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We Want Luke's Life to Count 

Health care workers scramble as local suicide rates reach epidemic proportions

Luke Dawson didn't kill himself. And still, he fell victim to El Paso County's suicide epidemic.

Dawson, a recent 20-year-old graduate of Air Academy High School, died the morning of March 12 while taking a bath in the Palmer Lake home that he shared with two housemates. He fell asleep, never to wake up again, as he unwittingly inhaled carbon monoxide fumes.

The invisible, odorless fumes had oozed upstairs from the garage adjoining the house. There, one of his housemates, 40-year-old Greg Stitch, was already dead. Stitch had started his beat-up old Plymouth Duster and sat in it with the garage door closed, waiting for the carbon monoxide to fill the garage and poison him to death.

Those who knew the two say Stitch would never have hurt Dawson intentionally. Dawson's death due to another man's suicide was, statistically speaking, a freak incident.

But it could have been prevented.

Earlier that night, Stitch had asked fellow patrons at O'Malley's Pub in Palmer Lake, just down the road from the house, about how he could get a gun to kill himself.

Earlier yet, he had expressed suicidal thoughts to Mike Thompson, the owner of the house where Stitch, Dawson and Thompson all lived.

No one intervened. No one offered any help.

If someone had, Stitch and Dawson might both be alive today, says Dawson's half-brother, Dan Taylor.

Always a smile

Stitch and Dawson were just two of the more recent victims of what state and local experts refer to as a suicide "epidemic." Last year in El Paso County, 95 people killed themselves -- about one out of every 5,000 residents of El Paso County -- according to the Health Department.

That's an increase of 30 percent from the previous year, when the number was 73.

To his grieving family, Luke Dawson was no statistic.

"He was our future," Taylor said of his brother. "We [won't] get to spend holidays with him, see him have kids."

Taylor, 37, raised Dawson from the time he was 9, when their mother died of an acute asthma attack. Dawson, who had never known his father, moved from Security to join Taylor and his wife in Oklahoma City. The family moved a number of times over the years, but they eventually settled down in a quiet neighborhood in northwest Colorado Springs.

"I'd made him a promise that he'd go to one high school," Taylor said.

Ever since he was 3, Dawson was an avid fisherman. He also played baseball. "He always had a smile of his face," Taylor recalled.

After graduating from high school, Dawson wasn't sure what he wanted to do. He enrolled in some classes at Pikes Peak Community College but dropped out and took a factory job at a company that manufactures compact discs. Just a few weeks before he died, he had moved into Thompson's house and was talking about going to work for Thompson, who was in the dairy delivery business. He'd also been talking about pursuing his passion for fishing by opening his own tackle shop.

Stitch was well-liked by friends and had a good job working for a highway striping company, Thompson says. He loved to ride his Harley-Davidson motorcycle. Like Dawson, he also enjoyed fishing.

The three housemates would sit around in the bachelor pad, complete with a big-screen TV and a pool table, and "shoot the shit," Thompson recalls. "We had a great time."

But Stitch, who had just finalized a divorce after being separated from his wife for several years, had serious problems.

"He was a big-time alcoholic, and that's what did him in," Thompson said. "He also did some drugs that stupid meth shit." (The coroner, in examining Stitch, found both alcohol and methamphetamine in his system.)

In an interview, Thompson said Stitch left only "little hints, maybe," that he was suicidal. However, according to a police report, Thompson told police that he and Stitch had been out playing pool on March 9, at which time Stitch had been depressed because his divorce was about to be final on March 11.

Stitch "wondered how much trouble it would be to get a gun," the police report says, "and Mr. Stitch had related that he was contemplating suicide." Thompson's response was that "no guns were allowed in his residence."

On the evening of March 11, according to Taylor, Stitch had again asked fellow patrons at O'Malley's about how to get a gun, saying he wanted to kill himself.

"Nobody stopped to help the guy," Taylor said.

The next morning, Stitch ended his own life, and accidentally Dawson's, by carbon monoxide poisoning. The last person who spoke with Dawson was Taylor, who called his brother on his cell phone at 8:30 a.m. The two had planned to meet for lunch to talk about Luke's plans to open a tackle shop, and Taylor was calling to confirm. "He sounded a little groggy," Taylor recalled. "I thought it was allergies."

The two agreed to meet at 11:30. Dawson never showed.

Stitch was found the following day by a friend of Thompson's, who was using the garage to do some work. Police found Dawson upstairs in the tub.

