From The Register-Guard, October 14, 2018

Sara Scofield doesn’t remembering calling 911 to report her own suicide attempt nearly 20 years ago. All she recalls is the sense of despair and pain she was feeling that day, waiting until she was alone, swallowing a handful of pills — and then waking up in the hospital.

A friend who was a paramedic told Scofield after she was released from the hospital that the 911 call that brought help came from her own phone. It was her voice on the call, he said.

“I was feeling very alone despite all of the people I knew were around me, supporting me,” said the 40-year-old Eugene resident, whose family has a history of suicide. “I thought that no one would care if I was gone.”

Suicide doesn’t discriminate, it affects people of all ages and races. Recent national and county trends have shown an alarming increase in suicide rates, especially among middle-aged men of all races who work blue-collar jobs or are veterans. And more disturbing is that mental health experts don’t understand why rates are increasing or why it’s this particular group. The hope is more funding for better support services and improved training at spotting the signs of suicide can prevent more deaths.

Scofield is one of many who have attempted to end their lives through suicide in Lane County — the county has one of the highest suicide rates in the nation.

A recent Lane County report shows that the county’s suicide rate is 50 percent higher than the national average. In 2016, the national suicide rate was about 14 deaths per 100,000 people. The same year, Lane County’s rate was about 22 deaths per 100,000 people.

Suicide is the 10th leading cause of death in the United States, claiming 45,000 lives in 2016, according to the Centers for Disease Control. It’s the eighth leading cause of death in Oregon where 771 people died at their own hands in 2016.

Exactly how many people have attempted to kill themselves is hard to accurately quantify, but according to the 2016 National Survey of Drug Use and Mental Health, around 1.3 million adults nationwide reported that they had attempted suicide in the past year. Lane County Public Health Suicide Prevention & Mental Health Promotion Coordinator Roger Brubaker said he doesn’t know why the county has a higher suicide rate than other areas, and the new report by Lane County doesn’t give an answer, either. The higher rate probably is caused by a combination of factors, including the county’s rural nature, the number of veterans who live here, the downturn in the economy, and a need for more mental health services and better training for both medical professionals and the public, Brubaker said.

Suicide is complex, he said. There is no common set of characteristics that define people who commit suicide. They can be children — some younger than 8 — and they can be senior citizens older than 90. They can be rich or poor, or high school graduates or professors with doctorate degrees. They are represented in every race and gender. And, they all have different reasons for taking their own lives, Brubaker said.

Yet while people who kill themselves don’t neatly fit into one mold, there is a commonality: Many of the victims share a history of mental illness. In Lane County, for example, nearly half of the 1,079 people who committed suicide from 2000 through 2016 were diagnosed with or showed signs of a mental illness or had signs of substance abuse, Brubaker said. Drug and alcohol abuse can be a sign of someone attempting to self-medicate their depression or mental illness.

More support services for people who have substance abuse or mental health problems can help, said Scofield, who continues to try to stay the course. She takes her medications and sees her doctors. She surrounds herself with people who support her and encourage her to seek help when they think she needs it.

“I’m like most people with a mental illness. I’m just trying to survive with a brain that’s not working right,” she said.

A family history of suicide

Scofield was 18 when she started noticing symptoms that she might have a mental illness.

“I wasn’t the person you would think this would happen to,” she said.

She was a good student, a member of student government and involved in clubs and athletics. She was expected to go to a good college and be successful in her chosen career. Scofield should have been happy — but she wasn’t. Life felt like more of a struggle than it should have been.

“It was both mentally and physically draining,” she said. “It was like walking through pudding.”

When Scofield turned 20, her brother, who had been diagnosed with bipolar disorder and depression, convinced her to see a doctor. Scofield was diagnosed with bipolar disorder, post-traumatic stress disorder and depression.

She was terrified.

Her father was in his late 30s when he committed suicide. Scofield was just 9 years old. Her paternal grandfather killed himself when her father was 16. And, her brother ultimately also would take his own life.

It was after her father died in 1988, that death and suicide became real to her.

“I saw that the loss of someone by suicide was treated differently,” she said. “The way people grieved was different and the way people treated his death was different. There were feelings of shame and blame surrounding his death.”

She started to understand what her dad may have gone through when his father killed himself. Scofield knew as a child that her grandfather’s death was different but didn’t know or understand why and no one would explain it to her.

At the time of his death in 1967, her grandfather, David Scofield, was mayor of Springfield and had served as city council member for six years. He was a successful pharmacist who had just sold the two pharmacies he owned and was the president of the Centennial-Professional Building, Inc. and McKenzie Broadcasting Company. He also was a veteran of World War II.

But Scofield remembers being told that despite being so successful, her grandfather never seemed happy.

At that time, people didn’t speak about suicide, Scofield said. It was a shameful thing, a sign of weakness — it wasn’t discussed.

Scofield believes her dad struggled the rest of his life thinking his father was weak and a coward for taking his own life. When her father started noticing the same symptoms of depression and mental illness in himself, Scofield is convinced he likely was afraid of being seen as weak and resisted seeking help. He did eventually seek treatment, but it came too late.

Scofield experienced another suicide in 2011 when her brother, who had encouraged her to seek help, killed himself. He was in his early 40s and had battled bipolar disorder, depression and alcoholism for more than 20 years.

He was in a very dark point in his life, Scofield said. He had helped numerous people fight their addictions and depression, but that day he couldn’t realize that, he could only see the darkness.

