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The original item was published from 1/17/2017 11:39:51 AM to 1/26/2017 12:00:05 AM.

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Butte-Silver Bow

Posted on: January 17, 2017

[ARCHIVED] The Public's Health column: Action team focuses on healthy community to lower suicide rate

The work in Butte-Silver Bow to prevent suicide continues, though the effort can be fatiguing and demoralizing. Despite tremendous community toil and collaboration, suicide continues. Seven adult males in Butte-Silver Bow have died since Oct. 5 — one in October, four in December (two on Christmas day), and two thus far in January.

Suicide is not an issue unique to Butte. Since 2000, the rate of suicide has increased by 28 percent in the United States at a cost to the country of $44 billion annually (an amount calculated by combined lifetime medical and work loss).

Alarmingly, in 2016, Montana ranked No. 1 in the country for suicide rate, almost double the U.S. rate (Montana is at 23.80 suicides per 100,000 in population, compared to the U.S. rate of 12.93).

Very alarming is the fact that Butte-Silver Bow has one of the highest suicide rates in Montana — a county with a horrifying suicide problem in a state with a horrifying suicide problem. The 2016 Montana Suicide Mortality Review Team Report features a chart with age-adjusted suicide rates in Montana per 100,000 in population from 1995 through 2014. Montana’s rate during that time was 16.4, compared to a Butte-Silver Bow rate of 20.6.

The Butte-Silver Bow Suicide Prevention Committee, formed three years ago, has evolved into what we’re now calling the Community Action Team. The mission of this coalition is to build a healthy community, with a vision focused on collaboration. Core values include using evidence-based approaches to prevent suicide, and to be “pioneering.” Indeed, several entities throughout the state have looked to Butte-Silver Bow on how we have worked on suicide prevention.

And yet, here we are. Seven men dead by suicide since early October.

Our committee began in early 2014 when kids in Butte-Silver Bow started dying by suicide. The state’s suicide prevention coordinator, Karl Rosston, told us back then that we were no different from any other community, prompted into action by fear. Rosston also cautioned us. Montana, he said, has had a high suicide rate for decades — don’t expect that to change overnight/

In a recent email to a newspaper editor, I explained the lessons our committee has taken in over the past three years. “What we have learned,” I said, “is that the vast majority of all suicides are linked to mental illness, most often depression and anxiety. The good news is that depression and anxiety are highly treatable. We need to continue to work very hard on the stigma surrounding the seeking of mental health treatment. In these parts, stigma is huge. Oftentimes, there are other contributing factors, such as alcohol or drug abuse. Research is always ongoing – studies are under way nationally to see if there is a correlation even to altitude. Isolation seems to be a thread, that those who are dying don’t seem to see an alternative. Impulse is often in play.”

We’ve learned that depression is highly treatable, with the combination of drugs and therapy being the best approach. The very good news is that the Affordable Care Act has allowed people to obtain health insurance — the most recent insurance enrollment survey conducted annually by the Montana Commissioner of Securities and Insurance found that 92.6 percent of Montanans had health coverage as of May 2016, an uninsured rate of 7.4 percent. That’s down from an uninsured rate of 20 percent in 2013. This means that most people with depression, anxiety and other mental illnesses have access to care. (In a recent discussion with U.S. Sen. Jon Tester, D-Mont., several Butte healthcare professionals relayed what they believe will happen with the repeal of the ACA — among other travesties, more people will die by suicide.)

In the midst of uncertainty at the federal policy level, work at the local level continues. The Community Action Team, comprised of more than 60 individuals, believes that if Butte becomes a healthier community, our suicide rate will decline. We are now at work on piloting a web-based system that we believe will smooth referrals between professionals and agencies, including referrals between school-based and community-based systems. We are also working on consistently getting kids to school, with knowledge that kids who graduate high school have a shot in life.

And we’re working on trauma, especially trauma sustained in early childhood — trauma such as being abused or watching your parent be abused. We’re learning what trauma means to children as they grow into adulthood, and what those traumas mean to a community. We’re trying to learn why some children can face trauma and be resilient, and other children can’t.

Which may lead us to enhanced knowledge about why some adults can face trauma with resilience, while others can’t.

On behalf of the Community Action Team, I dedicate the team’s work occurring in 2017 to the seven Butte men who’ve died by suicide since early October.

We’ll be thinking about all of you every step of the way.

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