By Hugh Cameron

A new map reveals the patterns of suicide throughout America. Newsweek spoke to experts about the contributing factors and potential remedies to the geographically complex issue.

More than 720,000 people die due to suicide every year, according to the World Health Organization. While the U.S. rate, defined as the number of suicide mortalities per 100,000 people, does not rank among the highest globally, data shows that America is failing to address the increasingly prevalent problem.

According to the U.S. Centers for Disease Control and Prevention (CDC), more people died from suicide in the U.S. in 2022 than during any year on record, going back to at least 1941.

An anonymous teenager poses for a picture in Arlington, Virginia, on June 11, 2021. The U.S. Centers for Disease Control and Prevention (CDC) said that suicide in the U.S. reached a record high in 2022

What Is Behind the Struggle With Suicide?

With contributing factors relating to the individual, their environment, and the inadequacy of intervention efforts, Newsweek spoke to several experts on what lies behind the issue in America.

"There is no single cause for suicide," Elly Stout and Dr. Kristen Quinlan of the EDC's Suicide Prevention Resource Center told Newsweek. "It's a complex, multifaceted problem with multiple risk factors – including economic challenges, social isolation, access to lethal means, and a lack of access to health and mental health services."

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Deborah M. Stone, lead behavioral scientist at the CDC and a longtime expert in suicidology and suicide prevention, agreed, stating that the issue stems from "a combination of individual, societal, economic and cultural factors."

Of the Latter, Stone said that "emphasis on individualism or the idea that people should be able to solve their problems on their own" was a factor that, combined with a cultural stigma surrounding mental health, could dissuade individuals from seeking help.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

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How Do Suicide Rates Vary Across the U.S.?

Drawing on the most recent data set from the CDC's National Center for Health Statistics, Newsweek created a map showing the disparities in suicide rates in the U.S.

The dataset, which shows a prevalence of suicide across the West and Midwest, points to Montana having the highest rate of suicide, with 28.7 mortalities per 100,000 individuals, closely followed by Alaska at 27.6.

The other end of the scale comprises states primarily in the North, as well as California, led by New Jersey with a rate of 7.7.

What Causes the Regional Variations?

While suicide's contributing factors are diverse, this significant disparity begs questions about the state-to-state differences and potential remedies.

Dr. Kurt Michael is senior clinical director at The Jed Foundation (JED), a nonprofit focused on suicide prevention among teens and young adults. He told Newsweek that geographic factors – rurality and isolation – play a role in higher suicide rates.

Stone of the CDC concurred, stating: "Suicide rates for rural populations are about 1.5 times that for urban populations," citing disparities in access to mental health care, as well as other factors including poverty, unemployment and higher rates of substance abuse.

According to Stout and Quinlan, this is explained by access to the necessary services in these communities.

"Access to health services and quality suicide care vary widely in the U.S., including varying uptake of Medicaid expansion, which increases access to health and mental health care for lower income populations," the pair said. "Rural areas usually have fewer behavioral health services available, and lack of connectedness may also be a challenge, particularly isolation of older populations."

They added that another variation, tied to geography, was the unique stresses faced by at-risk populations, such as indigenous communities, LGBTQ individuals and veterans, who have historically displayed higher rates of suicide.

However, the experts agreed that, while the contributing factors are varied and complex, the problem of suicide mortality is significantly compounded by access to "lethal means" – namely firearms.

A mural of a prairie scene with bison on the main street in Harlem, Montana, on February 13, 2019. Montana has the highest rate of suicide in the U.S.

While attempted suicide rates still vary across the U.S., when one compares suicide mortality to gun ownership across the U.S., a strong correlation emerges.

"States like Montana, with higher rates of gun ownership, experienced higher rates of suicide because of disproportionately higher numbers of firearm suicides when compared to states like New Jersey," Michael said, citing a 2013 study. "The differences were not better explained by other factors such as higher rates of attempts or mental health ailments."

Noting the other, myriad contributing factors – lack of access to healthcare, stigma around mental health concerns, loneliness, economic challenges – Michael added: "When these factors are coupled with ready access to the lethal means of suicide, it creates a perfect storm."

Efforts to Address the Problem

Stout and Quinlan directed Newsweek to the new 2024 National Strategy for Suicide Prevention, published by the U.S. Department of Health and Human Services in April, which includes over 200 actions that the government will take in coming years.

These include strengthening "upstream" suicide prevention, i.e., the factors that can increase suicide risk, strengthening "crisis response" by improving care for those already at risk, and giving increased attention to groups disproportionately affected by suicide.

However, while a promising development, they said: "Ongoing state investment is needed for sustained supports across the areas in the National Strategy."

Michael of JED said that reducing access to lethal means is "one of the more promising approaches to suicide prevention available."

"Though there are some helpful policy approaches to the problem of suicide, the most credible and time-sensitive way to intervene with individuals at risk for suicide is to make their environments safer," Michael told Newsweek. "For example, given that death by firearm is the leading method of suicide in the U.S., encouraging families to store all of their firearms securely before there is a crisis can be lifesaving."

Michael said that this method also applies to other lethal means, such as dangerous medications, and that counselling on access to lethal means (CALM), has been vetted as a best practice by the Suicide Prevention Resource Center.

He added that greater emphasis should also be placed on intervention efforts for America's younger populations by schools and universities.

"Every college and K-12 school should have a plan for crisis intervention and support for all students. While most colleges with students living on campus have a crisis hotline and a team that can respond directly to calls from residence halls, fewer have postvention plans, which are also important, and outline how a college will support students who have witnessed another young person in crisis or have lost a fellow student to suicide."

If you or someone you know may be considering suicide or be in crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline.

Additional Resources:

- CDC Suicide Prevention Resource for Action

- Suicide Prevention Resource Center

- Community-Led Suicide Prevention toolkit

- What Are the Warning Signs of Suicide?

- It's Ok to Say Suicide resource hub

- How to Tell Someone You Are Thinking About Suicide

- How to Ask Someone If They Are Thinking About Suicide
https://standingabovethecrowd.com/james-donaldson-on-mental-health-map-shows-which-states-have-the-highest-suicide-rates/