In N.H., suicide stressors abundant
Concord Monitor - 10/8/2017
Jeremy Hannan wishes he could ask his son Triston a question.
Why did the 15-year-old, a Concord High School student with good looks, an outgoing personality and a deep connection to others, take his life last month?
“What caused him to do something so heinous to himself?” Hannan asked. “What was that one piece that was missing?”
Hannan may never find out why his son became one of the hundreds of New Hampshire residents who die each year by suicide, leaving behind a grieving family, friends and a trail of unanswered questions.
But those who study suicide and want to help suffering families are trying to identify trends in what causes people to take their own lives – and how tragedies like Triston’s death can be prevented.
Most who are considering suicide exhibit warning signs, experts say. More than 90 percent of those who die by suicide have a diagnosable mental health disorder, according to the National Alliance on Mental Illness. Working together
When it comes to suicide, New Hampshire’s “Live Free or Die” attitude may not be helping.
“There’s this mentality that, ‘Hey, I’m not going to ask for help. I can do this myself. And if I can’t, I’m just not going to get someone else involved,’ ” Elaine de Mello, Training and Services Manager of the Connect Suicide Prevention Project, said. “It’s this sense of privacy, like, ‘I don’t want to make a mountain out of a molehill.’ A struggling person doesn’t know what to do, so they don’t do anything.”
For years, prevention groups like the ones de Mello works with have compiled data on at-risk groups in the state to better understand suicide deaths. Most agree that the best approach to preventing suicide is a collective one.
“This isn’t up to one sector of the community,” de Mello said. “It’s a group effort.”
In 2008, a group of New Hampshire leaders formed the State Suicide Prevention Council to raise public and professional awareness of suicide prevention, address mental health and substance abuse needs and promote policy change.
In collaboration with NAMI N.H., the Connect Suicide Prevention Program, the Youth Suicide Prevention Assembly and the New Hampshire Division of Public Health Services, the council produces regular state suicide prevention plans, providing a statistical overview of suicides and analyses. Guns
Suicide is an especially acute concern in New Hampshire. While there are many factors that go into someone’s decision to take his or her own life, New Hampshire residents are exposed to some major indicators of an increased suicide rate, experts say, including harsh winter months, high levels of drug abuse, wide access to guns and life in a rural area.
These factors have contributed to New Hampshire being placed in the top 20 states for most suicide deaths. The Granite State exceeds national rates in almost every age category.
Chief among the factors is access to firearms.
During one week in 2009, three people with no connection to each other bought firearms from Riley’s Sports Shop in Hooksett and took their own lives.
Then-owner Ralph Demicco got a call with the news from Elaine Frank of the Dartmouth Injury Prevention Center.
“When she told me this, I said, ‘Say that again? What am I missing here?’ ” Demicco remembered. “I couldn’t put it together. It didn’t make sense. I was very disheartened.”
Frank asked if Demicco wanted to work with the New Hampshire Firearm Safety Coalition to combat suicide deaths by firearms. More than 50 percent of those who took their lives in New Hampshire in 2016 did so using a firearm, according to the N.H. Office of the Chief Medical Examiner.
The coalition developed materials to offer gun shop owners and their employees to help them identify and address a potentially suicidal customer. Some posters were also directed toward gun owners, encouraging them to ask a friend to hold onto their firearm if they experience thoughts of suicide.
“None of us on the other side of the counter is a psychiatrist, but we can tell if someone is under duress or stress,” Demicco said. “It just takes a little bit of gumption to say, ‘can I hold your gun until this whole thing is over?’ ”
Forty-eight percent of gun shop owners agreed to exhibit the posters. Demicco was asked to present the group’s findings in Washington, D.C., at a conference for the American Foundation for Suicide Prevention. About 15 states adopted similar projects.
But the project wasn’t without obstacles.
Gun rights activists caught wind of the project and called store owners, warning them that the coalition was trying to stifle Second Amendment rights. That “put a damper on a lot of it,” Demicco said.
“A few store owners said it was much too controversial a subject,” he said. “They didn’t want to anger their customers.”
A part of suicide groups’ approach to limiting firearm deaths is honoring the right to bear arms, de Mello said.
“Firearms are not a bad thing for people to have, but they are very lethal, and they’re not helpful for people who are thinking of killing themselves,” de Mello said.
“Just like you wouldn’t get behind the wheel of a car if you were drinking, or leave medicine out where a toddler could find it – you wouldn’t let someone who is going through a stage of serious depression or suicidal thoughts have a gun.”
Although women attempt suicide more often than men, research shows that men are more likely to use more lethal methods – like firearms – in suicide attempts. Women are more likely to attempt suicide with an overdose, which does not always result in death. Women are also more likely to seek mental health treatment.
