fill the gap for some 700,000 workers in Wisconsin who work at smaller businesses, but it would allow employers with fewer than 10 employees, or those who see a big increase in costs due to parity, to opt out of the requirement.
The state provided $20,000 for school-based suicide prevention activities for 2009 and 2010 and also gave Mental Health America of Wisconsin a grant of $95,000 to coordinate suicide prevention efforts throughout the state. Wisconsin created a suicide prevention strategy in 2002 that has been effective in galvanizing forces towards reducing suicide, but it still lacks funding for local efforts, said Cheryl Wittke, director of Safe Communities, an organization that works with agencies, businesses and neighborhoods to prevent serious injuries and death, including suicide.
Gross, with Mental Health America of Wisconsin, said an ideal approach to suicide prevention is a locally based safety net where community members are educated on suicidal behavior and have the capacity to respond to warning signs with health care, support groups and proper police response.
While tapping into the community has helped Eiden’s family cope with his suicide, there are times, like his daughter’s wedding last year, when his absence is especially difficult for his family.
“There will be hard times like that again in the future, like grandkids he won’t see,” Vickie Eiden said. “But he left us with a lot of good memories. For me, over 30 years of good memories.”
The nonprofit Wisconsin Center for Investigative Journalism (www.WisconsinWatch.org) collaborates with its partners — Wisconsin Public Television, Wisconsin Public Radio and the UW-Madison School of Journalism & Mass Communication — and other news media.
Suicide Prevention Tips
According to Helping Others Prevent and Educate about Suicide (HOPES), a nonprofit organization based in Madison, people considering suicide may:
• Talk about killing themselves and become fixated on death.
• Make statements of hopelessness and belittle their own worth.
• Suddenly become happier or calmer.
• Lose interest in hobbies.
• Start visiting or calling loved ones.
• Start putting affairs in order and making arrangements.
• Start giving things away.
More than 90 percent of those who kill themselves have treatable mental illnesses, such as depression or substance abuse.
Some signs of depression:
• Substance abuse.
• Irritability, increased crying, anxiety and panic attacks.
• Difficulty concentrating and remembering.
• Disrupted eating and sleeping patterns.
• Loss of interest in ordinary activities.
• A persistent sad mood.
What to do when you notice a warning sign:
Talk with the person about depression and suicide in a nonjudgmental way to prompt him or her to seek help.
Some questions to ask include: “Do you ever feel so badly that you think of suicide?” and “Do you have a plan?” and “Do you have access to what you would use?” These questions will help to gauge whether the danger is immediate, and if immediate help is needed. Always take action when you learn of suicide plans, including calling 911 or taking the person to the emergency room.
Don’t try to minimize the person’s problems, convince him or her that things will get better or that he or she has many reasons to live. This may only increase feelings of guilt and hopelessness. It’s better to let the person know that help is available, depression is treatable and suicidal feelings are temporary.
If you deem the danger not immediate, acknowledge the person’s suffering as legitimate and offer to help work through the pain. Help to find a doctor or a mental health care professional right away.
Where to seek help
If you are contemplating suicide or have lost a loved one to suicide, these state and national organizations offer services such as counseling and support, or can connect you with help:
National Suicide Prevention Lifeline (Call this number if you are in crisis)
Helping Others Prevent and Educate about Suicide (HOPES)
Mental Health America of Wisconsin
Milwaukee office: 414-276-3122 or toll-free 866-948-6483
Madison office: 608-250-4368
National Alliance on Mental Illness (NAMI)-Wisconsin