Marshall Allen and Alex Richards

Sun, Aug 5, 2007 (1:13 a.m.)

The suicide rate among elderly Nevadans is nearly three times the national average, according to a Sun analysis of government mortality figures - a statistic that raises more speculation and questions than answers.

Nevada has long been known to have the highest suicide rate in the country, about twice the national average. Most striking within that data, the Sun found, was that the state also ranks first in the nation by an even larger margin in the number of elder suicides, based on data provided by the Centers for Disease Control and Prevention.

The possible reasons, experts speculate: Nevada's elderly are more lonely and more addicted to gambling than their peers in other states, and have fewer resources to help them cope.

The Centers for Disease Control registers every American death since the 1950s, providing such details as location, cause of death and general demographic information about the deceased.

From 1999 to 2004, the suicide rate among people older than 75 in Nevada was 48 per 100,000, compared with a national average of 17 per 100,000. Wyoming is the second highest ranking state in the same age range, with a rate of 40 per 100,000.

"(Elder suicide) is certainly something that's on our mind because of the fragile nature of some of the seniors we deal with," said Marilyn Wills, director of the Nevada Division of Aging Services. "We find many of the seniors here are pretty isolated from family and friends."

Las Vegas is one of the most transient places in the nation, and many seniors may have moved to the city to be near family, only to have them move away, Wills said. Or, a person may have moved here with a spouse who later passed away. Many seniors have no family in the area, and don't have the health or resources to make friends, Wills said. That isolation leads to depression, which correlates with poor self care and health problems, she said.

The CDC data has limitations. It says what happened, but doesn't explain why people kill themselves. And there can be variances based on human error and the way states and individual coroners classify causes of death.

Nevada experts cite many factors that contribute to suicide, including terminal illness, financial strain, isolation and gambling - all exacerbated in Nevada by a scarcity of mental health resources. But there is rarely a discernible single reason people commit suicide.

"The biggest challenge with suicide research is that the people you really want to talk to are dead," said Matt Wray, a UNLV sociologist who specializes in the study of suicide.

The Sun's analysis revealed other characteristics of suicide in Nevada.

Dorothy Bryant, director of the Suicide Prevention Center of Clark County, said some out-of-towners commit suicide here because it gives them notoriety back home, and others are intent on killing themselves but first want to go on a gambling binge or pursue other indulgences.

Public policy conversations about elder suicide are hampered by social stigma and age discrimination, said Laurie Moore, director of the Senior Mental Health Outreach Program. She said that because suicide seems more acceptable at an older age, there is less compunction to take action to stop it than with suicides among young people, when the event is widely considered to be very tragic.

And yet "there's a lot of pain behind those numbers," Moore said of the senior suicide rate.

Nevada's rapid growth and its underdeveloped mental health infrastructure also contribute to the problem, said Moore. It can take three months for an uninsured person to get an appointment with a psychiatrist, another expert said.

On July 23 Senate Majority Leader Harry Reid, D-Nev., introduced the Stop Senior Suicide Act to establish grants for elder suicide prevention and to improve mental health efforts. Reid, whose father killed himself, said in an e-mail to the Sun that the problem demands a response because "it affects everybody - family members, friends, the entire community."

Gambling is part of the fabric of Nevada and research has shown that gambling addiction is a contributing factor to suicide, researchers say. Wray, who is on a two-year fellowship at Harvard University, said addictive gambling among senior citizens is part of the suicide problem.

Research by Paul D. Shapiro, a former UNLV professor who teaches sociology at Georgia Southwestern State University, helps quantify problem gambling among senior citizens, which could help explain Nevada's high rate.

The study randomly surveyed 449 Clark County residents older than 55 to find their risk of problem gambling behavior. More than a third said they gambled for recreation and one in four moved to Las Vegas, in part, to gamble, the study showed.

The study also revealed that 13 percent of seniors were at risk of problem gambling in the past year. Risk factors included having trouble at work because of gambling, breaking up with a partner because of gambling, gambling to forget problems and writing bad checks or stealing money to gamble. Two percent of senior citizens surveyed were shown to be problem gamblers in the past year, and 2 percent more were considered pathological gamblers.

UNLV'S Wray said that as Nevada's population continues to age, it is incumbent to better understand what is causing such a proportionately high number to kill themselves.

The answers for now are elusive, he said.

"We don't know why there's a higher rate of suicide among seniors in Clark County, and yet we are holding the door wide open and saying 'Come on down,' " Wray said. "We should look more carefully. Is there something toxic, or lethal, about the environment? Or are we attracting seniors who are predisposed to suicide?"

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