Numbers are disturbing

El Paso County's jump in suicides could be a statistical blip, say local health workers and others involved in suicide prevention. Still, 95 suicides translates into one county resident committing suicide -- or "completing" suicide, the preferred term in the suicide prevention community -- every four days.

"The numbers [are] just really disturbing," said Kim Nolen, the injury prevention specialist for El Paso County's Health Department, who is working with local nonprofits to boost suicide-prevention efforts.

Consider it this way: Last year more people killed themselves than died from homicides and traffic accidents in the county -- combined.

And that's just using official numbers -- those reported by the coroner. While there are no official estimates of how many unreported suicides take place, many experts believe the total number of suicides, locally as well as nationwide, may be at least twice as great as the number that's officially reported.

"The problem is a lot bigger than anyone realizes," said Dale Emme, a board member of the Suicide Prevention Coalition of Colorado.

Dr. David Bowerman, El Paso County's coroner, said it's virtually impossible to accurately classify all suicides. "It's very difficult, as a medical examiner, to be absolutely certain."

When a person shoots himself in the head -- the preferred suicide method for men -- it's usually easy to determine that it was a suicide. And when someone leaves a suicide note, that's also evidence. But notes are only found in about one out of four cases, Bowerman said.

And, he pointed out, when someone overdoses on drugs -- the preferred method among women -- it's often tough to say if the suicide was intentional.

If there's reasonable doubt, Bowerman is reluctant to classify a death as suicide. Part of the reason is that many families don't want such a classification. There's still a great stigma attached to suicides; families are often ashamed and feel guilty. Sometimes there are religious reasons. The Roman Catholic Church has traditionally taught that suicide is a sin equivalent to murder and used to deny Christian burials to some suicide victims.

There are also practical considerations. In Colorado, insurance companies won't pay out life-insurance policies on people who have completed suicide during the first two years of the policy. Sometimes, insurance claims in these cases end up in court. "If you say that they are suicides, then you better be able to produce evidence," Bowerman said.

Challenging stereotypes

A closer look at the suicide statistics also challenges popular stereotypes about typical suicide victims being troubled teenagers or depressed women.

Locally and elsewhere, suicide rates -- calculated as suicide deaths per 100,000 residents -- are highest for the elderly, a phenomenon usually attributed to the fact that many old people are lonely and have health problems.

But in absolute terms, the greatest number of suicide deaths occurs in a different demographic. In fact, the typical suicide victim in El Paso County, as well as the rest of Colorado and the United States, is a middle-aged, white man.

Last year, 69 of the 95 reported suicides in the county were completed by men. More than half of those men -- 36 -- were between the ages of 30 and 59.

And in the decade between 1991 through 2000, an estimated 88 percent of all the people who killed themselves in El Paso County were non-Hispanic whites. (Non-Hispanic whites made up 76 percent of the county's population in the 2000 U.S. Census.)

"If you look at the largest group of people we're losing, it's the Caucasian male," Emme said.

Meanwhile, teen suicides are clearly a problem, experts say. In a 2001 survey of Colorado high-school students, conducted by the state Health Department, 19.3 percent of the students surveyed reported they had "seriously considered" suicide in the past 12 months.

Last year, eight people ages 19 and younger killed themselves in El Paso County; the youngest was 13 years old. This year, in just the first three months of 2002, three teenagers under the age of 17 killed themselves, according to the county Health Department.

And Tom Agnew, executive director of the Pikes Peak Suicide Prevention Partnership, the main local nonprofit group combating suicides, says he knows of additional local teens who have killed themselves since April 1.

"I'm really concerned," Agnew said.

Overall, El Paso County's statistical patterns roughly mirror the rest of Colorado, which usually finds itself in the top 10 states for annual reported suicides. Most of the states with the highest suicide numbers are located in the Mountain West.

Each year in Colorado, about 600 people kill themselves which is about the same number who are killed in traffic accidents, and greater than the number of homicides. Nationwide, the annual number of reported suicides is about 30,000. That places suicides among the top-10 killers in the country, and it would probably be in the top-five if it were accurately reported. In Colorado, it's the second-leading cause of death for teen-agers.

Statistics on suicide attempts are even more staggering. The National Center for Health Statistics estimates there are 750,000 annual attempts in the United States, and that 5 million living Americans have tried to kill themselves at some point.

The taboo subject

Almost all efforts to explain suicide statistics amount to speculation, because little research has been conducted on the issue. Suicide continues to be largely an ignored epidemic, experts say, because it's historically been a taboo subject due to the stigma attached to it.

Some attribute the high rates of suicides in the West to the region's culture of rugged individualism, combined with the fact that many residents have moved here from someplace else, leaving behind their old support networks of family and friends.

