Difficult economic times often take a toll on mental health, and Minnesotans Thursday had the chance to learn more about their status during National Depression Screening Day.
Research shows that recessions are often closely accompanied with an increase in suicide rates. The organizers see the free event as a way to draw more attention to mental health problems, especially those brought on during a rough economy. So far, Minnesota has not seen its suicide rates rise since the beginning of the economic downturn.
Mental health advocates say that could indicate the state is doing a good job of reaching out to residents in crisis. But they also say suicide is a deeply complicated situation that's rarely explained by just one event.
The suicide rate in Minnesota has held steady at around 11 suicides per 100,000 people from 2007 through 2009. The rate for 2010 is not yet verified, but the Minnesota Department of Health said preliminary numbers show last year held around the same with around 11.3 suicides per 100,000 people.
Suicide numbers are not available for the first half of 2011, but the agency's suicide prevention and mental health coordinator Phyllis Brashler doubts there will be much change.
"Do I expect to see a huge spike in our suicide numbers? Not really," Brashler said.
MANY RISK FACTORS
Brashler is aware of the national research that shows that suicide rates often go up during recessions, particularly those that result in a sustained, high rate of joblessness. But the increases in suicides are typically small compared to the rise in unemployment, she said.
"There are many different risk factors and protective factors when we're talking about suicide. Not everyone who loses a job is going to choose to end their life," Brashler said. "It's about figuring out what that mix of potential contributing factors is and that's going to be different for every individual. But certainly unemployment can play a part in that."
“Not everyone who loses a job is going to choose to end their life ... But certainly unemployment can play a part in that.”Phyllis Brashler
Most cases of suicide are associated with an underlying vulnerability such as substance abuse, exposure to trauma or a history of mental illness or suicide in the family. Brashler said about 90 percent of suicide victims have a mental illness, such as depression. Typically, they've also dealt with a near-term crisis which can include a health emergency or the loss of a relationship, a home or a job.
Dr. Dan Reidenberg, executive director of the group Suicide Awareness Voices of Education or SAVE, said someone who commits suicide has lost hope. As the current economic situation continues, he worries that Minnesota may yet see an increase in suicide rate.
"The longer it continues for everyone, the greater concern I have that more and more people are going to get to that place of complete hopelessness," Reidenberg said. "Anybody who is struggling with depression and then they reach this place of hopelessness is at really significant risk of suicide."
REACHING OUT FOR HELP
Barb Erickson, a nurse who answers calls for Hennepin County's mobile crisis intervention team known as the Community Outreach for Psychiatric Emergencies, has noticed that more people are calling their crisis line, and a change in the mix of callers.
"I think that we are hearing from more middle class people that wouldn't normally be needing our services and they're losing houses and losing jobs, and families are falling apart," Erickson said.
That doesn't mean that they're on the verge of suicide. Program supervisor Dan Lontkowski said in the past year, the percentage of calls related to suicide has remained fairly constant. Rather, he thinks the increase in overall calls may be a good sign that more people know that they can reach out for help.
"The taboo of talking about suicide is very gradually decreasing," Lontkowski said.
Christin Crabtree of Saint Paul wishes she had known what to do for her dad 14 years ago when he threatened to kill himself. Crabtree, now 31, had just recently accused her father of sexual abuse and he was facing a criminal court hearing on the matter. He was also battling alcoholism.
"His life was already really difficult and what happened with me, with the truth coming out, was just one more thing and he really felt ashamed," Crabtree said.
Crabtree made her father promise that he wouldn't commit suicide. But it wasn't enough. Two days later one of his work colleagues found him dead in his garage with his vehicle running.
Since his death, Crabtree has struggled with depression. But she said she has gone out of her way to get help.
"Suicide is not something that I personally consider an option for me at all," she said. "I feel like if I hadn't done the work that I needed to do then, maybe I would be more like my father and in that kind of state of crisis."
People sometimes avoid asking a depressed friend or family member if they're contemplating suicide for fear that they'll give them the idea. But mental health experts say research has shown that it is safe to ask that question. They say it shows empathy and recognition of that person's pain.
For a person who responds that they are suicidal, experts say it is crucial to get help for them immediately and to not leave them alone, even for a moment.