Suicide in the mountains: The connection been addiction & mental illness
If you or someone you know is considering suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Calls are free and confidential.
Drug and alcohol resources:
• Find the nearest Alcoholics Anonymous meeting at http://www.aa-westerncolorado.org.
• Find the nearest Narcotics Anonymous meeting at http://www.na.org/meetingsearch.
• A list of Mind Springs Health locations across the Western Slope is available at http://www.mindspringshealth.org/treatment/locations.
• Mind Springs’ 24-hour crisis line is 1-888-207-4004.
• Find a licensed psychologist in your community for ongoing therapy.
• If it’s an emergency, call 911.
Alcohol and suicide
• Almost 1/4 of suicide victims in the United States are legally intoxicated at the time of death.
• Suicide is 120 times more prevalent among adult alcoholics than in the general population.
• People who commit suicide while intoxicated are much more likely than those who are sober to kill themselves by violent means, such as using a firearm, falling or hanging themselves.
Source: “Acute Alcohol Intoxication and Suicide: A Gender-Stratified Analysis of the National Violent Death Reporting System,” from the journal Injury Prevention.
Editor’s note: This is the third part in a four-part series looking at suicide, drug and alcohol addiction, and mental health resources in the mountains.
Licensed clinical psychologist Jill Squyres moved to Eagle from Texas two years ago. She thought that suicide rates and depression would be low in the beautiful mountains of western Colorado, but has quickly learned differently.
“It’s very much a party culture,” Squyres said. “A lot of people here live like they’re in their 20s. Not like there’s anything wrong with that, except drugs and alcohol tend to be a part of that.”
Kim Baillargeon, of Aspen, lost her 23-year-old son Raymond Vieira to suicide Feb. 26. She read her son’s death certificate to the 360 people at the Aspen Hope Center’s community forum at the Wheeler Opera House in March. Her voice cracked as she read details about the “decedent” — details about how he killed himself in Snowmass Village that evening and that alcohol intoxication also contributed to his death.
It was his “last official document,” she said.
“Raymond’s death by suicide has crushed me,” she said. “To realize my child was struggling with alcoholism was devastating. It happened so quickly and he tried to beat it.”
Alcohol and drugs contribute to as many as 25 percent of suicides in the United States, according to the Colorado Office of Suicide Prevention’s Mantherapy.org. Vieira’s blood alcohol level was more than .220 when he died, Baillargeon told the audience, adding that she has heard of as many as 20 Aspen High School alumni who either committed suicide or died from a drug overdose in the last year and a half. She said she wished community leaders would spend tax dollars on the things that improve quality of life rather than on pet projects.
“Substance-abuse issues among our young adults continue to escalate and suicides are becoming epidemic,” she said. “The beauty of the mountains, five-star hotels and number of special events pale compared to the dark cloud that hangs over us.”
MENTAL ILLNESS AND ADDICTION
The lifestyle in mountain resort communities often centers on the party. Many move here for that lifestyle with dreams of being a ski bum and living life as if it’s a permanent vacation. Many have moved here to get away from problems they faced elsewhere.
The hospitality industry in which so many people work also promotes that lifestyle, said Tim Harrington, founder of Sustainable Recovery, an alcohol and substance abuse recovery program based in Carbondale.
Harrington owned a restaurant in Aspen more than a decade ago, and the lifestyle helped him reach his rock bottom, he said.
“That industry is close-knit — very supportive around your usage,” he said.
Harrington left Aspen and moved back to California. At one point he was homeless, living out of his car. Alcohol had been his poison, but it was poisoning his entire life.
“Thirteen years ago in June I had my last drink,” he said. “About a year after that last drink, I started working at a recovery center.”
While Mind Springs Health, the region’s primary mental health provider, promotes treatment as the best option, in Harrington’s line of work it’s just the tip of the iceberg, he said.
“Treatment is an introduction into recovery; it’s getting somebody stabilized. A little bit of education and then you’re done, you can’t stay forever,” he said. “The very crucial work is yet to be done, which takes place in the community. The challenge is how do you sustain recovery once you’ve left treatment.”
Harrington bases his programs on research that shows the best chance for recovering is continuing an intervention for 12 months. That means continuing everything from therapy to medication management to participation in mutual aid groups like Alcoholics or Narcotics Anonymous, as well as ongoing psychotherapy.
