Julie Rifkin's chances of killing herself were already high because she lived in Colorado.
That was the woeful summary of some health advocates as a throng of well-wishers gathered last Saturday to remember Rifkin and her two boys, Nathan, 13, and Gabriel, 12. Rifkin shocked Colorado Springs after shooting her sons, and then herself, about a week earlier.
Friends say Rifkin suffered from a psychiatric illness and had no health insurance. That was a potentially lethal combination in a state where the suicide rate is roughly 40 percent higher than the national average, said Cynthia Zupanec, a spokeswoman for the nonprofit Pikes Peak Mental Health, which serves psychiatric patients in the region.
As funding for mental-health and substance-abuse programs has been cut by 30 percent in the last three years, patients are increasingly being turned away, she said. Many wind up in emergency rooms, like Memorial Hospital's, which deals with 400 patients with such problems each month -- a staggering 13 a day.
About a third of them are held for further evaluation.
Last week, Ted Haggard, the pastor of New Life Church, where Rifkin attended, publicly scolded the hospital for not holding Rifkin. A friend of Rifkin's called 911 on April 22, alerting a dispatcher that Rifkin had threatened to kill herself along with her sons. Police took Rifkin to the hospital, but she was released shortly thereafter. The next day she went to a pawnshop, bought a gun and carried out her threat.
Chris Valentine, a spokesman for the hospital, said he could not speak specifically to Rifkin's case, citing a federal privacy law. However, he explained that a licensed clinical social worker and doctor qualified to handle patients with psychiatric illnesses are available 24 hours, seven days a week.
The hospital can put a 72-hour hold on patients who are an "imminent danger" to themselves or others, he added.
Darrell Williams, president the local Depression and Bipolar Support Alliance's board of directors, said the emergency room would have also grappled with the law, struggling to know if it was appropriate to impede Rifkin's freedom.
"She might have said she was no longer feeling [suicidal]," he said. "Then what do you do?"
Her husband, Donald Rifkin, was working out of state when his wife killed herself.
At the memorial, Gayle Haggard, Ted Haggard's wife, alluded to Rifkin's problems, among them the recent loss of a job.
"There were many struggles and sadnesses in Julie's life," she said.
She noted Rifkin, who often rose to help others, was a "perfectionist" and "very intense at times."
Turning to Donald Rifkin, Haggard told him that she knew his wife loved him and that she (Julie Rifkin) "was amazed you loved her."
That left the director of the support alliance, Karen Fallahi, who attended the service, reading between the lines.
People with severe depression may doubt they are worth such affection, she said.
-- Michael de Yoanna