Dying in a beautiful place

Many mysteries surround suicide. It’s a subject that has been scarcely studied in academia or journalism, and largely ignored in philosophy and religion. The subject has traditionally been a taboo. It is not to be discussed in polite company, or in any company at all. Families are embarrassed, humiliated and ashamed when a relative commits suicide. Until fairly recently suicide was damned by major religions.

Newspaper stories and paid obituaries seldom mention how a suicide died. When I was a young reporter for a big city daily I was told never to mention that a death was due to suicide. When I was editor of a weekly newspaper in Maryland, the publisher told me the word suicide could not appear in his newspaper. St. Mary’s County, Md., where the newspaper was published, was overwhelmingly Roman Catholic, and suicide victims at the time were barred from sanctified cemeteries and services.

Yet despite the conspiracy of silence and ignorance, or more likely because of it, the number of suicides has been steadily increasing across America; and year after year, New Mexico has usually been among the five worst states.

The clearest picture of suicides, nationally and in New Mexico, emerges from new information available for the first time in recent days.

SUICIDES AND GUNS

Almost all of the common assumptions about guns and suicide are wrong. It is generally believed, for example, that most of those killed by guns are minorities, the poor, residents of big city slums, drug addicts, criminals, etc. They aren’t. It is generally believed that accidents or self-defense or crimes, account for most gun deaths. Wrong again.

Suicides account for more gun deaths than accidents and homicides combined. Two-thirds of all gun deaths are suicides.

And New Mexico is one of the worst states for suicides. In 2012, only in Wyoming, Alaska and Montana did a higher percentage of people kill themselves.

New figures are contained in a report released April 22 by the National Center for Health Statistics. The study is the most up-to-date and authoritative analysis of suicides across the United States.

It showed that one of the fastest-growing categories of those who kill themselves is middle-aged white men living in rural areas in the mountain states of the West—the most beautiful and placid parts of America. Only those over 85 years old kill themselves at a faster rate than do the middle-aged.

The suicide rate is now the highest it has been since 1986. Between 1999 and 2014, the suicide rate among women increased 63 percent and for men 43 percent. And in recent years the overall rate has been increasing twice as fast as it did in earlier years. Among middle-aged Americans, suicide had been declining since the 1950s but is now climbing. The rate is also increasing very rapidly among girls 10 to 14 years old. While suicides are increasing more rapidly among women, men are still in the majority. Meanwhile, the oldest Americans, 75 and over, were the only ones to commit fewer suicides.

LIVING SHORTER LIVES

The new report parallels other recent studies showing a decline in life expectancy among middle-aged white Americans, particularly women. Life expectancy among poor whites is also decreasing. The studies attributed the increasing death rates to drugs, alcohol and suicide.

“We don’t really know enough about what’s driving this rise,” said Mark Kaplan, professor of social welfare at the University of California, Los Angeles. “Past research in this field has focused on young people and very old people. But we know far less about what’s causing suicides among the middle age range: 25 to 64-year-olds. We’re only now starting to invest in trying to understand this phenomenon.”

Some evidence links the frequency of suicides to the state of the economy. The last time suicides were as frequent as now was in the early and mid-1980s in the aftermath of the Reagan recession, when unemployment topping out at 10.5 percent was the highest since the 1930s. This was the period when the hollowing out of American manufacturing plunged the industrial cities of the Rust Belt into a depression that, in many places, has continued to this day.

Overall, more than 42,000 Americans died from suicide in 2014, and more than 21,000 of them were due to guns, according to the NCHS report. Noting that many suicides are recorded as accidents in death reports, Kaplan said, “The picture is likely even worse than is being officially presented.”

The statistics for New Mexico are even worse, depending on the year; anywhere from 50 percent to 100 percent higher than the national rate.

According to the New Mexico Youth Risk and Resiliency Survey, among children and adolescents who kill themselves in the state, 58 percent use guns. In 2011, 17 percent of Santa Fe County’s youth between grades 9 and 12 seriously considered committing suicide and 10.2 percent actually made an attempt.

In March, the New Mexico Crisis and Access line handled 2,624 calls; 27 percent of them included concerns about suicide, according to state officials.

Residents of rural areas are those most in danger of shooting themselves to death. A combination of economic depression, geographical isolation and a high percentage of gun ownership combine to crate a perfect storm in much of the inland West, in areas like Torrance County. From 2010 to 2014, the age-adjusted suicide rate in the county was 22.4 per 100,000. The comparable statewide figure was lower, at 20.5. The national figure was only half as much as the state.

Suicide is the second leading cause of death among adolescents in the nation, in the state and in the county. These figures come from a website called NM-IBIS, which is published by the N.M. Health Department. “Easy access to lethal methods, such as firearms” is listed on the site as one of the principal causes of the high suicide rate.

