Monday, March 27, 2006 | 7:21 a.m.
The toll free number for the state suicide intervention hotline is (877) 885-HOPE.
Nevada has had a high suicide rate for as long as the state has kept statistics on such matters.
As far back as 1929, the first year Nevada registered vital statistics with the federal government, the suicide rate here was more than twice the national average.
While the state has changed dramatically since then, the propensity for Nevadans to kill themselves has remained alarmingly consistent.
Newly compiled data by state Suicide Prevention Coordinator Misty V. Allen shows that 480 people took their lives in 2004, up 9.7 percent from the previous year. That's more than the 398 individuals who died in traffic accidents in Nevada that year.
From 1990 to 2000 Nevada led the nation in the number of suicides per capita. In 2004 the rate dropped slightly, to 18.5 suicides for each 100,000 population.
The national average in 2003, the last year for which comparison figures are available, was 10 suicides per 100,000 people. That year Nevada's rate was 19 per 100,000, which placed the state fourth nationwide.
Some reasons cited by experts as factors behind Nevada's high suicide rates, such as the high rate of gun ownership in the state, have remained fairly consistent throughout Nevada's history. Other factors, including an increase in suicides by children, reflect more recent national trends.
"Nobody knows definitively why as a general population, this number is consistently high here," said Dr. Ole Thienhaus of the University of Nevada School of Medicine. "We can look at individual cases and put together studies but the (cause) is hard to say."
Thienhaus, who chairs the school's department of psychiatry, said there seems to be a correlation between an accumulation of risk factors and suicide.
"Suicide victims seem to have a much higher rate of alcohol and substance abuse," Thienhaus said. "The vast majority of victims also have a mental illness that should have served as a warning."
There is a direct link between the state's mental health crisis and its high suicide rate, Thienhaus said.
Most of the people in hospital emergency rooms awaiting admission to the state's mental hospital "have specifically found to be a danger to self or others as a result of mental illness," said Carlos Brandenburg, director of the state Division of Mental Health and Developmental Disabilities.
Once they are admitted, they are stabilized on drugs and receive counseling, Brandenburg said. And the state provides after-care once those patients are released.
Dr. John Fildes, trauma director at University Medical Center, said that often people who have attempted suicide are happy they survived and are eager to get treatment.
Brandenburg said a recent survey showed the state is "serving less than half of the folks mentally ill in Clark County."
That points to a need for improved after-care and case management, Thienhaus said.
"Long term care doesn't just mean hospitalization," Thienhaus said. "It must also include supervised housing, sheltered workshops, access to outpatient care, all of the things necessary to avoid a recurrence of the factors that precipitated the initial suicide attempt."
While there is considerable information about suicide available, it does not always paint a clear picture.
Dr. Matt Wray of UNLV recently completed an extensive study on suicide trends and prevention in the state. His conclusions suggest there is more to the data than meets the eye.
It is a common assumption, for example, that gambling is a major factor in Nevada's high suicide rate. But other so-called frontier states that do not have legalized gaming also rank high on the list.
In addition, New Jersey, which also allows gaming, consistently ranks near the bottom of the list.
The fact that so many frontier states top the list suggests there may be something about living there that contributes to suicide attempts.
"Sometimes these figures can be a little misleading," Wray said. "Some of these areas are so sparsely populated that a few suicides can create an extremely high rate."
Experts say when analyzing data it is also important to go inside the numbers.
For example, statistics indicate that more men than women commit suicide, but women are much more likely to attempt it. Ignoring warning signs because a person is not in a "high-risk" group can be a fatal mistake, they say.
"One of the biggest causes of suicide is unrecognized and untreated depression," Fildes said. "People around these victims need to recognize what the warning signs are and look out for them."
Fildes said that while identifying at-risk groups is essential to understanding why a person might attempt suicide, it is more important to focus on prevention.
"We should do a mental health screen as part of a physical," he said.
By including the test in routine medical treatment, Wray said, it would help to de-stigmatize the illness, much as occurred with HIV testing, which encountered strong resistance initially but is now widely accepted.
Experts say recent efforts by Nevada legislators to address the issue are a step in the right direction. In 2001-2002 a legislative committee study resulted in the Legislature creating a suicide prevention program in 2003. The Legislature set aside $315,000 expected to come from federal funds, but that money never developed.
Last year the Legislature, at the recommendation of Gov. Kenny Guinn, approved $334,119 in state money for the program.
Allen was appointed statewide suicide prevention coordinator, and local advocate Linda Flatt was chosen as trainer and networking facilitator for Clark County. A statewide suicide prevention hotline also operates 24 hours a day, year round.
Flatt said the prevention program being developed initially will focus on youth suicide because that is a growing concern and because the group was awarded grant money last October from the Garrett Lee Smith Memorial Act to address the issue.
The act is named for the son of Sen. Gordon Smith, R-Ore., who committed suicide in 2003.
The money will be used to develop training programs for youths and adults who interact with them, as well as to raise public awareness on the issue.
Officials say the grant programs and private funding will be critical if the state is to change one of its least flattering historical trends.
"Because of the biennial legislature, even if the state continues to support the program, approximately 800 Nevadans will take their lives between sessions," Wray said.
"That's why it's crucial for everyone in the state to recognize this problem and become involved."
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