By Josh Davis, Associate Editor

(June 14, 2018) During a week when the Centers for Disease Control reported that “Suicide rates in the United States have risen nearly 30 percent since 1999,” the world lost a pair of luminaries to suicide, food and travel writer/TV personality Anthony Bourdain and designer Kate Spade.

Awareness is suddenly up, again, but the conversation is difficult.

“When prominent people commit suicide, it tends to have an effect on the general population. It brings the issue to the forefront,” said Jennifer LaMade, director of Planning, Quality and Core Services for the Worcester County Health Department. “If someone is struggling, they might think, ‘They did it – maybe I will.’ So, I think we have to be really careful how we cover suicide deaths.”

Locally, the increase in the suicide rate is closer to 6-18 percent, LaMade said, adding that the latest local data is about two years old.

LaMade said suicide rates in Worcester County are slightly higher than elsewhere in the state.

From 2014 to 2016, the suicide rate in Worcester County was 11.5 deaths per 100,000 people, compared to the state average of 9.6. From 2007 to 2016, there were 66 suicide in the county.

“It’s not unusual to see an uptick in rural populations as opposed to urban,” LaMade said. “If you look at the CDC report, you’ll see that most of the states that had really dramatic increases are out west – states like Wyoming and Montana.

“We would never know why that’s true, but some things that we speculate are that stigma (of depression and other mental disorders) is greater in rural jurisdictions and there’s often not as many resources, and that people are more isolated,” she added.

There’s a catch in the county statistics, however.

“When we track deaths from suicide, we only track … the deaths that occur from county residents,” LaMade said. “We often hear about suicides from people who are visiting. Occasionally, we’ll hear of someone who went to the beach and used a firearm, but these are not tracked in our [statistics].”

Men accounted for 83 percent of suicides in Worcester and nine out of 10 suicides in the tri-county area from 2014 to 2016 were by Caucasians, LaMade said. About 56 percent were between the ages of 45 to 64 years old, and firearms were used in most cases.

Along with the CDC report and recent celebrity deaths, Kim Klump of The Jesse Klump Memorial Fund said the topic of suicide is also on people’s minds because season two of “13 Reasons Why,” a show about teenage suicide, was recently released on Netflix.

The Jesse Klump Memorial Fund was established in the name of a local teen who took his own life in 2009 and is dedicated to education and outreach on the topic.

“In light of that … it’s an important topic to be discussing with anybody that you care about,” Klump said, adding the TV show this year includes a warning video and a website with resources for parents and teen viewers. “They have done some improvements that way, which is a good thing, but we still don’t recommend that parents let their children watch it alone – I don’t want to watch it alone.”

Klump also warned that increased awareness could increase instances of suicide – although the reasons are unclear.

“Is it actual copycat, or is it just the additional despair that more people have given up the fight?” she said. “It’s a, ‘Here, these people seem to have it all together and they lost it and gave up – how am I still holding on?’ kind of thing.”

For anyone having suicidal thoughts, Klump urged people not isolate themselves but to reach out to someone — anyone — for help.

“If you’re at that point, talk to anybody,” she said. “Anybody who seems sympathetic [can help]. That’s most important – to get people through that crisis – because they don’t feel like anybody cares at that point. If they can get some inkling that somebody cares, that’s sometimes enough to get them over that crisis mode.

“That doesn’t guarantee they’re not going to get to crisis again, but I keep hoping the more people become aware and the more people start to see and empathize with their fellow man … hopefully people can step in more when they’re needed,” she added.

Klump said anxiety levels seem to be “increasing exponentially,” which contributes to increases of depression and mental illness, and exacerbates the risk of suicide, especially in young people.

She also urged people to be more conscious of their own mental health.

“I feel that people do not do enough to take care of themselves,” she said. “Taking a day off from work – as a mental health day because you’re so stressed out – should be the same as taking a day off from work because you’re under the weather with a physical illness.

“Do something relaxing for you that helps you refocus your mind in a positive way,” Klump continued. “There are things that we can all do to help ourselves – and they aren’t being done.”

For people at risk, there are resources like local and national hotlines, including dialing “211.”

“Anyone at any time that’s having any kind of behavioral health problem can call Maryland 2-1-1 … and they’ll get a counselor online that will talk to them and give them resources,” LaMade said.

The National Suicide Prevention Lifeline — 1-800-273-8255 — is also an option, and a crisis response team available 24 hours a day is accessible just by calling 911, she said.

“If someone calls 911 and says someone is suicidal – or even if someone calls for themselves and says they’re thinking about suicide – the police and the crisis response team will come out and they’ll assess them on the spot, and either get them to the hospital or get them an appointment for the next day,” LaMade said.

She said the Worcester County Health Department also accepts walk-in appointments.

“People can some any day to the health department and get an intake and be assessed,” she said.

There is also the free Mental Health First Aid program, which trains community members to recognize signs and symptoms of mental health disorders and substance-use disorders, “and to actually learn how to intervene safely with people who may be considering suicide,” LaMade said.

She is the instructor for the next scheduled course, Sept. 6. To register, visit www.mentalhealthfirstaid.org/take-a-course.

“We want to educate the community on recognizing signs and symptoms, so that when our citizens need intervention, someone will always be available,” LaMade said.

Warning signs generally include changes in behavior, like changes in sleep and eating habits, or increased isolation.

“It could be if they’ve been very depressed and they’re all the sudden elated, it might be that they’ve made a plan [to commit suicide],” LaMade said. “It’s typically changes in normal behavior, but they fall closely around isolation and isolating yourself more.”

If you’re concerned someone is at risk, ask him or her directly, LaMade said.

“If you don’t have the dialog, then you’ll never know,” she said. “A lot of people think that if you ask someone you’ll put the idea in their head, but that’s proven to be inaccurate.

“What we train people to do in Mental Health First Aid is to go ahead say, ‘Are you thinking about killing yourself?’ And then, based on that answer, they get help for them immediately,” LaMade added.

She also underscored the importance of “having open dialogs about mental health and how people are feeling.”

“It’s a conversation that we sometimes shy away from, but actually it’s probably one of the most important conversations we can have when someone is showing symptoms of depression,” she said.

The health department also is encouraging participation in the annual Out of the Darkness walk for suicide prevention, held in conjunction with the American Foundation for Suicide Prevention. The event, this year, is scheduled for Sept. 22 on the Boardwalk and Caroline Street in Ocean City.

Some proceeds from the walk help pay for Mental Health First Aid courses and other local suicide prevention programs, LaMade said.

For more information or to register, visit www.afsp.org.

The 10th Annual Jesse’s Paddle Charity Fundraiser is scheduled for July 21 in Snow Hill.

For more information or to register, visit www.jessespaddle.org.