Suicide -- Rolling Stones article May 30, 2019 Suicide has Swept Across the West

The Centers for Disease Control recorded 47,173 suicides in 2017, and there were an estimated 1.4 million total attempts. Many of society’s plagues strike heavier at women and minorities, but suicide in America is dominated by white men, who account for 70 percent of all cases.

Middle-aged men walk the point. Men in the United States average 22 suicides per 100,000 people, with those ages 45 to 64 representing the fastest-growing group, up from 20.8 per 100,000 in 1999 to 30.1 in 2017. The states with the highest rates are Montana, with 28.9 per 100,000 people; Alaska, at 27 per 100,000; and Wyoming, at 26.9 per 100,000 — all roughly double the national rate. New Mexico, Idaho and Utah round out the top six states. All but Alaska fall in the Mountain time zone.

 Suicide in America is dominated by white men, who account for 70 percent of all cases.

 Last summer, I began a 2,000-mile drive through the American West, a place of endless mythology and one unalterable fact: The region has become a self-immolation center for middle-aged American men. The image of the Western man and his bootstraps ethos is still there, but the cliché has a dark turn — when they can no longer help themselves, they end themselves. I found men who sought help and were placed on a 72-hour hold in a hospital ward, and say they were sent home at the end of their stay without any help, collapsing back into the fetal position — the only thing accomplished was everyone in the small town now knew they were ill. 

“I have no one,” a man told me quietly over coffee. Outside, an unforgiving wind whipped through the tall grass. “The winters here are killing me.”
I found something else: guns, lots of them. Guns that could be procured in an hour. A house where a wife did a gun sweep and found dozens hidden. I found suicidal men who balked at installing gun locks on their pistols because they were afraid of being caught unarmed when mythical marauders invaded their homes. And I found that the men who survived suicide attempts had one thing in common: They didn’t use guns. Pills can be vomited, ropes can break, but bullets rarely miss.
For years, a comfortable excuse for the ascending suicide rate in the rural West was tied to the crushing impact of the Great Recession. But it still climbs on a decade later.
“There was hope that ‘OK, as the economy recovers, boy, it’s going to be nice to see that suicide rate go down,’ ” says Dr. Jane Pearson, a suicide expert at the National Institute of Mental Health. “And there’s a lot of us really frustrated that didn’t happen. We’re asking, ‘What is going on?’ ”
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Suicide Rate Hightest in Decades But Worst in Rural America Feb 8, 2018 by Mike Maciag
For years, confronting mental health issues has been a persistent challenge in a sparsely populated part of Alaska known as the Kusilvak Census Area. Most of its remote villages, which are home primarily to Alaska Natives who mostly work in the fishing industry, lack health clinics, and the closest hospital is a long plane ride away.
This and other factors have contributed to an alarmingly high number of residents taking their own lives. The area of approximately 8,000 people recorded a staggering 49 suicide deaths between 2012 and 2016 -- the highest rate of any county-level jurisdiction in the country.
Suicide is a perennial problem throughout the nation. The latest Centers for Disease Control and Prevention (CDC) data shows the 2016 national age-adjusted suicide rate reached the highest level seen in decades.

A review of the federal data, however, shows that it's rural America that is sustaining the largest increases. The aggregate suicide rate for counties outside of metropolitan areas climbed about 14 percent over the five-year period ending in 2016. By comparison, the rate within metro areas also increased -- but only by 8 percent. The largest metro areas, in particular, experienced relatively small increases compared to everywhere else.
The suicide rate is highest in the Western U.S., with Montana (26 deaths per 100,000), Alaska (25.4 deaths per 100,000) and Wyoming (25.2 deaths per 100,000) recording the highest rates. Rates were about three times lower in the more urban states of Massachusetts, New Jersey and New York.
Regional differences are largely a function of demographics.
White men die at the highest rates -- roughly 10 times that of Hispanic women and black women -- because they tend to have greater access to firearms. Women, on the other hand, carry out more suicide attempts but generally do so using less lethal means.
Gun ownership, which is more prevalent in rural areas, also explains why certain regions have higher suicide rates. Firearms account for about half of all suicide deaths. Research has found that mandating waiting periods, gun locks and other gun control laws are associated with fewer deaths.
Alaska's Statewide Suicide Prevention Council recently published a five-year plan outlining problem areas and strategies. Like other rural parts of the country, many of the state's communities are without access to mental health care. Cultural attitudes can pose challenges, too: The stigma associated with mental health may dissuade individuals from seeking care.
Among Alaska's indigenous villages, Eric Morrison of the council says a loss of culture or language, as well as the trauma associated with decades of colonization, may also be affecting older natives and their descendants. “The web of causality differs from place to place,” he says. “If there was one simple answer, we would have solved this years ago.” 
The fact that suicides occur more frequently in rural areas isn’t new. Recent CDC data, though, shows the disparity between rural and urban areas has slowly widened in recent years.
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