Quelling a quiet epidemic

The 12-year-old had attempted suicide before. Psychologists had warned of suicidal tendencies. The year before, he’d been a patient at West Hills Hospital in Reno. When a social worker closed his files, his case was considered “a great success.” But months later, while living with his father, he was still talking about suicide. One day in May, the boy told people at his school in Virginia City that he intended to take his life that night.

Yet nothing—and no one—stopped Michael Echo that day from shooting himself with a rifle. The boy was found dead just before midnight on May 21, 2002.

“There was no follow-up by the school,” the boy’s mother, Marie Echo, told a legislative committee last week. “There was no follow-up by the Department of Family Services. There was no follow-up by anyone. Michael still wanted to die. He provided all the warning signs.”

The distraught mother tearfully testified in support of several bills that came out of a legislative subcommittee that studied suicide, one of the leading causes of deaths for nearly all age groups in Nevada. One bill, SB 49, would create a statewide program for suicide prevention. Though the plan is anticipated to cost about $355,000 in the next biennium, staff of the new office would work to receive additional funding through grants. Another bill, SB 36, would authorize regional training in suicide prevention to teachers and administrators of public schools.

“If there had been a suicide prevention plan in place for schools and the community, Michael might have been recognized as high risk,” Echo said. “I don’t know that if every precaution had been taken Michael would still be here. But I know that, without a plan, some day another mother’s last image of her 12-year-old son will be lying in a box with a bullet hole in his forehead. Give another mother one more chance to hold her child.”

Echo was one of several surviving family members who testified at a Senate Human Resources and Facilities hearing March 7 on the suicide prevention bills. A Las Vegas woman told of her mother leaping from a sky rise. A mother told of her seventh-grader who hanged himself in the basement. A wife recalled the moment she first learned that her husband of 24 years had killed himself. A man told of reading the suicide note left behind by a Clark County elementary-school teacher.

After three hours of testimony, the committee unanimously passed the two bills, along with Senate Concurrent Resolutions 3, 4 and 5. SCR 3 “urges each community in Nevada to form a coalition of agencies and service providers to reduce the number of suicides and provide support for survivors.” SCRs 4 and 5 urge Clark County to boost public awareness of and establish a plan for suicide prevention.

More than half the suicides in Nevada occur in Clark County, which has no coordinated resources for those at risk. A suicide hotline (1-800-SUICIDE) for Las Vegas connects callers to the Crisis Call Center in Reno, which is staffed by volunteers from northern Nevada.

A public-awareness campaign for Clark County is already under development, said Mike Bernstein, a health educator for the Clark County Health District. In late April, print advertisements and radio spots will refer those at risk for suicide to the Crisis Call Center and to a Web site that is still under development, www.suicidehelpnv.org. The site should be up by late April. It’s integral to the campaign’s effectiveness with younger people who’re looking for help, Bernstein said.

“Teens don’t call hotlines,” he said. “But we know that 20 percent of them are thinking about suicide and one in 10 attempts it. We’re hoping the Web site is [a] more private [option].”

Nevada has led the nation in its suicide rate for several years, according to the Legislative Counsel Bureau’s Study of Suicide Prevention. Between 1995 and 2000, suicide ranked as the fifth-leading cause of death for all ages in Nevada—outranking motor vehicle accidents, diabetes and Alzheimer’s. The suicide rate during that period was more than double the homicide rate—and triple the rate of those dying from HIV-related causes.

Surprisingly, the high suicide rate is not heavily skewed by tourists, according to the study. Nearly 90 percent of Nevada’s suicide victims are residents of the state.

“We obviously haven’t paid a great deal of attention to what has been a serious problem,” said Sen. Randolph Townsend (R-Reno).

Sen. Dennis Nolan (R-Las Vegas), who sat on the Legislature’s interim Suicide Prevention Study Subcommittee, works part time for the Clark County Coroner’s Office. In his 15-year career, Nolan told the Senate committee, he’s had four co-workers commit suicide—three with handguns. A few of his high-school friends, over the years, have also taken their own lives. The 41-year-old senator hadn’t realized that Nevada’s problem was an epidemic, “until I started seeing it with my own eyes,” he said.

These days, a person walking into the Coroner’s Office in Clark County on any given day can look at a large board listing victims and the manner in which they died, he said.

“You’ll always see two or three with a ‘405’ written next to them, which means suicide,” Nolan said. “It’s especially tragic when young people are not equipped to deal with the issues they’re faced with—or they think they’re not equipped. Their last act, their last decision is an eternal decision. … People of all statures of life face this decision.”

Members of Nevada Families Eagle Forum had planned to protest what they thought was legislation that called for suicide education programs in the schools. But their opposition was forestalled by the careful wording of the bills. SB 36 does not propose classroom instruction in suicide prevention—only the training of teachers and administrators in how to identify and where to refer a student at risk.

NFEF President Janine Hansen was also concerned about the possibility of a statewide suicide prevention program becoming a gun control campaign. More than 1,500 suicides in Nevada between 1995 and 2000 involved firearms.

Hansen noted that the LCB’s Suicide Prevention Study lists such recommendations as “reducing access to lethal weapons” as a means of curbing suicide. Government funding for government programs, Hansen said, shouldn’t be used to try to limit access to guns.

“I’m concerned that this could jeopardize our right to keep and bear arms,” she said. She blamed the rise in suicides on a variety of things, including the removal of God from schools and psychotropic drugs like Prozac and Zoloft. She passed out a packet of information to legislators that included the sheet music for a Sunday-school song, “I Am a Child of God.”

“I learned that song as a child and it’s helped me over the years,” Hansen said. “I’ve battled depression my whole life. I’m not unaware of the difficulties people face. … I believe that the best suicide prevention is this [holding up a Bible], not this [holding up a book on Prozac].”

After the bills had been approved by the committee members, Sen. Ray Rawson (R-Las Vegas) cautioned Hansen and others not to confuse efforts intended to help suicide prevention programs with other red-flag issues, such as gun control.

“This is an important enough issue not to get it tied up with that,” Rawson said. “Use some wisdom and keep people from getting hurt."On Tuesday, the Senate adopted SCRs 3, 4 and 5, sending them on to the Assembly. SB 49 was referred to the Senate Finance committee. No action was taken on SB 36.One of the state’s leading advocates for suicide prevention programs, Linda Flatt of Las Vegas, applauded the committee’s vote.

"[Suicide] is preventable—if those around a person know what to look for and know what to say," she said. "It’s clear that this is not a problem that’s going to go away by itself."