Reporting on health and quality of life in South LA

US suicide rate up; South LA mental health expert has seen 'a decline in resilience'

The suicide rate among middle-aged U.S. adults has increased so substantially that by 2009, more people died by their own hand than from car accidents.

In a new report, the Centers for Disease Control and Prevention (CDC) describe suicide as an "increasing public health concern," noting that between 1999 and 2010, the suicide rate jumped more than 28 percent.

That means that at the end of the last decade, for every 100,000 people, about 18 middle-aged adults committed suicide.

Suicide and psychosocial stressors in South L.A.

Elena Fernandez, the director of behavioral health at St. John's Well Child and Family Center in South Los Angeles, said among her patient population, she's seen "a decline in resilience," and an increase in the number of people with "some level of suicidal ideation."

"A lot of that has to do with the psychosocial stressors of being unemployed, having a limited income, having no housing – having to couch-surf – having problems with family members," she said. "Having limited resources."

Fernandez also said a lack of "social connections such as friends, family, church [and] neighbors" can also contribute to suicidal tendencies.

But people "need to have the ability to recover quickly," she said – and part of her work is "providing some sense of hope."

"The question is how do we teach our community to be resilient," she said. "And to tell them they have been resilient, and they have the ability to spring back."

While Fernandez firmly believes that "it's how you frame things" that helps dictate a lot of a person's mental state, she also acknowledges that there are major gaps in people's support systems in South L.A. Mental health care is one of them.

"We're not doing enough preventive work," she said, citing a lack of resources as the primary reason. "We're still waiting for the crisis or emergency to happen. We cannot wait until that level."

The CDC's report

Among the agency's findings:

  • The three most common suicide methods were by firearm, poisoning (usually drug overdose) and suffocation (usually by hanging).
  • Changes in suicide trends among people younger than 35 and older than 64 didn't change significantly over the previous decade, which is why the study focused on the middle-aged.
  • There was a slightly larger increase in the suicide rate for women between 1999 and 2010 than for men – about 32 percent, compared to about 27 percent.
  • In terms of racial and ethnic trends, Native Americans and white people saw the biggest jumps.
  • Geographically, the increases were "widespread."

As far as what may have caused the rise, the CDC posited a few ideas:

Possible contributing factors for the rise in suicide rates among middle-aged adults include the recent economic downturn (historically, suicide rates tend to correlate with business cycles, with higher rates observed during times of economic hardship); a cohort effect, based on evidence that the "baby boomer" generation had unusually high suicide rates during their adolescent years; and a rise in intentional overdoses associated with the increase in availability of prescription opioids.

The CDC echoed Fernandez in its report, too, concluding that enhancing social support, "community connectedness" and access to mental health care can help address suicide risk. But Fernandez noted that the pervasive stigma of seeking mental health care, along with the general lack of availability of services in South L.A. and similar communities – whether it's primary care or mental health – doesn't make it likely that'll happen soon or quickly.

"Some individuals feel, 'I'm not at that level yet,'" said Fernandez. "But it takes one little trigger to make you go there: loss of a job, loss of your partner, your son is abusing substances. So it takes one little trigger for a patient that has been sad for a while to become suicidal and carry out that suicide plan."

Community clinics can help "normalize that," she added.

"The reality is we all have problems," said Fernandez. "But how are we going to resolve them?"

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