Minnesota suicide rate on the rise, mental health workers say

Is bad economy leading to serious depression?

On Black Thursday, when the stock market took its greatest dive in history, Wall Street bankers allegedly lined up to jump out of high-rise windows. The image has become an icon of the era—suicide and the Great Depression, forever linked.

The tale of widespread Wall Street suicide is actually a myth (only two suicides took place on Wall Street at all in 1929), but one that gained currency because it reflects a larger truth: Suicide rates increase during a bad economy. The suicide rate peaked at 17.4 per 100,000 in 1932, as unemployment approached 25 percent, the nation's all-time high. The current recession is the longest since World War II, and the national unemployment rate is at its highest since 1983 (8.5 percent).

So it's not surprising that Dr. Dan Reidenberg's phone has been ringing off the hook. A psychotherapist, Reidenberg is executive director of Suicide Awareness Voices of Education (SAVE), a national suicide prevention organization based in Bloomington. Recently, his agency has been deluged with calls both from people who need help and reporters who want to know how the economic downturn is affecting the suicide rate.

"What's happening right now is really what I consider a tsunami impacting the mental health and mental well-being of people in the country," says Dr. Dan Reidenberg, executive director of SAVE
Jana Freiband
"What's happening right now is really what I consider a tsunami impacting the mental health and mental well-being of people in the country," says Dr. Dan Reidenberg, executive director of SAVE
National and State Suicide Data. Source: Centers for Disease Control and Minnesota Department of Health.
National and State Suicide Data. Source: Centers for Disease Control and Minnesota Department of Health.

Though journalists are loath to report it—extensive media coverage of suicide has been linked to copycat deaths, so there is a natural reluctance to dwell on the details—there is no doubt that Minnesota's suicide rate is on the rise. Preliminary numbers from the Minnesota Department of Health indicate that last year's suicide rate was 11 people per 100,000—the highest since 1986. While the national suicide rate climbed just 4.2 percent from 2000 to 2005 (the most recent national data available), Minnesota's rate skyrocketed 15.7 percent during that period. And it's only getting worse. In the last two years, the state suicide rate in Minnesota is 23.6 percent higher than its 2000 low.

"Everyone who works in this field is extremely concerned. We're really in uncharted territory—as in the Great Depression," Reidenberg says.

Reidenberg cautions people against blaming the rising suicide rate directly on the economy. The truth is that plenty of people lose their jobs and don't kill themselves. In fact, when the financial crisis hit hardest last year, the state's suicide rate went up just a tick, rising 3 percent over 2007, when economic conditions were far more stable. Clearly, the financial crisis has not caused an epidemic of suicide.

Nor is it likely that any one factor—a bad day in the stock market, say, or a messy divorce—would cause someone to take her life. People who kill themselves typically suffer from multiple mental disorders, such as depression, anxiety, and substance abuse. Only when these problems are already present will economic woes push someone over the edge.

"What's happening right now is really what I consider a tsunami impacting the mental health and mental well-being of people in the country," Reidenberg says. "When you have a job loss, most people can get through that. When you start adding loss of your spouse, loss of your house, loss of your income, loss of your retirement, you start adding up a lot of things for your mental health to sustain."

At one time, Minnesota was a poster child for suicide prevention efforts. As the national rate peaked in 1986, a new wave of antidepressants known as SSRIs—which boost levels of the feel-good hormone serotonin—helped lower the suicide rate across the country. Minnesota's rate dropped faster than the national average, dipping to just 8.9 per 100,000 by 2000.

The issue of suicide became a national priority in the late 1990s, due largely to the advocacy work of people who had lost loved ones to it, like Minneapolis's Adina Wrobleski, who founded SAVE. Families left behind by suicide pushed for a national convention on the topic, and in 1998, the U.S. Department of Health and Human Services, the Centers for Disease Control and Prevention, and the National Institute of Mental Health convened in Reno to map out a plan to fight the problem. The health and human services department published a national suicide prevention plan in 2001.

That year, Minnesota became the first state to dedicate money to suicide prevention, launching a million-dollar-a-year program. Thirteen agencies were awarded state grant money for education and training programs. But as the state faced budget shortfalls mid-decade, grants were eliminated and the money dried up. Programs were cut, and Minnesota's suicide rates climbed closer to the national average.

Economics isn't the only factor at play. The rise in the suicide rate coincides with a decrease in the number of antidepressants prescribed. In 2003, the FDA determined that children and teens taking antidepressants face a 4 percent chance of having suicidal thoughts or behavior. The next year, the FDA mandated that a warning of the risk be added in a "black box" on the medications. As a result, parents were hesitant to allow their kids to take antidepressants, and doctors were more reluctant to prescribe them. In the year after the warnings, prescriptions for youth under 19 fell about 20 percent. During the same time, the suicide rate for that age group rose 18 percent—its first increase in more than a decade.

It's particularly surprising that Minnesota's suicide rate is climbing so rapidly, since in other major health indicators the state is considered a national leader. Minnesota has the lowest rate of deaths from cardiovascular disease in the nation, and one of the highest rates of health insurance coverage. It's home to the Mayo Clinic and the University of Minnesota, which boasts one of the most prestigious psychology programs in the country. And while fewer suicides happen here than elsewhere (in 2005 Minnesota's rate was 39th out of 50 states and the District of Columbia, up from 44th six years earlier), the state seems to be losing ground.

"We don't have a good explanation. We've taken care of these other things. We haven't taken care of our suicide," says Jon Roesler, the state's epidemiologist charged with tracking the numbers. "I don't know if it's Minnesota Nice—we don't like to talk about it."

The problem with trying to attack it as a public health issue, he says, is suicide's very personal nature. But if you know someone who is experiencing suicidal thoughts, the path is clear.

"You put your arms around them and you hold them tight," Roesler says.

The national suicide prevention hotline is always open: 1-800-273-TALK. 

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