Anthony Bourdain, Kate Spade and Suicide Awareness in the US

Rapidly rising suicide rates are the health crisis too few are talking about.

Posted Jun 08, 2018

What do the suicides this week—of fashion icon Kate Spade and the "original rock star of the culinary world" and master of media Anthony Bourdain—tell us? The untimely deaths of famous, very well off, professionally successful people signal the importance of raising awareness around a significant public health problem in the U.S. It was announced yesterday that suicide rates increased by 25% across the United States between 1999 and 2016 (US CDC, 2018). Forty-nine states saw increases in suicides, and 25 saw a stunning rise of more than 30%. On June 7, the CDC’s principal deputy director Dr. Anne Schuchat stated, “Suicide is one of the top 10 causes of death in the US right now.” In 2016, approximately 45,000 lives were lost to suicide. The lead author of a new study, Deborah Stone, said, "We typically see that firearms make up about half of all suicides, and that tends to be pretty consistent." Professor and Dean Galea of Boston University agrees, saying, "A lot of suicide is a one-time effort, so having guns available… makes one more likely to complete suicide, but that in and of itself is not an explanation for why suicide is going up.”

The National Violent Death Reporting System showed that 54% of those who committed suicide in 2015 did not have a known mental health condition. Furthermore, the CDC tells us the nationwide "increase in suicide rates cannot be linked to a particular mental health diagnosis" (Carey, 2018). So, what factors are associated with the rising rates? Drilling down on the data, the researchers found that circumstances such as loss of a relationship, or relationship problems that did not get resolved, were associated with suicide. What else?

Professor K. Bryant Smalley at the Mercer University School of Medicine described the mental health care challenges experienced by patients in rural areas as the "three A's": availability, accessibility and acceptability of care. Smalley pointed out that about 85% of federally designated mental health professional shortage areas are rural. "Due to higher poverty rates, higher likelihood of hourly pay and productivity-based labor, and lack of transportation infrastructure, mental health services are often not accessible even if they are available in a rural community — that is, even though it is there, many people either cannot get to it or cannot afford (either directly or indirectly) to go," he said. If you haven’t lived in a small town, then you might not understand why folks are reluctant to show up at helping professionals’ offices. "Rural residents face lower levels of anonymity in seeking services due to the close-knit nature of rural communities," Smalley continued. The possibility of "someone seeing your car parked at the only psychologist's office" means rural residents are less likely to seek care when needed. This is why tele-health mental health services by phone can be so important in outlying areas, and in Western states where population density is lowest, and suicide rates are rising most rapidly. This is all from the bird's eye view. What does this all look like at the local, personal level?

A year ago I wrote a blog post after musician Chris Cornell’s suicide. It spoke to the two voices of Cornell, and how his loss profoundly impacted his fans, including me. My major point was that we don’t know the depth of peoples’ suffering, the silent struggles they endure daily. And because of this, we don’t ask people who may be silently suffering the tough questions, and don’t wait to hear their real answers. By the way, there is a prevalent myth that asking people whether they have considered harming themselves or ending their lives will “give them ideas.”  It’s simply not true. So, ask away. It’s not going to push them over the edge. But you may find out just how long they have been walking along the precipice.

After that post was published, a usually quite chatty friend, who lives in a rural area, ghosted me. When she finally responded, she was furious. She said that the post sounded like it had been written by someone who didn’t understand suicide. This confused me at first. Then I remembered the major takeaway from my own post, and asked her the tough questions:

“Do you have intimate familiarity with despair?” “Yes.”

“Do you sometimes struggle with a sudden, fervent wish to die?” “Yes,” she replied. 

She was angry because I had preached from on high about the importance of asking difficult questions and waiting to really hear the answers, but hadn’t done that with her.

What You Can Do

• The National Suicide Prevention Lifeline is 1-800-273-8255. Call to speak with someone who will provide free and confidential support 24 hours a day, seven days a week. If you want to learn how to help someone in crisis, you can call the same number. 

• It takes money, and innovations in social and public policy, to effectively deal with a public health crisis. It's here. Calls to legislative representatives can stress that funding for mental health services should be increased at the state and national levels.

• Take these simple steps to help someone at risk: "Beginning a conversation, helping keep them safe, helping them connect and then follow up with them....We don't think every single suicide can be prevented, but many are preventable" (CDC).

• Does someone in your life seem withdrawn, out of sorts, or with changing eating habits? Or, paradoxically, has someone gone from low energy, down, or depressed to suddenly full of life and energy? If your reaction to the latter scenario would be simply one of relief, think again. That friend, co-worker or family member may have just decided to end it all.

Ask the tough questions. Wait to hear the real answers. It may be the most important thing you do in a lifetime.

References

Carey, B. (June 8, 2018). Defying prevention efforts, suicide rates are climbing across the nation. Retrieved June 8, 2018 from https://www.nytimes.com/2018/06/07/health/suicide-rates-kate-spade.html

Scutti, S. (2018). US suicide rates increased more than 25% since 1999, CDC says. Retrieved June 7, 2018 from https://www.cnn.com/2018/06/07/health/suicide-report-cdc/index.html