For months, Teton County Community Prevention Specialist Beverly Shore has repeatedly called a set of grandparents in the valley, trying to talk them through preventive steps to keep their young granddaughter from dying by suicide.
At night the girl’s feelings of loneliness and isolation often intensify.
Shore begins her calls by ensuring the girl is in a safe place. Then she asks the grandparents about lethal means. In Wyoming, 75% of suicides involve a firearm, though medications and ropes also carry a risk.
More than anything, she encourages the couple to talk with their granddaughter openly and honestly about her suicidal thoughts.
“They need someone to reach in, because it’s hard for them to be able to reach out,” Shore said.
Through therapy and positive coping techniques, that family now has a path to recovery. Shore feels momentary relief, but also a lingering sadness.
“You hope … that they feel more comfortable and that they feel like they can actually act and do something now to help their loved one,” she said.
That lingering sadness comes with the knowledge that not every family will be reached in time.
In 2020, 181 Wyomingites killed themselves.
That’s a rate of 31 deaths per 100,000 residents, up from 29.4 in 2019, the highest suicide rate in the nation.
The state’s suicide rate has remained high for years, despite efforts to destigmatize counseling and provide more accessible care.
Shore said she is equally concerned about the years ahead.
“There isn’t a single person that hasn’t been affected mentally by COVID in some way,” Shore said. “The aftermath of this will be long lasting.”
At a national level, preliminary data show a 5.6% decrease in suicides in 2020, though suicidal ideation increased, accompanied by a rise in anxiety, stress and depression according to a November 2020 joint report by Northeastern, Harvard, and other universities.
Indicators for suicidal ideation are similar to the changes people were forced to make in the pandemic: irregular sleep and eating habits, withdrawing from activities that you normally loved to do, and distancing from others.
“We are seeing many people struggling at higher levels,” said Deidre Ashley, executive director of the Jackson Hole Community Counseling Center.
Suicide can impact any individual in any community, but it is typically the result of underlying mental health conditions, which can be exacerbated by financial insecurity and social isolation.
There is also particular concern for young adults and adolescents. While suicide is the seventh-leading cause of death in Wyoming, it ranks second for people between the ages of 10 and 34. Teen suicide rates in Wyoming increased 40% from 2017 to 2019, and suicidal thoughts in young adults have spiked as a result of the pandemic, according to reports from the United Health Foundation and data from the American Association of Suicidology.
Due to remote learning, many students are missing the structure, support and community provided by in-person school systems. Jackson Hole High School also stopped offering suicide prevention training for students this year due to an inability to adopt the programming to a digital platform.
Under the Jason Flatt Act, suicide prevention training is required for all Wyoming teachers, though it is only a four-hour training every four years. Jackson Hole High School is one of the few schools in the state that offers similar preventative training yearly for students.
The evidence-based training gives students tools and confidence to speak with friends who may be suicidal.
Last year Cody High School students who had lost friends and family to suicide lobbied in support of a bill that would have made student training mandatory in schools across the state. Lawmakers weren’t swayed.
The Legislature also refused a proposal to survey middle and high school students on their health and behavior as part of the Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance System. Wyoming is one of four states that don’t participate in the program.
With one person dying by suicide every two days in Wyoming, the inaction from legislators is “frustrating” and “disappointing,” for health officials like the Counseling Center’s Ashley who emphasize that suicide is a preventable death.
Amid budget cuts the Wyoming Department of Health has taken some steps for prevention. The department funds training for thousands of state residents each year and places a community prevention specialist like Shore in each county.
Jackson also has a comprehensive counseling program and community support for mental health services from public officials and private providers.
The Community Foundation of Jackson Hole and the St. Johns Health Foundation partnered with the newly formed Mental Health JH coalition to remove the stigma and cost of mental health care by providing free counseling sessions during the pandemic. They have since expanded the sessions through June and are planning a countywide Behavioral Health Assessment to identify community needs going forward and find ways to improve accessibility.
“This is obviously a hugely needed program,” said John Goettler, president of the St. John’s Health Foundation.
Goettler said the program had 200 participants in December, when they decided to renew, and that number has now grown to 700. Sixty-one percent of those participants came from referrals.
A large number have come from the Latino population.
The free sessions opened a “huge door to the community to say ‘I need help even though maybe I can’t afford it,’” said Daniela Peterson, owner and clinical director of Vista Counseling, the largest Spanish-speaking counseling center in the valley. “That made a huge difference.”
Many Latino clients come with a history of unresolved trauma exacerbated by the stress and anxiety of housing insecurity in Jackson. Anxiety arises when you have frequent worries about something and you don’t know what to expect.
“That’s what the pandemic has caused,” Peterson said. “Nobody knows what’s coming next.”
Anxiety, Peterson said, often leads to depression, which when untreated can cause suicidal ideation.
“And we’ve seen a lot of that — just people not speaking about it, because when you are really suicidal, you don’t want to share that, you don’t want to say anything about that because you don’t want anyone to stop you.”
To combat those thoughts, it is critical to offer holistic case management, including advocacy, medicine and psychotherapy, Peterson said, as well as emphasizing the impact that suicide has on loved ones and the community.
Adam Williamson, who responds to the majority of crisis calls for the Community Counseling Center, said recent cases have been more severe.
“Take everything that makes up a life, work and relationships, and make every one of those things more difficult,” Williamson said. “That’s living in Teton County.”
But Williamson also said he is amazed by the resiliency and courage of the community.
The well-received “Let’s Talk” campaign has encouraged a broader conversation around mental health issues and how to address them as a community.
“Maybe even, there is a silver lining within this pandemic,” Shore said. “And it’s that more recognition, and more talk and acceptance has come around mental health, because there isn’t one single person that hasn’t been affected.”
“We are seeing many people struggling at higher levels.” — Deidre Ashley Jackson hole community counseling center