A new analysis of the latest federal health statistics says that Montana had the second highest rates of deaths from alcohol in 2017, and substantial growth in its suicide rate that year as well.
Released Tuesday, the “Pain in the Nation Update” from the non-profits Trust for America’s Health and Well Being Trust says that when it came to growth in the number of deaths from drugs, alcohol and suicide combined, Montana and New Jersey led the nation in 2017. Each state saw a greater than 15-percent increase in such deaths.
"And there’s no one cause," says Ben Miller, the chief strategy officer at Well Being Trust.
"It’s not that I can look at Montana and say, well, it’s just this one thing. But I think that when we look at the trends of the states, unfortunately, some states have put in more progressive policies that allow for us to address drug and alcohol and suicide a little more effectively. Other states are lagging behind."
The 15-percent increase in deaths to drugs, alcohol and suicide in Montana between 2016 and 2017 compares to a 6-percent increase nationwide. Five states saw their rates go down, including Wyoming, Utah and Oklahoma.
When it comes to deaths due to alcohol alone, just under half the states saw their rates go down or stay the same. Among those where rates went up, only Mississippi and Montana saw their alcohol death rates rise by more than 15 percent.
"I think when you compare Montana to other states, what you’ll probably find is that there’s usually issues around accessibility. How often is alcohol available? Education -- what do people know about excessive alcohol abuse and drinking? And then, there's always policy, such as taxation, and how much tax do we put on alcohol. And does that enable or support people to feel like they can buy more because it’s at a cheaper rate," Miller says.
When it comes to suicide, all but eight states saw their death rates go up between 2016 and 2017, the average increase was 4 percent. Montana was among five states with the biggest increase in suicide rates, all above 15 percent, nationwide had the highest overall suicide rate in 2017. The states with the lowest suicide rates that year were New York, New Jersey and the District of Columbia.
MILLER: We know that there is a direct relationship between accessibility to firearms and suicide. We know that most individuals that successfully complete suicide do so with a firearm. So sometimes issues of gun control, issues around gun violence, these are inevitable in discussions around self-harm and suicide.
ERIC WHITNEY: When you start using the phrase ‘gun control’ in Montana, lots of red flags go up, peoples’ political resistance just is immediately triggered. Are there means of preventing suicide deaths by gun that are short of just taking everybody’s firearms away?"
MILLER: Oh, absolutely, and I do not mean to imply that we want to take everyone's firearms away, that's not the intent here. It's just the ability to access it. So yes, there are common-sense, evidence-based policies to address suicide in much more effective ways than just recognizing that it's a problem. For example, we can go into primary care, we can begin to screen for suicide, we look in the emergency department, we can begin to talk about it in our communities in different ways and see what the risk factors are for individuals who potentially could be at risk of suicide. And one of those risk factors is accessibility to a firearm, one of those risk factors might be the fact that you have some type of underlying depression, other risk factors might be a family history or even knowing someone that's died by suicide. Those things are all factors that we can look at and address, and hopefully pursue, that don't necessarily take us all the way down to having gun control as the one answer.
If there’s good news for Montana in the Pain in the Nation Update report, it may be that as much of America is struggling with a huge spike in deaths due to synthetic opioids, Montana’s opioid overdose rate has dropped by more than half since 2009.
And Miller says there are solutions to Montana’s problems with deaths by suicide and alcohol beyond just finding strategies to decrease access to firearms and alcohol. They include increasing education for adolescents about drugs, alcohol and suicide. And, Miller says, kids need access to mental health professionals in the schools that they can talk to.
Montana has long struggled to recruit enough mental health clinicians to serve the state’s widely distributed population, but Miller says it’s not necessarily about the number of clinicians, it’s about where they are.
"Mental health clinicians historically have operated in mental health settings," Miller says. "So it could be a community mental health center, it could be a private practice. What we're saying and what I think the evidence shows is that when you take those clinicians and you actually move them into schools, and move them into primary care, move them into the emergency department, move them into our houses of worship, then you begin to more proactively address that community need upstream. So that it's not just constantly catching the folks that have accute crisis, but you're actually going into the community and are providing solutions much more up front than traditional."
Ben Miller is the chief strategy officer at Well Being Trust. The analysis of deaths from alcohol, drugs and suicide that organization released Tuesday with the Trust for America’s Health can be found here.