Furthermore, New Mexico has passed few laws restricting gun ownership and declines to implement some federal recommendations at the state level. Thus, for example, people under temporary domestic violence restraining orders or those who have been committed involuntarily to mental institutions for short terms can legally buy guns.

These are the very types of emotionally unstable or potentially violent people who may be tempted to kill themselves—and perhaps others.

N.M. WORSE THAN U.S.

In the most recent mass shooting, just last week in Appling, Ga., 50-year-old Wayne Anthony Hawes killed himself with a bullet in the head after killing five people—all believed to have been related to him. “He’s been kind of a ticking time bomb,” his daughter said. Such atrocities have become so common that the national media largely ignored this one.

Closer to home, in September, a 32-year-old man and a 29-year-old woman made a suicide pact to kill themselves while hiking in the East Mountains off N.M. 337. He did shoot himself to death but she only wounded herself. Their reasons are unknown, but police thought they might be drug related.

Over the past 20 years New Mexico suicide rates have always been at least 50 percent higher than the national rate, and over that period both the state and national rates have been rising. Across all ages, suicide is the 10th-most common cause of death.

It seems ironic, but the highest rates of suicides are in the most storied and desirable, most placid and pleasant parts of America, the small towns and countryside of rural Western states like New Mexico, in areas like the Estancia Valley and East Mountains. Alaska and a belt of Western mountain states—Montana, Idaho, Wyoming, Nevada, Colorado, Utah and New Mexico—all have age-adjusted suicide rates at least 50 percent higher than the national rate.

It also seems ironic that those who give up on life are often not the classically oppressed—women, blacks, Hispanics. Seventy percent are instead the people for whom American society was made—white males. And the largest numbers of suicides aren’t the morose young overwhelmed by adolescent angst or the ailing elderly facing hopelessness and a painful death. They are, as in the Georgia case, the middle aged.

The great exception to this generalization is the native tribes of North America, especially the First Nations of northern Canada. An unprecedented wave of suicides has recently devastated some of the these communities. The numbers are so horrifying that the government in Ottawa declared it a national emergency.

Perhaps the most tragic case is that of Attawapiskat, a First Nations community of 2,000 in northern Ontario. Since last fall, there have been more than 100 suicide attempts. The youngest was 11 years old, the oldest 71. Eleven people tried to take their lives on a single Saturday evening. “We’re crying out for help,” said Attawapiskat Chief Bruce Shisheesh. “Just about every night there is a suicide attempt.” Throughout Canada’s Indian communities, suicide is the leading cause of death for those under 44 years old. Many blame the communities’ extreme poverty and isolation, and the cultural dysfunction linked to forced integration in white-run schools until a generation ago. But no one really knows.

SOME TRYING TO HELP

Reasons for America’s high and increasing suicide rates are mostly speculative. Among people of working age, suicide seems to increase during economic hard times. Among the young, bullying is a common linkage, and the upsurge in bullying on social media may be an important factor. Among the very old, the hopelessness of cancer and dementia seem at least contributory.

However, the one factor that tracks well with suicides is gun possession. Typically, the higher the rate of gun ownership the higher the rate of suicide. The highest suicide rates, in rural areas of the inland West, are the areas where gun ownership is most common. Guns don’t make people want to kill themselves, but they do make committing suicide awfully easy and convenient if a person has a mind to do it.

The rising tide of suicides is not due primarily to recent relaxation of prohibitions against doctor-assisted suicide. Most suicides use a gun. It is quick, certain, painless and convenient. It takes no effort, no planning, no complex logistics or equipment, no help from a doctor to prescribe medicine, no calculations to set up carbon monoxide asphyxiation or a hanging from the rafters. Unlike a car wreck or suicide by cop, it doesn’t imperil the innocent. Nor does it require a hard-to-find place like a skyscraper, deep water or a high bridge. A bullet is the ultimate do-it-yourself ending.

International comparisons are difficult because each country calculates suicide rates differently. The current issue of The Economist magazine takes a stab at it. The magazine concludes that suicide rates are higher than in the U.S. in Sweden, France, Germany and Belgium but lower in Holland and Britain.

New Mexico has been seeking ways to prevent suicides. One of the more promising current initiatives uses a federal grant to train general practitioners to recognize patients’ danger signs. Research has shown that most of those who commit suicide had seen a general physician in the previous six months but very few had seen a psychologist or psychiatrist. The initiative is only now getting under way, so it is too soon to know if it will have an impact.

Meanwhile, in Colorado, in the Gun Shop Project, a state-funded program, gun sellers and range operators in five western counties are asked to raise awareness of suicide.

At least some folks are trying to do something new.