Others note that the region's economy has transformed itself, with many small ranches, farms and mining operations going out of business in recent decades. The adjustment may have been hard to handle for many proud, hardscrabble farmers and ranchers who were raised on the idea that they could support their families off the land, says the Suicide Prevention Coalition's Emme. "A lot of it comes back to a feeling of failure."

Supporting that notion is the fact that, in Colorado, suicide rates are significantly higher for rural areas than for urban areas, and they are also higher for the Western Slope than for the state as a whole.

Yet another explanation is a general lack of mental-health services in much of the West. According to Dr. Tom Barrett, director of Colorado Mental Health Services, the region suffers from a severe shortage of mental-health professionals. And more than 90 percent of suicide victims suffer from depression, another mental-health problem, or substance abuse, says Barrett, who also served as co-chairman of a state commission on suicide prevention.

According to Barrett, an estimated 169,000 Coloradans suffer from serious mental health problems. Of those, only 77,000 are getting help.

"We have a very serious problem in Colorado," Barrett said.

Nolen, of the El Paso County Health Department, says it's a common complaint locally that people who are seeking help regarding suicide end up being "passed around."

"A lot of people are not getting the response they need," Nolen said.

As for why so many white, middle-aged men complete suicide, some speculate that it's a group of people who may feel less comfortable seeking help or expressing their feelings to others. They may also face greater pressure than others to succeed as breadwinners.

The male-female ratio among reported suicides might be a bit skewed, speculated Bowerman, El Paso County's coroner, due to the difficulty in classifying drug overdoses (the preferred method among women) as suicides. Statistics on attempts suggest that more women than men actually attempt suicide, even though far more male deaths end up being reported.

The increase in suicides in El Paso County last year could be due to the downturn in the economy, notes Nolen. It could also just be a blip; the statistics for the first quarter of 2002 suggest the total for the year could go down from last year. No way to escape

The reasons people kill themselves are also not well understood from a scientific viewpoint, partly due to the obvious reality that victims can't be interviewed. But as Barrett notes, a great majority are believed to suffer serious depression or other mental-health problems.

Agnew, whose own son killed himself two years ago after struggling with depression, believes most suicide victims don't truly want to die but see no other way to escape their anguish. He compares them to the people who leapt from the top floors of the World Trade Center after the terrorist attacks. "Did they want to die? No. But did they want to get away from the pain, the heat and the flames? Yes. I think that's a pretty good parallel."

The high suicide rates translate into more than just personal losses, Agnew says; they also amount to a loss to the community.

For example, when a local 13-year-old completed suicide last year, "that person had talents and would have developed skills, and the community loses that," Agnew said.

When a 97-year-old killed himself, "he took with him history -- family history, city history, the history of the nation -- and that's a loss to the community."

Agnew estimates that suicides and attempted suicides in El Paso County last year cost the community $10 million in terms of criminal investigations, medical expenses and autopsies. If you calculate how much those who killed themselves could have contributed to the economy over their lifetimes, the economic loss may be as much as $100 million, he says.

Driven by survivors

Despite a historical lack of organized efforts to combat suicides, the tide appears to be turning slowly.

In 1998, then-Colorado Gov. Roy Romer agreed to form an advisory commission on suicide prevention, which has led to the creation of a suicide prevention office in the state Health Department.

Last year, U.S. Surgeon General David Satcher announced a newly developed national strategy to combat suicides. The strategy includes adding more suicide-prevention programs in schools, colleges, jails and workplaces; strengthening requirements that health-insurance plans cover mental health and substance abuse; encouraging doctors and nurses to ask at-risk patients about the presence of firearms, drugs and other lethal weapons in their homes; and using public-service announcements.

Most suicide-prevention efforts, however, have come from the grassroots level -- driven mainly by survivors.

In 1980, Colorado Springs resident LaRita Archibald formed Heartbeat, a local support group for suicide survivors. Archibald and her husband had lost their 24-year-old son to suicide in 1978, and she quickly realized there were few places for survivors to go for support and help.

Within 18 months, the group's monthly meetings drew dozens of people, coming from as far away as Kansas. It was one of the first groups of its kind anywhere, Archibald says. Today, there are Heartbeat chapters all over Colorado, and similar groups all around the country.

Heartbeat is now the "aftercare" component of the Pikes Peak Suicide Prevention Partnership, a volunteer-driven organization that also focuses on prevention through education, and intervention through the operation of a suicide hotline, which gets about 700 calls per year. The partnership is affiliated with the Suicide Prevention Coalition of Colorado, which in turn is affiliated with the National Council for Suicide Prevention.

