When Helen Pridgen needs a “little boost,” she revs up the older model blue Corvette resting in her garage, drives around the city and thinks about her son, Clay. Bearing the license plate 4UCLAY, the car helps her through tough times. She imagines him smiling — the good times, of which there were many.
“He had an adventurous spirit,” says Helen, “the type of person who knew how to seize the moment and encouraged others to live life with vigor. It was his dream to purchase an old ‘vette and rebuild it with his dad. Clay, however, never got the opportunity.”
A year or so after sharing his dream about the car with his mother, Clay took his own life — succumbing to his battle with major depression at the young age of 25 in 2000. “He was alone when he died. I wish there was someone who had walked in. I wish there was someone who had talked to him that day,” says Helen, who now serves as South Carolina area director of the American Foundation for Suicide Prevention (AFSP). “For the past 15 years, I’ve been asked the question ‘Why are you so involved? Why are you passionate about this issue?’ I do this in Clay’s memory, and I do it to support others who are at risk today. I do this because someone else’s loved one might be saved.”
Today, Helen’s story is one of many nationwide, chronicling the more than 41,000 suicides that now occur annually across the United States. Suicides are the 10th leading cause of death, accounting for nearly 12.6 deaths for every 100,000 people nationally. While the number of top 10 leading causes of death has decreased or held steady, suicide rates are increasing, according to a recent report released by the Centers for Disease Control.
The most recent data from The State Department of Health and Environmental Control shows that 698 residents of South Carolina committed suicide in 2013. The numbers have grown nearly every year since 2003, when 496 residents of South Carolina took their own lives.
“Somebody dies by suicide in South Carolina every 12 hours, and we’re ranked as number 27 in the country. That’s too many, and we need to do better,” says Helen. “There are twice as many South Carolinians who die yearly by suicides than by homicides, though people think it’s the other way around. So, it’s a huge problem for us. It’s vastly underfunded, and that’s one reason we’re where we are today.”
While all demographics are affected by suicides, white males made up the highest numbers, accounting for 488 of the 698 South Carolina suicides in 2013. Though suicides affect all ages, the highest suicide rates were among people 45 to 64 nationally (19.1 per 100,000) and in South Carolina (20.9 per 100,000). Suicide is the second leading cause of death in people aged 15 to 34, and the fourth leading cause of death for young people age 10 to 14.
Mental health is often an underlying cause of suicide, and approximately 90 percent of people who die of suicide have a diagnosable psychiatric disorder at the time of their death, according to the AFSP. “We have a mental health care crisis,” says Jill Harkavy-Friedman, vice president of research for the American Foundation for Suicide Prevention. “To reverse the trend of suicide increasing, we need to invest in research, education and support policies that help people with mental disorders get the help they need. We need to talk openly and honestly about this serious, but preventable, health issue.”
“Stigma kills”
The America Foundation for Suicide Prevention has a goal of reducing the suicide rate 20 percent by 2025. The keys include more funding for research, marketing and infrastructure. “Key factors that will facilitate suicide prevention efforts include research, education, access to mental health care and reduced access to lethal means,” Jill says. “Legislation plays a role in suicide prevention. On the federal level, financial support for barriers and nets on bridges would reduce access to lethal means.”
The National Violent Death Reporting System, which gathers information about individuals who have died by suicide, has now been funded in 32 states, and groups like AFSP continue to advocate for fully funding the system in all 50 states. “What’s needed is more resources and evidence-based treatment for mental illness and suicidal ideation and behavior,” Jill says. “Overarching federal mental health legislation initiatives have been proposed, although they have not yet been enacted.”
Helen adds, “We are at the same point with suicide that we were in the 1970s with cancer, when people didn’t want to say the ‘c’ word … well stigma kills. A lot of factors came together in the 1970s to highlight the need to fund research and better treatments for cancer. Cancer mortality rates have gone down, heart disease mortality has gone down, HIV/AIDS has gone down — suicide is going up. We need to better understand this huge health problem.”
On the state level, many states have begun to enact mandatory suicide prevention training for teachers and counselors, among other groups, and many states have begun to address access to lethal means. In South Carolina, steps have been taken to “re-market” suicide as a preventable chronic illness.
