Inadequate access to mental health care is a major contributor to St. Clair County's high suicide rate, which soared 13 percent above the rest of the state in the past decade, according to the county Health Department.
Between 2006 and 2016, an average of 25 individuals in St. Clair County took their own lives each year. Per 100,000 people, an average of 10.7 died by suicide annually, nearly 13 percent higher that the statewide rate of 9.5 suicides per 100,000 people, according to the Illinois Department of Public Health.
"I would really say it’s an access to care issue," said Mark Peters, director of Community Health for St. Clair County. "We have very few qualified, certified mental health providers in our county for the population we serve."
In a county of just more than 264,000, there is only one mental health care provider per 1,090 people, according to the University of Wisconsin Population Health Institute, which maintains a database for counties nationwide. In Madison County, there are 710 residents per one mental health care provider. In other Illinois counties, the ratio can reach more than 5,000 people per mental health provider.
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"The resources are just not here," says Tom Smith, Chairman of the Board for Karla Smith Behavioral Health in O'Fallon. "State money is drying up and has been for years. We need more psychiatrists, more counselors, more people who are professionals dealing with this epidemic of mental illness in our society."
The county's Mental Health Board did see a $300,000 increase in its funding after County Board members approved the money at their March meeting. Executive Director Dana Rosenzweig said those additional funds will help improve access to care.
Smith co-founded the behavioral health organization after his daughter, Karla Smith, took her own life at the age of 26 after a seven-year battle with bi-polar disorder.
Despite efforts by public and private entities and suicide prevention alliances, the numbers haven't changed much in St. Clair County over the years, Peters said. Between 2003 and 2012, the suicide rate was 10.9 per 100,000 residents, only slightly higher than the rate from 2006 to 2016, according to the Illinois Department of Public Health.
Equipping the public with knowledge about what to do when a one's self or a loved one experiences suicidal thoughts is a key strategy in lowering suicide fatalities, Smith said.
"Those people close to them are the first responders," Smith said. "Most people will change the topic because they’re afraid to ask the question, 'Are you suicidal?' Because if they say yes, people don’t know what to do with that."
In St. Clair County, white men in their middle years are more vulnerable to suicide, according to Peters, the Community Health director.
But with one in five Americans experiencing mental illness in their lifetime, Smith said, most anyone can be at risk of having suicidal thoughts. All the more reason, he added, for the general public to be informed about the signs so they can recognize them in themselves and others.
The American Foundation for Suicide Prevention maintains a list of warning signs on their website. In addition to those signs, one of which is talk of self-harm, Smith said he learned three main signs of suicidal thinking after his daughter died.
Before Karla Smith died, she told her family on Christmas in 2002, "she was not worth the chemicals that made up her body and thought she was a burden on the universe," Smith said.
She died less than a month later.
"When people get to the point of wanting to take their life, there’s at least three things going on normally," Smith said. "One, the person feels very much alone. Two, they feel like they are a burden on other people, that the world would be better of without them. Three, they develop the ability to overcome our innate desire to be alive... That, I think, is the background to people taking their own lives."
The St. Clair County Health Department advocates for the "QPR" program, or the question, persuade, refer approach, Peters said. QPR training teaches people to recognize warning signs and question a person about them, persuade them to seek help and refer them to appropriate services.
Training individuals in the QPR approach and increasing education are part of the county's ongoing suicide prevention plan, which aims to decrease the amount of suicide deaths in St. Clair County 20 percent by 2023.
Anyone who is experiencing suicidal thinking or knows someone who is can call 911 or contact the National Suicide Prevention Lifeline anytime of day at their toll-free number, 1-800-273-TALK (8255). The service can be used anywhere in the United States, and connects the caller to a certified crisis center near where the call is placed. The National Suicide Prevention Lifeline website is at suicidepreventionlifeline.org.
The St. Clair County Mental Health Board maintains a county directory of community support services on their website.
Loved ones can take five steps to helping someone who is experiencing suicidal thinking,according to the National Suicide Prevention Lifeline:
- Ask — it may be a tough question but it is so important to ask someone directly if they are having suicidal thoughts or contemplating ending their life.
- Keep Them Safe — work with the person to remove any lethal means available to them (i.e. firearms, medications, etc.)
- Be There — be present, listen with compassion and without judgment, let them know you care about them.
- Help them stay connected — work with them to connect to others who also care — friends, family, therapists, clergy, teachers, coaches, etc.
- Follow Up — check in regularly with the person you are concerned about, for the days and weeks after the crisis, let them know you are thinking about them, and that you are there to help if needed. These check-ins will go a long way to help that person feel cared about and on the road to recovery.