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CDC data show more suicides have no reported mental health link

Times-Tribune - 10/7/2018

Oct. 07--Kerry Bentler was just 12 years old when she leaped from a rock ledge near Interstate 81 and tried to end her own life.

Back then, she knew nothing of mental illness, but she knew something was wrong. She suffered from hallucinations and angry outbursts. She was perpetually in trouble at school for fighting.

"I was afraid to say anything. I was afraid to be ostracized. I had anger issues," she said. "I was also afraid I would be put away."

Bentler, now 47, of Scranton, is one among thousands who attempted suicide unaware of or who have no mental illness diagnosis.

Data published in June by the U.S. Centers for Disease Control and Prevention shows that 54 percent of people who died by suicide in 2016 had no known mental health condition.

The figure accompanies evidence that suicide rates that year rose nearly 30 percent across the United States.

In Pennsylvania, the rate of suicide deaths per 100,000 people age 10 and older rose 34 percent.

Only one state, Nevada, saw a decrease in suicide deaths, which fell by a slim 1 percent.

While more than half of people had no known mental illness, it doesn't mean that everyone who dies by suicide suffers from it, said Dr. Leighton Huey, associate dean for behavioral health integration and community care transformation at Geisinger Commonwealth School of Medicine in Scranton.

"There are multiple factors that go into why somebody feels that their only course of action is to kill themselves," he said.

Beyond mental illness, someone at risk for suicide may suffer from drug or alcohol addiction, chronic pain or relationship problems. They may feel excluded from regular social interactions. They may have financial woes, problems with housing or any combination of the above.

Add to the mix access to lethal means, for example a gun in the home, and a daunting stage is set for suicide. It speaks to the complexity of mental health and a person's will to live.

"If somebody reaches that conclusion that they're better off dead, probably by definition that's a psychological issue. It's not necessarily a psychiatric diagnosis," Huey said. "But it is a statement about the place where the individual is at that particular moment in time."

In Bentler's case, however, myriad illnesses tormented her unchecked for years, including bipolar with psychotic features, borderline personality disorder, obsessive compulsive disorder and anxiety, she said.

After surviving the rock ledge leap, Bentler tried again to die by cutting her wrists, but her mother walked in and stopped her.

As a teenager, she drove her car into a telephone pole on purpose, a crash she miraculously walked away from, she said.

After high school, she had a daughter and suddenly felt hope that everything would be OK. But the pain and voices in her head persisted.

Others said she was selfish. She had a child and a family. Aside from mounting debt and an eating disorder that left her notably thin, from the outside, her life had a semblance of order. She kept a clean house, ran every day for exercise and had a good job.

Her suicide attempts weren't selfish, she said. She believed that her daughter and loved ones would be better off without her.

"All I wanted to do was get out of the pain, it wasn't necessarily that I wanted to die," she said.

The CDC's data release comes at a time when the nation grapples with the idea of physician-assisted suicide.

In June, a state appeals court in California reinstated a law, one that a lower court earlier deemed unconstitutional, allowing terminally ill patients to choose to end their lives. California Gov. Jerry Brown last month strengthened the state's death with dignity laws by protecting anyone who advises or encourages a terminally ill loved one or family member to consider suicide.

Before that, advising a dying or suffering person toward physician-assisted suicide was a felony.

Huey cautioned against drawing equivalency between untreatable physical suffering and psychological anguish, for example, from depression.

"Those conditions can be treated successfully. A person is not destined to remain in that state for the rest of their lives," he said. "The idea that they can get help and they can feel better is really an important message from a community perspective."

Kathy Wallace, president of the Northeast Suicide Prevention Initiative, used to think mental health issues unequivocally stood at the root of every suicide, but not anymore.

"I think, more than not, people are dealing with anxiety and depression, but I really don't think that everyone has an untreated or undertreated illness," she said. "I think that something can happen and they just feel so despondent ... that it throws them into thinking life isn't worth living."

Bentler finally sought help at age 30 following complaints at work that led her manager to suggest she see a doctor. Her doctor recommended a therapist, who sent her to psychiatrist.

Even after getting help, she still contemplated death. She hoarded medicine and practiced counting out the pills needed to execute a fatal overdose.

While thoughts of suicide never completely left, she's determined to beat them and help others.

She served on the board of directors for the National Alliance on Mental Illness Scranton chapter, and now sits on the board of the Northeast Suicide Prevention Initiative. She's a certified forensic peer specialist working in the Lackawanna County mental health court. She advocates for those with mental illness to steer them away from the judicial system.

"What I do is walk their journeys with them, through my lived experiences, and try to help them in whatever way I can," she said. "I had to go through that pain and that struggle for a reason, and my reason is to help other people."

Contact the writer:

joconnell@timesshamrock.com;

570-348-9131;

@jon_oc on Twitter

Know the risks

National Suicide Prevention Lifeline explains the risk factors and warning signs of suicide, as well as how to speak with someone potentially in danger of it.

For information, call Lifeline at 800-273-8255 or visit www.suicidepreventionlifeline.org.

Risk factors

--Mental disorders or family history of mental illness.

--Loss of a relationship, job or financial stability.

--Access to firearms or other lethal means.

--Feelings of hopelessness.

--Major illness or injury.

--Exposure to others who have died by suicide.

--Previous suicide attempts.

Someone may be considering suicide if they:

--Talk about wanting to die.

--Buy a gun or look for other lethal means.

--Talk about feeling hopeless, trapped or feeling unbearable pain.

--Talk about being a burden to others.

--Act anxious, agitated or reckless.

--Display extreme mood swings.

--Sleep too little or too much.

--Show rage or talk about revenge.

--Use drugs or alcohol more frequently.

Guidelines for helping someone who may be considering suicide

--Listen and talk openly about suicide.

--Ask questions such as, "How can I help?" or "How do you hurt?"

--Never promise to keep someone's suicidal thoughts a secret.

--Seek help from an agency that specializes in crisis intervention and suicide prevention.

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