It has taken decades for survivors to first overcome the traditional stigma of suicide, and then to organize and become a force that can press for change, says Emme, a founding board member of the national council. Today, the local, state and national prevention partnerships work directly with government officials to improve prevention efforts and promote research.

Colorado, through the statewide prevention coalition, is the only state in the country that is looking at targeting all age groups with its prevention efforts, Emme says. Other states have tended to focus such efforts on teen-agers and the elderly.

"We're actually on the cutting edge here," Emme said.

Targeting churches

In El Paso County, the Health Department entered into an agreement last year with the local Suicide Prevention Partnership and Pikes Peak Mental Health to help combat suicides.

"It's a preventable-health issue," Nolen said. "We believe that through education and teaching people about suicide and the warning signs to look for, [suicides] can be prevented."

Part of the effort will be to promote public awareness by developing a speaker's bureau, including survivors and mental-health experts, who can speak at schools, churches and workplaces.

"We're targeting churches to start with, with the hope that we can reach some of that middle-aged population," Nolen said.

She said another goal is to improve the coordination of local mental-health and suicide prevention services, so that it's easier for people to get the help they need.

There are, however, obstacles to overcome. For instance, organizers will need to identify funding sources for the efforts, which will likely be in the form of grants.

Agnew said it's also been problematic in the past for speakers to get into some local schools. Some school officials still consider suicide a taboo and seem to believe that talking about it might actually encourage teenagers to do it, Agnew says -- an idea he rejects. Education and awareness, he says, are essential weapons in the fight against suicide.

"If I'd had any of the information two years ago that I have now, maybe my son would still be alive," said Agnew, who knew little about suicide and its warning signs at the time. "Maybe I would have reacted differently. Maybe I would have taken his depression more seriously."

Taylor, whose brother fell victim to his roommate's March suicide, agrees.

"I don't think talking about things makes people more prone to do them," he said.

If his brother's housemate,Thompson, had been more educated on suicide, he might have taken steps to intervene when Stitch began talking about killing himself, Taylor says. Instead, "his attitude was, 'Don't do it in my house.'"

Likewise, the bar patrons who heard Stitch asking for a gun could have done something. "That was his last attempt to get some help," Taylor believes.

Taylor calls Thompson a "good guy" and said he doesn't hold him accountable for his brother's death. However, "his attitude was partly responsible for the whole thing. Society's attitude is responsible for the whole thing. It's a taboo subject. We don't talk about it."

Thirty years ago, people didn't talk about drunken driving, either, Taylor notes. Since then, drunken-driving deaths have been reduced thanks to public awareness and education. Likewise, education and awareness have helped decrease tobacco use and increase the use of seat belts in cars.

Taylor isn't just talking the talk when he advocates education; he's also walking the walk. He has signed up to be part of the local suicide prevention speaker's bureau, hoping that talking about his brother will help increase awareness.

It's one way that Taylor and his family are trying to make meaning out of his brother's death.

Said Taylor, "We want Luke's life to count."

capsule

If you or someone you know is contemplating suicide, call the local suicide hotline, 596-LIFE (596-5433). The hotline is staffed by trained volunteers, and callers can remain anonymous. In an acute emergency, call 911.

For information about the Pikes Peak Suicide Prevention Partnership, or to volunteer, call 573-7447.

The Warning Signs Warning signs of suicide include when a person is:

seriously depressed

increasingly isolated

giving away prized possessions

doing poorly in school or at work

making statements about wanting to die

acting violently

taking unnecessary risks

threatening to commit suicide

suddenly happy for no reason after a long depression

abusing drugs or alcohol

One of these signs may or may not signal trouble. More than one sign often means that some help is necessary.

What to do:

Listen. Discuss a threat openly and calmly. Ask if the person has a plan. A detailed plan indicates immediate risk.

Show concern and support. Suggest alternatives. Encourage the person to seek help.

Get professional help from a counselor, mental-health professional or crisis prevention center. If the person refuses, do not worry about being disloyal; contact a reliable family member or call a professional and seek help yourself.


What not to do:

Do NOT keep it a secret.
Do NOT sidestep the issue or treat it lightly.
Do NOT leave the person alone.
Do NOT offer simple solutions.
Do NOT judge.
Do NOT offer or suggest drugs or alcohol.
Do NOT try to be a therapist get professional help.

SOURCES: Pikes Peak Suicide Prevention Partnership, Colorado Department of Health.

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