The stigma against seeking mental health assistance is something that is taking men’s lives, said Peter Evers, CEO of Riverbend Community Health in Concord.
“They don’t want to talk about their problems because it’s perceived as a sign of weakness,” Evers said. “Because of that, they’re more likely to come to an extreme decision.” Weather and location
According to statistics, rural communities are more likely to be affected by suicide than urban ones. This is largely due to isolation and a general lack of resources in rural areas.
In the U.S., Alaska, Wyoming and Montana have among the highest suicide rates, while more urban states like New York and California have some of the lowest suicide rates.
This is true on a statewide scale, too.
In New Hampshire, northern Coos and Carroll counties are some of the most affected, while Hillsborough, home to two major New Hampshire cities – Manchester and Nashua – are among the least affected.
“You would think higher populated rates, but it’s actually the opposite,” de Mello said.
Weather could also be a factor, de Mello said.
New Hampshire, Maine and Vermont have higher rates of suicide deaths than southern New England states, like Connecticut and Rhode Island.
“We need to think about how much our long, hard, dark winters play into this,” de Mello said.
She also said more people in the northern, isolated parts of the state are accessing mental health services through telemedicine, or apps on their phone. There is a 24-hour suicide prevention text and call line. Drug use
In addition to having higher than average suicide rates, New Hampshire remains above the national average for people with substance abuse issues.
This is no coincidence, and the common denominator is often mental health.
No one knows this better than former state Supreme Court Justice John Broderick. Broderick was severely beaten in 2002 by his son, John, during a time when his son’s mental illness was untreated and he abused alcohol.
Broderick said most people who abuse drugs use them as a release from symptoms of untreated mental illness.
“There’s no logic, except to say, maybe with this drug I can get some release,” he said. “Often times they are acting out in self-destructive ways because they don’t like the people they believe they are or they want to escape the person they are.”
Many people could be saved from developing substance abuse issues by receiving timely mental health treatment, Broderick said.
“It’s not going to be a single solution for drug addiction, but it’s going to save a lot of people from going down that path,” he said.
One-third of people who killed themselves in 2009 had alcohol in their systems, according to the CDC. About one-fifth tested positive for opiates, which include prescription pain medications and heroin. Triston’s story
Jeremy Hannan said his son, Triston, suffered from anxiety and depression for many years before his death.
He described his son’s mental state as “two sides of the same coin.”
“On one side, you have this perfect kid,” Hannan said. “Triston could have done anything in life – he had the drive, he had the personality, he had that infectious smile that would just draw people in.”
But he also had a more troubled side, his father said.
Triston was someone who was always standing up for others, Jeremy said. Though Triston’s father said his son identified as straight, he was part of a team of students who founded a gay-straight alliance at his former high school in Claremont. Violence against women was something that also particularly bothered his son, Jeremy said.
Triston saw injustice in the world and he felt frustrated by it, Jeremy said. But it didn’t look like normal, 15-year-old kid frustration. For Triston, it was all-consuming and at times felt inescapable.
Triston had attempted suicide twice before he moved to Concord last spring, his father said.
He spent time in two treatment facilities, the Brattleboro Retreat in Vermont and Becket Family of Services in Orford. Jeremy did his best to try to talk to his son about how he was feeling.
But it wasn’t enough. On the morning of Sept. 20, Triston got up at 5:30 a.m., dressed for school and ate breakfast. Then, instead of going out to the bus stop, he went into the woods behind his mother’s house and hung himself, Jeremy said.
Jeremy said he thought Triston was doing well in Concord. Triston told him he had made friends and was well-liked.
According to the most recent New Hampshire Youth Risk Behavior Survey, more than 80 percent of New Hampshire students said they wouldn’t talk to their parents about negative emotions.
“There’s an old saying, ‘it takes a village to raise a child,’ and it’s true,” Hannan said. “It’s not just mom, it’s not just dad. It’s not just the aunts and uncles, it’s the friends, the teachers.”
“If the whole community doesn’t circle around and help all at once, unfortunately, things like this are going to keep happening.”
(Leah Willingham can be reached at 369-3322, email@example.com or on Twitter @LeahMWillingham.)
WHERE TO GO FOR HELP
If you or someone you know is considering suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255.
Other local resources include:
-The N.H. Community Behavioral Health Association is an organization comprised of 10 community mental health centers throughout New Hampshire. The association serves as an advocate for a strong mental health system across the state. Call 225-6633.
-Riverbend Community Mental Health provides specialized behavioral health services for children, adolescents, adults and their families. Call 228-1600.
-NAMI N.H. is a grassroots organization of and for people of all ages, their families and friends who are affected by mental illness. Through NAMI N.H., you’ll meet other individuals and family members who have struggled with mental illness. Call 225-5359