Recession Takes Its Emotional Toll on Cities

Leslie Storm, director of an Oregon suicide helpline, is scrambling to find shelter for a cash-strapped 52-year-old man who says he will hang himself by the end of the week.

The man, who could not work for a couple of months because of a medical condition, told Storm that he is behind on his rent and his roommate plans to kick him out Feb. 26. It is the kind of situation she is dealing with more in these days of rising unemployment and evictions.

"He's telling me that he is slipping through the cracks, and it breaks my heart," says Storm, director of the crisis line program of the Oregon Partnership. "He has medical problems and says he can't go live under a bridge."

The Oregon suicide and drug and alcohol help lines received 71% more calls in January 2009 than it did the previous January, including more calls from people having suicidal thoughts because of severe financial stress, Storm said.

Promoting Awareness

The federal government and nonprofit advocacy groups are getting the word out about the national suicide prevention lifeline (800-273-TALK) and focusing more on other prevention efforts because they are worried that the rising tide of unemployment and foreclosures could lead to more depression, drug and alcohol abuse, divorce, and ultimately for the most vulnerable, suicide.

At the same time, the recession has forced state governments to cut back on social services designed to help people in physical, mental, and financial stress at exactly the time when demand for those services is greatest, says Susan Byrne Lee, president and chief executive officer of Mental Health America of Northeast Florida.

The nationwide data on suicide lags by three or four years, so we likely won't know whether suicides are spiking for a few years, by which point everyone hopes the recession will be over. But even before the crisis, suicide rates were higher in certain parts of the country, especially in the Intermountain West including Montana, Nevada, Colorado, Wyoming, and Oregon, and lowest in densely populated states such as New York, Massachusetts, and New Jersey. It is unclear why this is the case, but researchers believe that people in more rural states might have less access to care, tend to be more isolated, and have ready access to guns.

To get a sense of where the pain points are greatest, came up with a list of the 20 unhappiest cities. These are major cities that were ranked based on their rates of suicide, depression, divorce, unemployment, job loss, population loss, crime, amount of green space, and cloudy days. We gave most emphasis to suicide and depression rates, crime, and economic factors. The city with the highest overall score in our index was Portland, the beautiful Oregon city that also has very high depression and suicide rates. St. Louis, New Orleans, and Detroit were high on the list largely because of their rates of crime, unemployment, and population loss. Other cities such as Las Vegas, Tucson, Sacramento, and Jacksonville, Fla., ranked high because of their suicide rates and difficult economic conditions.

In Las Vegas, a Suicide Increase

Mike Murphy, coroner for Clark County, Nev., which includes Las Vegas, said he has noticed an increase in economy-related suicides, but he doesn't have any hard data yet.

He is seeing more suicides involving elderly people, including two recent husband-and-wife suicide pacts. The increase in suicide among seniors could be because of economic conditions. But it could also be because Las Vegas has become a destination for retirees, he said.

He said it is a misconception that Vegas suicides are tied to gambling (though it's impossible to know the precise causes). Murphy said people who take their own lives might have had problems long before they moved to Las Vegas.

"A lot of people will come to communities such as ours to make a new start in life," Murphy said. "But if they bring habits from where they came from, nothing will change except geography."

Murky Causes

Matt Wray, an assistant professor of sociology at Temple University who is studying the high rates of suicide in Las Vegas and in other parts of the Intermountain West, said it is still unclear why suicide rates are higher in certain locations.

Just like there is a suicide belt, there is also a homicide belt (Washington, D.C., Philadelphia, and Baltimore) and a stroke belt (Southeastern U.S., including South Carolina, Georgia, Alabama, and Mississippi).

Wray said it is unlikely that gambling is causing the high suicide rates in Las Vegas because Atlantic City, N.J., another gambling center, has a low rate of suicide. But it is impossible to know for sure because people who commit suicide don't always leave notes, and even if they do, they might be too embarrassed to discuss gambling losses in those letters, Wray said.

Wray believes that the rural nature of states such as Nevada, Montana, New Mexico, Alaska, Colorado, Idaho, Oregon, and Arizona could play a part in the suicide rates. More densely populated places, where residents are closer to friends, family, and social services, tend to have lower rates. Other factors that act as protective forces are marriage, religion, and having a large network of extended family, he said.

The Writing on the Wall

The economy is likely to worsen the problem, but it is hard to say for sure. The last time there was a big increase in suicides was during the Great Depression. The shorter and less severe recessions in the 1980s and early 1990s didn't result in a significantly larger number of suicide cases, he said.

"It is going to be tragic if the current economic decline results in spikes in suicide rates," Wray said. "But for someone who has been studying these trends, I don't see how it's not going to result in that."

Richard McKeon, lead public health advisor on suicide prevention for the Substance Abuse and Mental Health Services Administration (SAMHSA), said the federal government is acting now because it will be too late once the latest suicide data is collected, released, and studied. SAMHSA, which funds the national suicide lifeline, says its publicity efforts have helped boost the number of calls answered by the telephone lifeline by 25% in January compared with the previous January (although economic troubles likely contributed to that rise).

Preventive Measures

David Litts, director of science and policy for the Suicide Prevention Resource Center in Newton, Mass., said preventing job losses and decreasing foreclosures is one of the best ways to prevent suicides.

The idea is to reduce the strain, Litts said. Reducing those losses will reduce feelings of hopelessness.

Storm, who runs the Oregon crisis lines, said Americans should do more to help by volunteering at suicide helplines and taking care of friends and family when they ask for help.

"The man who is threatening to hang himself says his wealthy mother isn't returning his calls," she said.

"Life is hard," Storm said. "Why not be kind?"

Click here to see America's Unhappiest Cities.

Before it's here, it's on the Bloomberg Terminal.