The state’s Department of Health and Environment Control took the lead role in 2003 to create a task force to develop the state’s first Suicide Prevention Plan. Aligned with the National Strategy to Prevent Suicide, the state plan called for increased awareness that suicide is a preventable public health issue. It also called for the development of support, including statewide coalition.
“The state plan allowed us to access federal grant money for training and getting the message out,” says Joy Jay, executive director for the Mental Health America of South Carolina who served on the state’s first suicide task force. “We made great strides in increased funding, education, survivor support and coalition participation following the release of the state plan. We trained teachers. We trained churches. It was around $100,000 for three years, and it really went a long way.”
In 2010, the plan was revised to call for continued promotion of suicide prevention as a public health issue requiring broad-based support from public and private groups, individuals and communities. With the number of suicides in South Carolina still increasing, suicide prevention groups are again urging leaders to revisit efforts to fund research and educate the public.
“We’re at a pivotal point, so there needs to be more marketing and more attention on suicide and mental health so that people can come to understand it, talk about it and ask for help when they need it … just as they do for cancer and other illnesses,” Helen says. “We need the funding both to let people know when they need help as well as for the help to be there.”
Sound research will help better understand the trends, including a recent spike in the number of veterans and elderly residents taking their own lives.
“Twenty percent of suicides are by veterans, particularly middle-aged veterans,” says Jill. “Rates for youth have remained stable recently. Three to four times as many men as women died by suicide, with white men accounting for 70 percent of all suicides. We would like to see a decline across age, gender and ethnic groups.”
“Reducing stigma about mental health and suicide is one strategy that may help people feel more comfortable expressing their feelings and seeking services, and states like South Carolina can take additional steps to decrease the risk of suicide among youth,” says Dr. Dorian Lamis, a licensed clinical psychologist and an assistant professor in the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine.
A Preventable Death
“Knowing the signs of suicide and what to do can save lives. Warning signs include changes in mood including depression, humiliation and irritability; changes in behavior including alcohol and substance use, social isolation, crying, withdrawal and aggression; changes in appetite, weight and sleep; as well as talk about suicide, wanting to disappear, feeling like a burden or intense pain,” Jill says. Additional signs can be found at http://www.afsp.org/preventing-suicide/suicide-warning-signs.
Suicide prevention groups also urge residents to take action:
• Seek help immediately. If you think a suicide threat by someone is real and urgent, get them to a local mental health clinic or hospital emergency room immediately.
• Do some research. After seeking treatment, visit advocacy online sites for tips on managing mental health issues. Some of these sites include: afsp.org, scdmh.org, name.org and mha-sc.org.
• Reach out to others. Survivor support groups are located in the Midlands and statewide. Locations are available at afsp.org.
• Become an advocate/supporter. This year’s Out of the Darkness community walk by the American Foundation for Suicide Prevention’s South Carolina chapter is scheduled for Oct. 17, and similar events are planned for Spartanburg, Hilton Head (Oct. 24) and other cities statewide. More information is available at afsp.org.
For teens, the signs can vary and include: changes in personality, changes in behavior, sleep disturbance, change in eating habits or fear of losing control.
“A warning sign does not necessarily mean that your child is considering or will attempt suicide, but these signs should not be ignored,” Dr. Lamis says. “Respond to your child immediately, thoughtfully and with loving concern. Don’t dismiss a threat as a cry for attention.”
Parents should talk to their teens about suicide, using a few strategies to make both parties feel more comfortable: “Talk in a calm, non-accusatory manner. Express loving concern. Convey how important he or she is to you, focus on your concern for your teen’s well-being and health. Reassure your adolescent that seeking services can change his or her outlook,” says Dr. Lamis, author of more than 100 peer-reviewed articles and book chapters and senior editor of the recently published book, Advancing the Science of Suicidal Behavior: Understanding and Intervention (2015).
For Helen, her son Clay is gone, but not forgotten. Each fall, she starts her blue Corvette, driving it to the annual Columbia Out of Darkness Walk to highlight suicide prevention and awareness. On Oct. 25, she’ll join hundreds more survivors and supporters at Riverfront Park in Columbia, one more rally, one more ride and perhaps one more life saved from suicide.
“I’m a fighter for this. I know we have to do better, and we can do better,” Helen says. “I see lives that are saved each day because someone saw the warning signs and knew what to do. It is preventable.”
