Good evening. I’m Susan Kohler, CEO of Missoula Aging Services, the Area Agency on Aging for Missoula and Ravalli counties. Tonight my commentary is about suicide, a tragedy that has touched many of us personally. Although some find this topic uncomfortable, I hope to raise awareness of the importance of taking action and finding solutions. I’ll also tell you about an important summit on suicide prevention being held here next week.
While Montanans pride ourselves in many areas, there is no pride in the fact that our state ties for the highest rate of suicide in the nation for all age groups, according to a 2011 National Vital Statistics Report. Statewide, Yellowstone County had the highest number of suicides at 509 between 1994 and 2013, followed by Missoula County at 394. Based on percentages, many rural counties top this list, with Deer Lodge and Park counties sharing number one and Custer County coming in second. Regardless of numbers or percentages, we all can better understand suicide and participate in its prevention.
Most people don’t know how many older adults are dying of suicide. Among those 65 and over in Montana for 2012 through 2013, the suicide rate was 73 per 100,000, compared with just over15 per 100,000 nationally. Those over age 85 were at the greatest risk of all age/gender/race groups. These sobering statistics are underscored by the fact that most of these people had contact with their primary care physician within a month or less of their suicide.
According to Karl Rosston, the state Suicide Prevention Coordinator, multiple factors contribute to Montana’s high rate, including social isolation, alcohol use, access to firearms and limited mental health and crisis stabilization services. The biggest factor is the stigma many have towards mental illness, specifically depression.
Among older Montanans who completed suicide, 85 percent were male. Other risk factors include the recent death of a loved one; uncontrollable pain or fear of a prolonged illness; perceived poor health; social isolation and loneliness; and major changes in social roles, like retirement. Unlike risk factors among the young, alcohol or substance abuse and acting on impulse are less important, while there is a higher prevalence of undetected depression.
Staff members at Missoula Aging Services experienced a situation which drives home these grim facts. An older driver for our Meals on Wheels program took a break from volunteering due to health care issues. One day he called sounding somewhat irrational, so we invited him to come into the office, where we assessed his needs and started the process of helping him with support services. After returning home, he carefully laid garbage bags on the floor and shot himself. Our staff was devastated; like most people, we did not realize how serious his situation was.
Physicians may detect some of the signs, but they can’t do this alone. While depression is very treatable, many older adults won’t discuss their feelings of depression due to the stigma they feel. Some even assure their physician they are fine. It takes family members and others to be observant. Pay attention if someone is acting out of character, talking about ways to kill oneself, expressing hopelessness or feeling no reason to live, or isolating from family and society. Yet not everyone exhibits these signs; some actually appear happier than they have been, others may want to give away things. Surviving family often say they had no idea a loved one was contemplating suicide.
What can you do to help prevent an older adult from completing suicide? If you sense that someone may be depressed, offer your support. Be respectful and acknowledge the person’s feelings but try to not express shock or talk the person out of his or her feelings, which can shut down communication. Encourage the person to seek treatment. If they resist, offer to research treatment options, make phone calls, review insurance benefit information or even go with the person to an appointment. While HIPPA prevents physicians from sharing medical information with you without the patient’s written permission, you can contact their physician explaining what you are observing and ask that they look into these symptoms.
Above all, educate yourself. I applaud our community for holding “Not Alone: A Missoula Suicide Prevention Summit” on September 9 at the University of Montana to address the state’s staggering statistics and explore solutions to address all age groups affected by suicide. If you’d like information or to attend, please contact Kristie Scheel at 258-3881 or see my commentary at mtpr.org, where I have listed the web site. http://www.co.missoula.mt.us/healthpromo/SuicidePrevention/index.htm
Help is available, including the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or 911 if you feel suicide is imminent. Let’s all work to get Montana off the top of this list, and most importantly, save lives.
This is Susan Kohler, CEO of Missoula Aging Services and as always thanks for listening.