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Suicide numbers up in rural Iowa

BY TYLER HARRIS | JUNE 11, 2010 7:30 AM

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Rural Iowa is made up of small towns. Farmhouses dot the countryside amid long stretches of corn and soybeans.

It’s quiet, safe, and simple.

But these rural areas have a problem: Suicide rates are alarmingly high, and prevention spending and resources remain limited.

It’s something Jack Larew knows too much about.

His son, John Larew of Lone Tree, committed suicide in 1991.

The 34-year old father of two enjoyed farming and frequent deer hunting, and he had played football for the local high-school team, the Lions.

“He was a pusher,” said his father, sitting in the local BP store, one of two gas stations in the town of just more than 1,000.

But John Larew suffered bouts of depression and problems in his marriage, his father said.

Jack Larew, a retired farmer, has been dealing with the death of his son for nearly two decades.

“You hate to see your son die before you do,” he said. “You can’t prevent everything.”

Numbers on the rise

Rural communities make up 89 of Iowa’s 99 counties. Roughly half of the state’s population lives in those counties.

And it’s in those communities that officials are seeing alarming numbers:

• From 2000 to 2008, 1,568 people committed suicide in rural counties of Iowa, versus 1,382 in the state’s urban parts.

• The suicide rate of from 2000 to 2008 in rural counties was 11.36 per 100,000 population; it was 10.82 in urban counties.

• In 2008 alone, the rate for rural counties was 13.55 — the highest the average in Iowa has been since 2000 — and it was 11.46 in urban counties.

Numbers have steadily increased in Johnson County, too, jumping from 19 in 2008 to 39 in 2009. County Medical Examiner Mike Hensch said he has noticed an increase in depression-related suicide.

At higher risk

While suicide affects all parts of the state, features unique to rural Iowa put those living there at a higher risk.

They are less likely to talk about mental-health issues, which often precede suicide, said Stephen Trefz, the executive director of Community Mental Health Center in Iowa City.

Dale Chell of the Iowa Department of Public Health said farmers tend to be self-resourceful, relying on themselves to solve many of their problems, so they are less likely to seek mental help, especially from licensed professionals.

“You don’t see many farmers at the [grain] elevator saying, ‘I’m going to go see my therapist,’ ” Trefz said.

Farmers and ranchers are among the highest risk groups, he said, likely because of the physically strenuous work.

The problem may be compounded by the prevalence of guns in rural areas.

“About everyone around here [hunts],” Larew said.

Of the 1,568 deaths in rural counties since 2000, 846 were by firearms. In urban areas, 580 have killed themselves with guns. In Johnson County, firearms also accounted for the largest number of suicides — 59 out of 139.

And people don’t talk about suicide, either.

Mallory Hall, an Iowa State University student from the small town of DeWitt, said she didn’t know anything about suicide growing up.

But since she was in eighth grade, she says she has known four people who have committed suicide.

“Parents don’t want to bring it up,” the sophomore said. “It’s a really uncomfortable subject for a lot of people.”

Recent tough economic times also had an effect, following a similar pattern to that of the farm crisis in the mid-1980s, Chell said.

People in urban areas such as Iowa City know where to seek help, Trefz said, because they often walk by signs every day. But in rural areas, these centers can be simply a small clinic with nothing indicating the services provided.

The percentage of their budgets spent on mental health services is often lower in rural areas, and a shortage of psychiatrists contributes to the problem.

While an urban county such as Black Hawk had as much as 30 percent of its budget devoted to these services in 2007, a rural one such as Adams had as little as 6 percent, according to the Iowa Consortium for Mental Health.

In the absence of help provided by the state or county, many turn to local churches for solace.

“I have had people talk to me about those situations,” said the Rev. Diane Townsley of the United Methodist Church in Oxford. “The church should be there for anybody who needs it.”

But while church leaders may be willing to help, Townsley said, they generally lack any specialized training required for suicide prevention, and people may be afraid to talk to religious leaders who may frown upon suicide.

Getting help

Getting help in rural Iowa is still difficult, but some rural communities have implemented Teen Screen, an instrument created by Columbia University in 1991 to identify students who are at risk of committing suicide and potentially suffering from mental illness.

“This program is excellent because in a rural environment like ours, we lack the resources,” said Amy Fessler, a guidance counselor at North Central School in Manly, Iowa. “With only two or three psychologists in our vicinity, children have to wait weeks or months to get an appointment — it’s ridiculous.”

The 300-student school implemented the program after a student committed suicide during the 2006-07 school year.

“A huge factor about mental health is the stigma attached — children just don’t like to talk about it,” Fessler said. “Hopefully, programs like these can open them up.”

And the Johnson County Crisis Center is extending to rural areas to reach people of all ages.

“We recognized that that’s one area that we currently don’t reach out to very well,” said Keri Neblett, who works for the center. “In the past we haven’t done a whole lot of outreach.”

She described a situation when the Crisis Center put on a program that shared a video on suicide. After showing the video, one man who attended said he had been considering suicide.

“He had never heard of the Crisis Center before,” she said.


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