Stigma. What does it mean? Dictionary.com defines it as “a mark of disgrace or infamy; a stain or reproach, as on one’s reputation; a mental or physical mark that is characteristic of a defect or disease.” In reality, stigma can prevent us from reaching out for help when we are in an emotional crisis and most in need of support. It can force us to feel we must push through and to pull ourselves up by our bootstraps and get over it, even when we can’t. It can make us feel inadequate because only the weak talk about their feelings and seek help.
Stigma, and fear of retaliation and further isolation, is costing Idahoans their lives — over 300 lives too many each year — because of suicide. In 2014, the most recent data available, 320 Idahoans took their own lives, for a rate of 19.6 deaths per 100,000 people. The U.S. rate was 13.4 deaths per 100,000 people. Idaho’s suicide rates are 46 percent higher than the national average, and Idaho consistently ranks in the top 10 among states for suicide. Idaho had the ninth-highest suicide rate in 2014.
Suicide is the second-leading cause of death after accidents for Idahoans ages 15-34 and for males ages 10-14. Older white men in Idaho are more likely to die by suicide, particularly those older than 85, followed by men between the ages of 45-54. The means used to complete suicide are varied, but firearms account for 60.4 percent, followed by suffocation and poisoning, each at about 20 percent.
In 2015, 1 in 5 Idaho youths attending regular public and charter high schools reported seriously considering suicide. One in 10 reported making at least one attempt. This means that in an average Idaho high school classroom of 30 students, six are seriously considering taking their lives.
Particularly alarming is that for every suicide completed, it is estimated that there are 25 attempted suicides. This means that in 2014, while 320 people died by suicide, there were about 8,000 Idahoans who attempted suicide. Each week in Idaho about six people die by suicide and 150 are attempting to take their own lives.
Stigma can also mean suicide deaths and attempts are not reported so as to not put a “mark of disgrace” on a family. Stigma creates barriers to treatment for mental illness, and it appears to be worse in rural areas than in larger cities. Stigma leads to more suicides because people are embarrassed or discouraged by cultural norms to ask for help. It is time to change the conversation!
Even as I consider our challenges in Idaho, I also feel fortunate that we have many impassioned people and groups working to make a difference and change the conversation. Idaho lawmakers heard those conversations during the most recent legislative session and took action to direct and fund the Idaho Department of Health and Welfare’s Division of Public Health to create an Office of Suicide Prevention. This office will work with stakeholders to determine the best ways to implement the 10 goals of the Idaho Suicide Prevention Plan and focus on coordinated suicide prevention and intervention activities statewide.
The 10 goals are:
1. Public awareness
3. Gatekeeper education
4. Behavioral health professional readiness
5. Community involvement
6. Sccess to care
7. Survivor support
8. Suicide prevention hotline
This office will initially focus on supporting youth suicide prevention activities and the Idaho Suicide Prevention Hotline as well as public awareness. The office will pull together stakeholders working in the area of suicide prevention and intervention to continue conversations about how we can make a difference in Idaho and put those ideas into play.
As this work unfolds and we begin to have more robust conversations and coordinated suicide prevention and intervention activities across the state, we can each take part to change the conversation and eliminate stigma.
▪ Know. Know the warning signs of suicide.
▪ Ask. Ask directly whether someone is considering hurting themselves.
▪ Listen. Really, truly listen.
▪ Reach. Reach out to others in need of help and reach out when you need help.
▪ Call. Call the Idaho Suicide Prevention Hotline at 800-273-TALK (8255) if you or someone you know is in crisis.
▪ Pledge. Take the stigma-free pledge at nami.org/stigmafree to learn more about mental health issues, see the person and not the illness, and take action on mental health issues.
▪ Encourage. Help people get help.
▪ Talk. Start the conversation about suicide prevention.
Taking action on your own and collectively can save lives. Idaho is an amazing state in which to live and it is entirely possible to change our culture to ensure that everyone has a sense of belonging and hope. However, unless we change the conversation and openly talk about suicide and how best to address it, we will continue to see our children, our men and women, and our elders take their own lives. It is time, Idaho, to make a change.
Elke Shaw-Tulloch, master of health sciences, is the state health officer and Division of Public Health administrator with the Idaho Department of Health and Welfare. Find out more at healthandwelfare.idaho.gov.
If you or someone you know is in crisis, call 800-273-TALK (8255).
Warning signs of suicide
- Threatening to, talking or writing about suicide
- Previous suicide attempt
- Seeking methods to kill oneself
- Agitation, especially combined with sleeplessness
- Giving away prized possessions, making final arrangements, putting affairs in order
- Feeling hopeless or trapped
- Withdrawing from friends, family or society
- Changes in eating patterns
- Dramatic mood changes
- Increased alcohol or drug use
- Inability to sleep or sleeping all the time
- Recent loss of a friend or family member through death, suicide, or divorce
- Sudden dramatic decline or improvement in work/school work
- Themes of death or depression in conversation, writing, reading or art
- Neglect of personal appearance
- No longer interested in favorite activities or hobbies
- Chronic headaches, stomach aches, fatigue
- Taking unnecessary risks/recklessness
- Sudden, unexpected loss of freedom or fear of punishment/humiliation
Protective factors for suicide
When people and communities have the factors below, the risk for suicide drops significantly.
- Cultural and religious beliefs that discourage suicide and support self-preservation
- Skill in solving problems, resolving conflict and handling disputes non-violently
- Strong connections to family
- Strong connections to community support
- Effective professional care for mental, physical and substance abuse disorders
- Easy access to a number of different types of professional help
- Being supported to seek help
- Mental and medical health care relationships that are ongoing
- No access to highly lethal means of suicide
Risk factors for suicide
- Mental disorders
- Alcohol and other substance use disorders
- History of trauma or abuse
- Some major physical illnesses
- Previous suicide attempt
- Family history of suicide
- Job or financial loss
- Relationship or social loss
- Easy access to lethal means
- Local clusters of suicide that have a contagious influence
- Lack of social support
- Sense of isolation
- Stigma associated with seeking help
- Barriers to accessing mental health care and substance abuse treatment