Men, rural residents, at highest risk of suicide in Michigan

By CRYSTAL CHEN
Capital News Service
LANSING – In Michigan, one person dies by suicide about every six hours.
That statistic puts the state right in the middle of a national trend.
Suicide is the tenth-leading cause of death among Americans, according to the Centers for Disease Control and Prevention (CDC), and in  2016, the national age-adjusted suicide rate reached the highest level in decades.
In Michigan the response to increasing suicide rates has been to focus on two groups overly represented: men and rural residents.
Men are four times more likely to die by suicide, and men account for 79 percent of all U.S. suicides, a CDC study found. It’s the fourth-leading cause of death among men ages 35-54.
“Men do not always recognize that they are experiencing a diagnosable mental illness such as depression or bipolar disorder,” said Courtney Miner, the program manager of Healthy Men Michigan.
The Healthy Men Michigan campaign promotes mental health among men 25-64 and is funded in collaboration with the CDC.
Male depression, a risk factor for suicide, goes undiagnosed 50-65 percent of the time, Miner said. Other risk factors among working-age men include financial problems, alcohol and drug abuse, legal problems and life stressors.
Jodi Jacobson Frey, a principal investigator of the Healthy Men Michigan Campaign Research Project, said that “unique approaches specifically tailored to the needs of this hard-to-reach population” are needed because of their unusually high risk of suicideem, coupled with their limited use of mental health resources.
The situation is worse in rural areas. A CDC study found that people are more likely to commit suicide in rural areas than in urban ones.
Sandi Stasko, a family services coordinator  at Community Mental Health of Ottawa County, said negative factors such as high unemployment and lack of treatment options in rural areas contribute to higher suicide rates.
CDC data shows Ottawa County has the second-lowest suicide rate in the state, with Leelanau County the lowest and Alcona County highest.
Stasko said her agency is committed to increasing awareness of mental health issues. In 2016, it  passed the first dedicated county-wide mental health millage in the state.
“Part of those dollars go to offering community-wide trainings on mental health first aid, QPR (Question, Persuade, Refer) and other mental health topics,” Stasko said. It also developed a Facebook page as a community resource on mental health.
Though the community provides multiple mental health treatment options including community and private providers, “transportation, especially in rural areas of Ottawa County, can make treatment difficult to obtain,” she said.
Patricia Smith, the violence prevention program coordinator of Department of Health and Human Services, said transportation is a big hurdle to accessing mental health services. She is working on a project to provide Upper Peninsula residents access to services.
“It’s an enormous issue,” Smith said, “not wholly in Michigan, but certainly in Michigan.”
Robert Moore, a professional counselor at Community Mental Health of Allegan County, said residents have a choice as to whether to seek services when experiencing mental health problems. “Some choose not to due to insurance costs or coverage.
“There is a lack of psychiatric care available to all consumers regardless of insurance, as well as other mental health options such as case management or other related services, ” Moore said.
According to Moore, the greatest challenge in rural areas is that community health agencies tend to be the only major local mental health provider “but they are restricted by state and federal guidelines as to who can be eligible for services.”
A stigma still surrounds seeking treatment and it’s stronger among men than women, research shows. Studies demonstrate that men have a general unwillingness to acknowledge mental health problems and suicidal thoughts, and are less likely to seek available services.
Miner, of Healthy Men Michigan, said that even when depression is identified, men may be reluctant to ask for help, communicate their inner feelings or form groups around emotional issues.
“Gender socialization, including traditionally masculine stereotypes, also play a role in men’s behavior in seeking treatment,” Miner said.
The campaign is designed to reduce barriers to getting help by decreasing stigma, increasing social support and providing appropriate, convenient and effective referrals for treatment.
It also provides free online screening for problems including suicide.
According to Miner, so far, more than 3,850 individuals have visited the website (HealthyMenMichigan.org) for a screening. Over half have been men in their working years and about half screen positively for suicidal thoughts or behaviors.
Miner said current programs often struggle to reach out to and engage men in their middle years who are at higher risk for suicide.
Funding is always a problem with implementation of suicide prevention programs, Stasko said.
Moore said that community mental health services have been dealing with funding cuts or funding freezes for some time now. “The strain is placed on staff who see increased caseloads.”
But the impact of suicide prevention programs can be limited by staffing levels and funding, he said.
New techniques and concepts are shared to support mental health needs, and staff are encouraged and required to attend professional development each year, Moore said. However, “as always, there are cost restrictions that prevent our staff from accessing cutting-edge clinical trainings, and therapeutic techniques are tailored to each individual as appropriate.”
Miner said suicide prevention programs are often underfunded and have difficulty reaching men in rural areas where resources are even more scarce.
Technology offers some promise to rural residents, and options for treatment via the internet, webcam and phone are available, said Stasko, but “not covered by many insurances companies, policies or plans.”
For those with suicidal thoughts, Stasko advised, “Ask for help, and keep asking until the right help is found.”
Miner said people with suicidal thoughts want to hear stories of hope, recovery and resilience. A mix of social support to reduce isolation is critical to minimize depression and prevent suicide.