The unseen epidemic

How can the U.S. reduce suicide rates? The strategies are varied but it starts with greater public awareness o

In general, the news media has a tendency to pay little attention to suicides unless they are tied to a murder, a celebrity or qualify as unusual in some way. The traditional thinking is that the last thing a newspaper or broadcast outlet wants to do is advertise or glamorize the behavior and thereby inadvertently encourage more people to take their own lives.

The problem with this well-intentioned oversight is that it perpetuates a cultural stigma, an unspoken understanding that suicide is a taboo subject. But keeping silent is no way to address what is ultimately a public health issue — a point that advocates recently underscored as part of the recently concluded National Suicide Prevention Week.

The numbers can't be overlooked. In 2013, more than 41,000 people took their own lives in the United States, or an average of 113 per day, while nearly 500,000 Americans were medically treated for self-inflicted injuries. The Centers for Disease Control and Prevention estimate the cost of suicide at more than $51 billion per year but also caution that's a conservative figure based mostly on medical bills and lost wages and does not measure the enormous harm inflicted by suicide and suicide attempts on families and communities.

Although Maryland has one of the lowest suicide rates in the nation (9.08 deaths per 100,000 people, compared to the national average of 12.57), the cost is still substantial: Suicide is the 11th leading cause of death in the Free State, and even in a state with the 46th highest suicide rate, more people die each year from suicides than by homicide.

That last fact bears repeating. For all the concern about a rising number of homicides in Baltimore and elsewhere, more people will die from suicide than will be murdered. Gun violence is no different: Suicides by firearm outnumber gun-involved homicides by a 2-to-1 margin. As recent Johns Hopkins-led research noted, gun control laws can have a big impact on suicide rates. The suicide rate dropped by an estimated 15 percent in Connecticut after that state approved gun restrictions in 1995 while Missouri, which repealed a long standing gun control law in 2007, saw annual suicides rise by about 16 percent since then, the study found.

Traditional suicide prevention is aimed at providing mental health services to individuals who are expressing suicidal thoughts or actions. But experts say not every suicidal person can be so easily spotted, and the behavior is frequently impulsive. That's why, for instance, making it more difficult to purchase or possess a firearm is inevitably helpful in reducing suicide rates.

Still, there are many other strategies to lowering the suicide rate beyond putting away guns. The CDC recommends, for instance, that stronger ties to family, community and religion can be helpful. Learning more productive ways to resolve conflicts and providing easier access to alcohol and drug addiction services can lower the likelihood of suicides as well.

And, of course, people need to be aware of risk factors. A family history of suicide or child abuse, previous suicide attempts or a diagnosis of clinical depression or other mental disorder, a notable increase in local suicides, a physical illness or significant loss and an unwillingness to seek help or share thoughts with others are considered to be circumstances that put individuals at greater risk of suicide.

In Maryland, a variety of steps have already been taken in recent years to stem suicides, from the creation of a youth crisis hotline (800-422-0009) to the establishment of in-school programs that facilitate intervention. Signed into law by Gov. Larry Hogan earlier this year, Lauryn's Law (named after a Prince George's County 15-year-old who took her own life) requires school counselors to be educated on mental health issues such as depression, substance abuse and youth suicide every five years in order to be certified.

And while those actions have been helpful, government can't take care of this problem alone. Ultimately, there is a critical role for all of us to communicate to our friends, our family members and our co-workers, particularly those who might be suffering suicidal thoughts, that there's nothing wrong with seeking help and support. Sometimes, one small act — perhaps a brief conversation or a few words of encouragement — can make all the difference.

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