Suicides up 30% in Louisville, outpace murder
When a national study listed Louisville as the third unhappiest city in the country, psychologist Kevin Chapman was reminded of why he opened a full-time private practice last year.
The study covered feelings of respondents upset over everything from rent hikes to cold weather. But Chapman, a former University of Louisville professor, said the survey's findings overall were about stress levels that more of his patients say they are experiencing.
And the effects can be deadly.
Louisville Metro Police have recorded 77 suicides this year, a 30 percent jump compared to this time a year ago and one more than the city totaled all of last year. The suicide total also far exceeds the city's homicide total this year, which stood at 53 as of Sept. 17.
Officials at the state and city level, however, admit Louisville's suicide count could be higher given that the police do not investigate all deaths that turn out to be ruled suicides.
"Suicide has increased steadily over the last decade in general, and Louisville specifically," Chapman said. "That's why I wanted to roll up my sleeves. I still do the research as a scientist, but the real work is out in the trenches with people who are hurting."
Hub Johnson's family wants answers after they claim PETA investigation led to suicide
In his clinical practice, Chapman's patients confide they are experiencing perpetual hopelessness based on an array of problems, whether they're mental-health related, such as chronic depression, or disease and traumatic injury.
"These are things that we as a city struggle wrapping our head around to begin with," he said. "And if we can't understand the mental-health implications of those conditions, then it's going to be even more difficult to deal with suicide."
City seeking answers
September is Suicide Prevention Month, and city officials admit they are struggling to understand reasons behind the increase as they look for ways to better penetrate populations more susceptible to self-inflicted violence.
"We're still trying to figure out and learn more about suicides, and why they're happening," said Anthony Smith, director of the city's Safe & Healthy Neighborhoods Department.
One of the stated goals of Smith's office is to develop and promote a citywide strategy for suicide prevention, and his office is partnering with other community organizations to get a better handle on the problem.
A 25-member work group helped formulate the One Love Louisville plan, released this year, that addressed reducing suicides.
The work group tasked Smith's office with half a dozen initiatives to reach that goal, such as securing resources to improve the suicide hotline for partnering agencies such as Seven Counties Services; improving the dissemination of prevention strategies among Jefferson County Public School employees and volunteers; helping faith-based groups provide training for religious leaders to recognize and counsel those with mental health issues; and assisting Louisville companies in creating protocols for employees with issues of suicide.
Library offering course on death and dying
Smith said it has been difficult to get a conversation started about suicide. While murder is seen as a public safety concern — and a potential political problem for mayors — for neighborhoods or an entire community, "suicide is a little bit more private," he said.
"We're trying to figure how to get people out of those pipelines, and out of those systems," Smith said. "Part of it is how do you create awareness around them and getting people to pay attention to both homicides and suicides equally? It's difficult."
Raising awareness and getting answers to the problem are also complicated by the lack of an accurate, comprehensive suicide count because the city and state governments track suicides differently.
According to the Kentucky Violent Death Reporting System, which goes toward the state's Centers for Disease Control count in a national database, Jefferson County has had 572 suicides from 2010 to 2014. When asked for the same data, the city showed 442 suicides during that period.
Melissa Brown, a researcher with the reporting system, said state officials measure incidents based upon the results of investigations conducted by county coroners rather than just law enforcement.
"In Kentucky, suicides do not have to be investigated by police," she said. “Some states require it; Kentucky does not. So if they’re reporting just the suicides that they investigate, then they wouldn’t necessarily catch those cases that were listed on the death certificate as a suicide.”
The city uses the Metro Police numbers in its studies because the Jefferson County coroner's statistics tend to be behind, Smith said. And the city hasn't "been able to work with others to get a comprehensive number," he added.
Brown said the 77 suicides counted by the city so far this year are accurate; "it's just not all of them." It is also likely even the state numbers aren't completely accurate, she continued, because in many cases there is a lack of evidence to prove a person killed him or herself and cases are left undetermined.
“It is a guarantee that suicide numbers are representing the bare minimum of absolute confirmed suicides and that there are more,” Brown said. “There’s just not enough evidence to prove beyond any doubt whatsoever.”
Targeting the problem
In all of Kentucky, suicides outpace homicides by nearly 4 to 1. It is the second-leading cause of death for Kentuckians ages 15 to 24.
In Louisville, a report released by the city's Center for Health Equity last fall showed that over a four-year period ending in 2010, the local suicide rate was 13 incidents per 100,000 residents, slightly above the U.S. rate. It also was higher than Louisville's homicide rate of 9 per 100,000 during that same time frame.
Suicides occur throughout Jefferson County, but Dr. Sarah Moyer, interim director of the Metro Department of Public Health and Wellness, said her department found some areas have a higher rate than others. For instance, the Germantown, Portland and Highview neighborhoods have suicide rates as high as 20 per 100,000 residents, which is four times the rate of the Algonquin, Phoenix Hill and Park DuValle neighborhoods.
Out of the 39 ZIP codes that make up Louisville, city records show that 16 made up 73 percent of suicide victims.
The city is trying to aim its services, resources and initiatives at the demographic most vulnerable, which data show tend to be white men over age 25 who live across the southwestern and southeastern swaths of the county.
"I don't have a theory about the rise, but it's an issue we're working to reverse," Moyer said. "It's a concern."
Moyer's department is a founding member of the Bounce Coalition — made up of leaders from 16 collaborating organizations — that is focusing on childhood trauma such as abuse, neglect and dysfunction. She said it is no coincidence that the first Bounce site was an elementary school in southern Louisville.
Transgender people face high suicide risks
"It's working to build resilience toward toxic stress in elementary kids to prevent suicide and then also other chronic diseases as they get older," she said. "We're really moving backward to get to the root of the cause of why this is happening."
Moyer pointed out the health board gathered a wide-ranging group of stakeholders to coordinate enrollment in the Affordable Care Act that expanded mental health access. The federal overhaul now defines behavioral health and counseling services as essential services to be covered on parity with other health care services.
City officials are also heartened that the Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities recently received a five-year, $3.6 million federal grant for a youth suicide prevention program called Zero Suicide. State agencies are using that funding to sponsor clinical training for assessing and managing suicide risk and piloting those efforts, which could trickle down to the city level.
Chapman said those are good signs, but added many clinicians are now overworked and that the city needs to expedite getting the newly insured to the right provider.
"One thing that's not unique to Louisville that's consistent with other cities is the risk factor of not having easier access to clinical intervention, which can take the form of being on a wait list, not having the right insurance and not being able to see specific providers of your choice," he said. "My colleagues have substantial case loads and can't devote attention to every client the way they need. We need more funding put into mental health to make this treatment available to more people."
Reporter Phillip M. Bailey can be reached at (502) 582-4475 or pbailey@courier-journal.com
HOW TO GET HELP
»American Foundation for Suicide Prevention-Louisville Metro, (502) 550-7939 or www.afsp.org
»Kentucky Suicide Prevention Group Inc., kentuckysuicideprevention.org
»Metro United Way, phone: 2-1-1, metrounitedway.org
»National Alliance on Mental Illness-Louisville, (502) 588-2008, www.namilouisville.org
»Seven Counties Hope Now Hotline, (502) 589-4313 or (800) 221-0446, www.sevencounties.org
»Suicide Prevention Consortium Kentucky, (502) 564-4456, TTY: 502-564-5777, www.spcky.org
»The Brook Hospitals, (502) 426-6380 or (502) 896-0495, www.thebrookhospitals.com
»Veterans Crisis Line, (800) 273-8225 and press 1, or text 83825, www.veteranscrisisline.net