Suicide rates rose in Utah and every other state but Nevada between 1999 and 2016, with big increases seen across age, gender, race and ethnicity, according to a report released Thursday by the Centers for Disease Control and Prevention.
In North Dakota, the rate jumped more than 57 percent. In the most recent period studied (2014-2016), the rate was highest in Montana at 29.2 per 100,000 residents, compared with the national average of 13.4 per 100,000.
Utah had the fifth-highest overall suicide rate at 25.2 per 100,000, and since 1999, the state saw a 46.5 percent increase in residents taking their own lives. It is a crisis that has led Gov. Gary Herbert to create a youth suicide task force and state lawmakers to fund a new staffer to study why Utahns have died by suicide.
Only Nevada saw a decline — of 1 percent — for the overall period, though its rate remained higher than the national average.
Increasingly, suicide is being seen not just as a mental health problem but a public health one. Nearly 45,000 suicides occurred in the United States in 2016 — more than twice the number of homicides — making it the 10th leading cause of death. Among people ages 15 to 34, suicide is the second leading cause of death.
Overall, the most common method used was firearms.
“The data are disturbing,” said Anne Schuchat, CDC principal deputy director. “The widespread nature of the increase, in every state but one, really suggests that this is a national problem hitting most communities.”
It is hitting many places especially hard. In half of the states, suicide among people 10 years and older increased more than 30 percent.
“At what point is it a crisis?” asked Nadine Kaslow, a past president of the American Psychological Association. “Suicide is a public health crisis when you look at the numbers, and they keep going up. It’s up everywhere. And we know that the rates are actually higher than what’s reported. But homicides still get more attention.”
In Utah, Michael Staley joined the state’s medical examiner’s office last year. His task is to study those who die by suicide, searching for answers as to why, with the hopes of better understanding the state’s rising rates.
“It is sort of a question that is the bane of my existence in a way — why Utah?” Staley said of the state’s high suicide rate. “To be completely honest, we don’t have very many answers.”
What Staley does know is that for the suicide rates to go down in Utah and other states, far more people have to be informed about the warning signs and be willing to talk to someone who may be suicidal.
“While it is nobody’s fault, it is everybody’s problem,” he said. “We all have a role to play in stopping suicide.”
Warning signs, listed by the Utah Suicide Prevention Coalition, include threats, verbal or written, to hurt themselves, increased substance abuse, feelings of being trapped or hopeless, withdrawing from loved ones, unusual recklessness and dramatic mood changes.
“People need to know it is OK to ask ‘Are you contemplating hurting yourself? Are you going to kill yourself?’” Staley said. “It is not just OK to ask, we should ask. Absolutely.”
High suicide numbers in the United States are not a new phenomenon. In 1999, then U.S. Surgeon General David Satcher issued a report on the state of mental health in America and called suicide “a significant public health problem.” The latest data at that time showed about 30,000 suicides a year.
Kaslow is particularly concerned about what’s emerged with suicide among women.
“Historically, men had higher death rates than women,” she noted. “That’s equalizing not because men are [taking their lives] less, but women are doing it more. That is very, very troublesome.”
Among the stark numbers in the CDC report was the one signaling a high number of suicides among people without a known mental health condition. In the 27 states that use the National Violent Death Reporting System, 54 percent of suicides were by individuals without a known mental illness.
But Joshua Gordon, director of the National Institute of Mental Health, said that statistic must be viewed in context.
“When you do a psychological autopsy and go and look carefully at medical records and talk to family members of the victims,” he said, “90 percent will have evidence of a mental health condition.” That indicates a large portion weren’t diagnosed, “which suggests to me that they’re not getting the help they need,” he said.
Cultural attitudes may play a part. Those without a known mental health condition, according to the report, were more likely to be male and belong to a racial or ethnic minority.
“The data supports what we know about that notion,” Gordon said. “Men and Hispanics especially are less likely to seek help.”
The problems most frequently associated with suicide, according to the study, are strained relationships; life stressors, often involving work or finances; and recent or impending crises. The most important takeaway, mental health professionals say, is that suicide is not only an issue for the mentally ill but for anyone struggling with serious lifestyle issues.
“This gets back to what do we need to be teaching people — how to manage breakups, job stresses,” said Christine Moutier, medical director of the American Foundation for Suicide Prevention. “What are we doing as a nation to help people to manage these things? Because anybody can experience those stresses. Anybody.”
The rates of suicide for all states and the District of Columbia were calculated using data from the National Vital Statistics System. Information about contributing circumstances for those who died by suicide was obtained via the National Violent Death Reporting System, which is relatively new and in place in only 27 states.
“If you think of [suicide] as other leading causes of death, like AIDS and cancer, with the public health approach mortality rates decline,” Moutier said. “We know that same approach can work with suicide.”
Tribune editor Matt Canham contributed to this article.