NYAPRS Note: The portrait below is a chapter in another installment of USA Today’s look at mental health and stigma in America. Their exploration of suicidality, the lack of adequate prevention services, and the stigma surrounding outreach to those experiencing suicidality can be found here: http://www.usatoday.com/longform/news/nation/2014/10/09/suicide-mental-health-prevention-research/15276353/
40,000 Suicides Annually, Yet America Simply Shrugs
USA Today; Gregg Zoroya, 11/9/2014
Standing high above the San Francisco Bay, perched on an I-beam outside the Golden Gate Bridge railing, the man dressed neatly in khakis and a button-down shirt hesitated.
Kevin Briggs stood a few feet away, imploring him not to jump. In nearly 20 years as a California Highway Patrol officer policing the famous span, Briggs had more success than failure in talking troubled souls back from the ledge.
He and two other officers persisted for nearly an hour on this day in 2007, and the man, perhaps 35 years old, seemed touched by their earnestness. He reached over three separate times to shake Briggs’ hand.
Then it was suddenly over. “He said, ‘Kevin, thank you very much,’ ” Briggs recalls quietly, “and he left.”
The man plummeted to his death in the waters below.
There’s a suicide in the USA every 13 minutes.
A short ride from the Golden Gate Bridge where about 1,600 of these deaths have occurred over the years, actor-comedian Robin Williams took his life at his Tiburon home in August.
Americans are far more likely to kill themselves than each other. Homicides have fallen by half since 1991, but the U.S. suicide rate keeps climbing. The nearly 40,000 American lives lost each year make suicide the nation’s 10th-leading cause of death, and the second-leading killer for those ages 15-34. Each suicide costs society about $1 million in medical and lost-work expenses and emotionally victimizes an average of 10 other people.
Yet a national effort to stem this raging river of self-destruction — 90% of which occurs among Americans suffering mental illness — is in disarray.
In a series of stories this year, USA TODAY explores the human cost of allowing 10 million Americans with mental illness to languish without care. On the dark edge of that spectrum is a consuming urge to die, and those committed to understanding suicide say there are potential solutions if there is a national will to seize on them.
The country seems almost complacent with this staggering death toll. America’s health care community remains mired in confusion over how to tackle suicide mostly because the public — and with it, the federal government — never gets serious about finding crucial answers.
Basic questions about whether suicide is a public health problem, whether it can be prevented on a broad scale, whether suicidal thoughts and actions are a disorder or a symptom of other disorders, remain widely debated.
Perhaps as a result of this scattered approach to what is clearly a health crisis, greater sums of money and research are devoted to curing diseases and social ills that kill far fewer Americans despite clear historical evidence that more investment translates into more lives saved.
“Is there the kind of concerted effort (for suicide) that’s been made with HIV, with breast cancer, with Alzheimer’s disease, with prostate cancer?” asks Christine Moutier, chief medical officer for the American Foundation for Suicide Prevention. “There’s never been that kind of concerted front.”
“When we invested in HIV/AIDS and breast cancer, we dramatically reduced the rates of death,” says Jill Harkavy-Friedman, vice president of research for the foundation. “If we invest in suicide prevention — really invest in it — then we have a good shot at bringing it down.”
The National Institutes of Health — the largest source of research money — spends a small fraction on suicide compared with diseases such as breast and prostate cancer that result in as many or fewer American lives lost. The suicide research budget for the National Institute of Mental Health (NIMH) has actually been shrinking since 2011.
The Centers for Disease Control and Prevention promotes several “winnable” priorities, among them motor vehicle injuries and HIV. Suicide, though more costly in lives than either of those categories, is not on the list.
Lawmakers’ agendas are heavily influenced by public disinterest and a persistent view in the USA that anyone bent on killing themselves cannot be saved. Briggs saw the worst of this during suicide crises on the bridge when drivers passing by would yell out, “Go ahead and jump.”
“If the public doesn’t think you can do anything about it, they won’t support it,” says Alex Crosby, a CDC epidemiologist who focuses on suicide prevention.
“Can you really stop somebody who wants to kill themselves? I still hear that,” says Jane Pearson, chair of the NIMH research consortium. “Changing that perspective is really critical.”
Only in one area did Americans react to suicide. When soldiers started killing themselves in record numbers during two arguably unpopular wars in Iraq and Afghanistan, a groundswell from the public and Congress drove the military to respond.
The Army suicide rate tripled from 2004 and 2012 as more than 2,000 GIs took their lives. A new RAND study says that since 2005, about $230 million was poured into suicide research, more than two-thirds of it from the military.
“All the military research is likely to benefit civilians as well,” says Michelle Cornette, executive director of the American Association of Suicidology.
A centerpiece effort is a $65 million study — the cost split between the Army and NIH — analyzing soldier suicides and tracking tens of thousands of troops over a period of years to understand self-destructive urges.
“The level of detail we are getting … nobody has ever done anything on that scale in any population relating to suicide risk,” says NIMH study scientist Michael Schoenbaum. “We have an enormous amount to learn.”
Briggs, who retired from the CHP last year, says answers are long overdue. Promoting crisis management and suicide prevention, he says the nation must find a way to treat despair before the only resort is a police officer begging someone not to jump.
“Get them before they’re up on the bridge,” Briggs says, “because when you’re up on that bridge, it’s almost game over.”