Last month, the Centers for Disease Control and Prevention came out with some troubling news: Average life expectancy has declined for the third consecutive year in the United States, in part due to a rise in suicides.
In 2017, 783 Minnesotans died by suicide. At 13.8 per 100,000 residents, Minnesota’s suicide rate is nearly on par with the national rate, 14 deaths per 100,000 residents, and the two numbers are rising in tandem.
That Minnesota’s suicide rate remains high is hardly a surprise: it’s been on a slow, steady rise for nearly two decades.
But the problem isn’t spread out evenly across the state: While suicide rates for men increased in the metro area, overall, suicide rates are significantly higher outside the Twin Cities metro, where it’s often harder for people to access mental health services.
A shortage of care
This is all familiar to Kelly Sather, an adult mental health supervisor for St. Louis County, who works in Virginia, Minnesota. In St. Louis County, which includes Duluth and a broad swath of rural northeastern Minnesota, the suicide rate in 2017 was 18.5 per 100,000 residents — higher than the state average.
It’s harder for people get access to the services they need when they live far away from a city that has them — especially these days, when there’s a critical shortage of beds for mental health patients and a serious lack of psychiatric providers, Sather said.
When it comes to beds, she fears a shortage of them will lead to earlier discharges, meaning people who are not ready to leave the hospital are forced to go to make room for others. If there isn’t room, she fears people who need help won’t be admitted in the first place.
The shortage of mental health workers is so severe that St. Louis County is considering recruitment outside the region. For people placed in community behavioral health hospital, it can be two to three months before there’s a community psychiatrist available to see them — and it might be by videochat, not even in person, Sather said.
Minnesota’s metrics are particularly bad for men, says Melissa Heinen, a suicide epidemiologist at the Minnesota Department of Health. The suicide mortality rate for women in Minnesota is about 5.4 per 100,000 — below the national rate of 6.1 per 100.000. The suicide mortality rate for men in Minnesota is on par with the national rate, at 22.4 per 100,000 residents (all rates in this story are age-adjusted).
“There’s a lot of interest in trying to understand … the life stressors, or circumstances, or social conditions related to suicide deaths,” Heinen said. “Financial instability, housing security, relationship problems, interactions with police and law enforcement — I think we need to be doing more to alleviate some of those life stressors, for our male populations specifically.”
Data show women are more likely to receive care for mental health crises or self-inflicted injuries, Heinen said, which suggests increasing behavioral services and access to care could help lower rates.
Making changes
Minnesota’s suicide rate hasn’t always been this high, and Heinen see that as evidence it can go back down. For now, she has a few prescriptions for that.
One is 24-hour access to quality care through hotlines that are fully integrated across Minnesota and span a continuum of care.
Another is to step up suicide care. There are 16 organizations in Minnesota currently using the CDC’s Zero Suicide model, which aims to stop people from falling through cracks in care.
A third is restricting access to the means by which people commit suicide. Minnesota is set apart from the country as a whole in how many of its suicide deaths involve guns: In Minnesota, four out of five firearm-related deaths are suicides, Heinen said.
“There’s a smaller percentage nationally that are suicides. In general, when we talk about firearm death prevention, we’re really talking about suicide prevention in Minnesota,” she said. “That’s a piece, if you look at our firearm suicide rates compared to nationally, that becomes obvious.”
In light of that, one solution is to limit access to lethal means during a time of crisis, Heinen said: to have a neighbor, friend or family member secure lethal means, such as guns, during a window of time while a person is having a mental health or substance abuse crisis.
“We know it’s preventable. That’s why I show up every day at work. We can do things to prevent these deaths; we just need to do more,” she said.
Out of the Darkness
In the three years since she lost her husband, Nick, to suicide, Tanya Downs has poured her energy into advocacy work. She’s taken training on suicide intervention and group facilitation, and plans to lead a group to help youth who have lost a friend or family member to suicide in the spring. This fall, she organized the second annual Out of the Darkness walk for suicide awareness and prevention in Duluth.
It took place at Leif Erikson Park, along Lake Superior, a place she chose because Nick was an avid outdoorsman and fisherman. More than hundred people signed up, and Downs was gratified to see that passersby who bumped into the walk that morning joined up.
Nick was 33 when he took his life in 2015. For Tanya, there were no warning signs.
“I didn’t see it. I was pregnant. We were picking out baby names like two days before everything happened. We were newly married, we were expecting our first child together, he had a son from his previous relationship … everything was going so well,” she said.
The past three years have been hard, but they’ve pushed her into advocacy. She wants people going through mental health crises to know that suicide is a permanent solution to a temporary problem, and she wants people like her, who have lost a friend or a family member to suicide, to know they’re not alone.
“It’s a topic nobody wants to talk about, but it’s something that we need to talk about because it’s affecting everybody,” she said.
For suicide prevention resources, text “MN” to 741741 to connect via text message with Crisis Text Line; call 1-800-273-8255 for the National Suicide Prevention Hotline or click here for local mobile crisis support.