Harrington has personally felt suicidal due to addiction and depression, and said he has lost several friends to suicide in the Roaring Fork Valley over the years. If the conversation doesn’t continue, he believes the suicides and addiction problems won’t ease up.
“What we’re discovering more and more is that there is definitely a relationship between the mental illness piece and the addiction piece,” Harrington said. “As high as 60 to 70 percent have both (addiction and mental illness).”
MORE RESEARCH, MORE DISCUSSION
Of the eight Summit County suicides in 2013, three were alcohol-related. Of the 11 Garfield County suicides in 2013, nine had drugs or alcohol involved.
In a U.S. Dept. of Health and Human Services’ Substance Abuse and Mental Health Services Administration white paper on the subject, “Substance Abuse and Suicide Prevention: Evidence and Implications,” it is noted that “alcohol and drug abuse are second only to depression and other mood disorders as the most frequent risk factors for suicide.”
The paper goes on to describe a concerning relationship between those top two risk factors.
“Depression may be associated with increased substance use and chronic substance abuse may be a factor in the development of depression or other mood disorders,” according to the research.
The relationship between the two and what health care providers, both physical and mental, can do about it has become a subject of even more research. The National Institutes of Health is currently looking at ways emergency room practitioners, who are responsible for risk-assessment and referral of suicidal people in their emergency rooms, can develop evidence-based standards for identifying suicidal patients. Currently, there are none. Emergency rooms see patients across the board, from those who have attempted suicide to those overdosing on drugs or alcohol.
The research is being done by the University of Massachusetts in Worcester through 2015 and is predicted to improve detection of suicidal ideation that would enhance quality of care and reduce suicides.
Identifying drug and alcohol addiction and suicidal ideations isn’t the sole responsibility of emergency room doctors and nurses, though. Suicide prevention coalitions throughout the region are trying to educate everyone about personal responsibilities in lessening the problem.
The Eagle County suicide prevention coalition Speak Up Reach Out is trying to address the problem through education within the schools and through local businesses, and like the Aspen Hope Center has done in the Roaring Fork Valley, through public discussion.
“The physical signs we tell people are changes in eating habits, if somebody seems sad all the time,” said Speak Up Reach Out Executive Director Erin Cochrane-Ivie. “If people all of a sudden are getting their affairs in order, finishing all their projects at work, or giving away any of their possessions. Abuse of alcohol and drugs is another one. The person who is sober might not make that decision but once you add that extra layer, it makes it really easy (to make a bad decision).”
Casey Wolfington, a clinical psychologist with practices in Summit and Eagle counties, said drug and alcohol use is a common coping skill for teenagers. She tries to encourage patients she works with to utilize other coping skills available in the mountains such as outdoor activities.
“New coping skills and strategies can include group activities, exercise, athletic programs, having a mentor, or something as simple as going for a walk and listening to music,” she said. “A journal is good for kids who like talking to their parents.”
Sustaining recovery is challenging to say the least in a resort environment where drug and alcohol use is the norm. The lifestyle is one of the factors that so many regional mental health experts attribute to the relatively high suicide rates in mountain resort communities — addiction creates short highs often followed by extended lows.
“There are a lot of different reasons why people engage in substance abuse,” Squyres said. “Someone has to be able to confront their reasons.”
People with so-called addictive personalities are those who have trouble with self-control and self-discipline, she said. They might have more trouble keeping things at a moderate level, but it’s not an excuse.
“If you’re someone who falls into things quickly, you need to know that and find ways to provide an external strategy,” she said. “If one drink clouds judgment and you can’t stop — if you’re that kind of person then you shouldn’t drink.”
But because making these decisions alone is often impossible for people who suffer from these kinds of problems, finding help and pursuing help become critical to their success.
Harrington believes more people will seek the help they need if the community never lets the public discussion fade away. The discussion, he said, has to keep both drugs and alcohol use and suicide prevention at the forefront. But rather than react, the community has to get in front of the problem. That’s the only way that discussion can create positive results, he said.
“There are so many common themes with a personal recovery and personal transformation,” he said. “If we do decide to talk about this regularly, it has to be about hopefulness, empowerment and forgiveness, and it has to be blame- and- shame-free.”
Lauren Glendenning is the editorial projects manager for Colorado Mountain News Media. She can be reached at firstname.lastname@example.org or 970-777-3125.
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