Common characteristics

Men are about four times more likely than women to complete their suicide, said Sally Spencer-Thomas, a clinical psychologist and professional speaker on suicide prevention. Woman, on the other hand, are more likely to make multiple suicide attempts than their male counterparts.

Spencer-Thomas’ brother committed suicide in 2004. She is a member of a team of experts who helped create the website Mantherapy.org for the Colorado Health Department in order to reach out to middle-age men who are grappling with life and depression. The website mixes tongue-in-cheek humor about what a manly man is with information on mental health disorders and places to get help.

In Lane County, about 37 percent of the 1,079 people who died by suicide from 2000 to 2016 were middle-aged men, Brubaker said.

While there isn’t a specific type of person who dies by suicide, the majority of middle-aged men who take their lives do have some common characteristics, said Spencer-Thomas. They are from all races and typically work in blue-collar jobs. They often had a vision of what their life would be like — including a home, a family and comfortable income — by the time they reached mid-life, she said.

Today’s world is tearing that dream apart, she said. They live with divorce. Some see their jobs sent overseas or replaced by machines. They’re feeling overwhelmed and as if they’ve lost control over their lives.

“They only seek professional help because an employer or a partner told them they had to go,” she said. “Traditional therapy isn’t a good fit for this type of person. It doesn’t make sense to them.”

They don’t think they have a mental health problem, Spencer-Thomas said. Rather, to them, it’s just a problem with their job or boss or family or with themselves.

Because they don’t have a way of expressing those feelings to others, men in this group may try to self-medicate by using alcohol or drugs, Spencer-Thomas said, which is why many of these men also may have substance abuse problems. Using alcohol or drugs leads to other problems and the situation spirals further out of control to the point that they may believe the only answer is to kill themselves.

In Lane County, about 33 percent of the 688 men who killed themselves over the past 17 years were reported as having problems with drugs or alcohol, Brubaker said. Yet only 40 percent of those men had a history of getting treatment for a mental illness.

Despite what these men might think, depression and mental illness are not weaknesses, Spencer-Thomas said. Men who are feeling overwhelmed or depressed have a health problem and need to seek help, she said.

Getting help

Kaitlyn Garlets understands what it’s like to be afraid to seek help for a mental illness. She found herself struggling with depression in 2011. She was going through a rough patch with her family and her boyfriend. And, she had just learned she couldn’t have children, something she always has wanted.

“I started having these thoughts in my head that because I couldn’t have children, no one would love me and that I didn’t deserve to be on this planet,” said the 22-year-old from Veneta who recently moved to Eugene.

The anxiety and depression built into a whirlwind in her mind becoming all she could think about, Garlets said. But she didn’t feel as if she could share her thoughts with someone because she feared they would say she was crazy and tell her to snap out of it. Garlets said she started researching ways to take her life.

One day while taking a bath, Garlets decided she would just slip under the water and die. Her mother walked in to the bathroom to grab something a few seconds after Garlets slid under the surface. She asked Garlets what she was doing. Garlets told her she was washing her hair.

The incident scared Garlets and for many years she tried to deal with her depression and anxiety issues on her own, but she kept having panic or anxiety attacks. Her depression was so intense some days she couldn’t get herself out of bed, she couldn’t eat, she couldn’t go to work and she couldn’t do her favorite activities, drawing and painting.

“It wasn’t that I didn’t want to get out of bed or that I didn’t want to paint or draw. My body physically wouldn’t let me do those things. People don’t understand depression,” she said. “I don’t look like someone who would have depression. I’m an outgoing person. I love to talk. It was like I was wearing a mask.”

In 2016, her fiancé convinced her talk to her primary care doctor. Garlets’ doctor put her on medication but she found that talking to a therapist worked better for her.

“It really helped to be able to talk to someone other than my family,” she said. “There are a lot of resources out there. You don’t have to feel alone. Therapy does help, but it takes time.”

Primary care doctors are often the first medical experts that people who are showing signs of mental illness or substance abuse will talk to, Brubaker said. As well, primary care physicians and social service agencies countywide need more training in how to screen and identify patients who may have a mental illness and may be thinking of suicide. Physicians and social service agencies also need more information about services and programs available for a patient who may need help.

Public health officials, teachers, family, legislators, friends, employers and coworkers need to start looking at suicide and mental health as a health problem that needs to be treated like any other disease, Brubaker said. More services and financial support are needed for people with mental illness and additional training is needed for medical professionals and the public so they can spot the signs of someone who is struggling, he said.

After her brother’s death, Scofield became active in fighting against suicide and getting more mental health services into the community. She joined the American Foundation for Suicide Prevention as a spokeswoman and traveled to Washington, D.C., to lobby for a bill that would allow the Federal Communications Commission to consider changing the suicide prevention hotline to a three digit number, such as 911 or 411. Three digit numbers are easier than remembering 800-273-8255, the 11-digit national number.

“911 is great for most emergencies, but not always a good choice for someone who is having a mental health crisis,” she said. “When you call 911, you’re connected with the police, fire department or paramedics.”

As highly trained as these first responders are, they aren’t well trained in how to help someone who is in a mental crisis, she said.

“There is hope,” Scofield said. “If someone you know is struggling and you think they may be experiencing a (mental health) crisis, go to them, sit with them, tell them ‘I’m here for you.’”