Suicides in Massachusetts increased 40 percent from 2004 to 2014, driven by a rise in middle-aged men taking their own lives, according to a recent report from the state Department of Public Health.
The state’s experience parallels that of the United States as a whole: In 2014, suicides nationally reached the highest level in more than 30 years.
But even with the increase, Massachusetts continues to have one of the lowest suicide rates in the country. The state’s 2014 rate was 9 people per 100,000, compared with the national rate of 13 per 100,000.
Massachusetts recorded 608 suicides in 2014, more than the number of homicides and motor vehicle deaths combined.
More than three-quarters of those who committed suicide were men, and 56 percent were between the ages of 35 and 65.
Middle-aged men “account for the largest numbers of suicide deaths, and they’re the group that is most difficult for us to impact,” said Alan Holmlund, director of the health department’s Suicide Prevention Program. “They want to be independent. They don’t want to ask for help. They don’t, as a group, see mental health treatment as something that is viable for them.”
Just over half of those who died by suicide in Massachusetts had a documented mental health problem, but specialists say that psychological issues are often not known. Research has found that, in general, about 90 percent of people who committed suicide had a mental health problem.
Among middle-aged men, the lingering effects of the Great Recession may be a factor, said Steve Mongeau, executive director of the Samaritans, a suicide-prevention organization. “There’s a lot of concern about being a breadwinner, provider, caretaker, protector. When things go asunder, it can be brutal,” he said.
A year ago, the state launched a website, www.massmen.org, intended to reach this group. It offers anonymous screenings for depression, anxiety, and problem drinking, as well as links to resources.
But Mongeau saw reason for hope in the statistics, which suggest that suicide rates may have stabilized over the past five years. Most of the increase occurred between 2004, with 433 suicide deaths, and 2010, when the number reached 602. The worst year was 2012, with 624 deaths.
“We can in fact turn the tide,” Mongeau said. “People are being more open, more willing to talk about mental health issues and suicide.” The Samaritans has doubled the number of community workshops on suicide prevention it holds across the state.
Holmlund, the state official, attributed Massachusetts’ comparatively low suicide rate to several factors: The state has few very rural areas, so health resources, including emergency medical services, are always nearby. The state also has a robust behavioral health system, good access to health care services, a low rate of gun ownership, and 10 years of suicide prevention activities, he said.
“I know that we are preventing deaths,” Holmlund said. “We are identifying people that are vulnerable, and we are helping them to seek the kind of treatment they need.
“It’s just very difficult with prevention to say what the numbers would be if we were not doing the kinds of activities we’re doing now,” he said.
Franklin County had the highest suicide rate, at 17 per 100,000. Holmlund said, however, that the rate has fluctuated over the years, so it’s not clear whether the 2014 numbers signify a problem specific to that region. But Franklin is one of the state’s more rural counties, and rural areas tend to have higher suicide rates, probably because of less access to services and higher unemployment.
Elsa Ronningstam, a clinical psychologist at McLean Hospital, said an important contributing factor to suicides is a failure to provide adequate follow-up when a patient is discharged after a psychiatric hospitalization. Additionally, among young people, the pressure to succeed can be overwhelming. “We live in a very high-achieving society,” she said. “Young people who feel a lot of pressure can readily experience that there is no light at the end of the tunnel if you fail or if you don’t score on top.”
For more information about recognizing the signs of suicide and seeking help, visit www.mass.gov/dph/suicideprevention or www.suicidology.org. Additionally, the Samaritans will talk at any time, by phone or by text, at 1-877-870-HOPE (4673). The National Suicide Prevention Lifeline is 1-800-273-TALK (8255).Felice J. Freyer can be reached at firstname.lastname@example.org.