Officials in Montana wrestle to explain reasons why the state has the highest rate of suicide in the US at nearly twice the national average and its rising Kevin Lowney lies awake some nights wondering if he should kill himself. I am in such pain every night, suicide has on a regular basis crossed my mind just simply to ease the pain. If I did not have responsibilities, especially for my youngest daughter who has problems, he said. The 56-year-old former salesmans struggle with chronic pain is bound up with an array of other issues medical debts, impoverishment and the prospect of a bleak retirement contributing to growing numbers of suicides in the US and helping drive a sharp and unusual increase in the mortality rate for middle-aged white Americans in recent years alongside premature deaths from alcohol and drugs. A studyButte-Silver Bow Community Health Needs Assessment for 2014 23 faced obstacles to receiving needed healthcare. About one-third said they could not afford the cost of the doctor or prescription. Nearly 8 said they skipped or reduced prescription doses in order to save money. Kristen Ryan is among them. She works with children with disabilities in Butte. Her husband is a maintenance engineer at an elementary school but has two additional part-time jobs, including bar shifts, to bring in extra cash. Its to keep our head above water, to keep our kids in clothes and hot lunches. We make too much money to get help but it still is difficult, she said. The couple owns a small house Ryan bought when she was single but it only has two bedrooms to house four children and they cannot afford to buy a bigger place. Ryan and her husband both have health insurance through their jobs but they hesitate to go to the doctor because they have to meet the first $5,000 of treatment costs. It has to be something pretty significant for me to go and the same for my husband, she said. I see that in my husband where his back will hurt or hes got a funky foot and sometimes hes in a lot of pain but he wont go because he knows that its going to end up costing a lot of money just to see the doctor.
Chronic pain and suicide The Princeton study and Rosston both identified chronic pain as a big driver of suicide among middle-aged people. The typical death certificate that I often read is a typical 55-year-old male who is having chronic pain issues in his back and is not being treated, he said. We know nationally that about 30 nationally since 1999. Montana has 82 painkiller prescriptions for every 100 people.
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Case and Deaton say that addictions are hard to treat and pain is hard to control, so those currently in midlife may be a lost generation whose future is less bright than those who preceded them. Sullivan thinks it is less bright for other reasons. She said for many the prospect of retirement is a fresh crisis. Where people landed in life, expecting to exceed what their parents accomplished, really is at play in our country, she said. Once you retire, youre on a fixed-income when life becomes more interesting and not in a good way. What do you do with your limited income? Lowney had to cash in his small pension of $17,500 to pay medical bills. Ryan sees no prospect of retiring. My job cut the employer contribution to my pension a couple of years ago. I prefer not to think about that because I know I dont have anything. Its very small. Its not going to be enough to live on, she said. I think public housing or something like that might be in our future as we get older because I dont know that were going to be able to do it on our own. We owe my mother-in-law quite a bit of money because sometimes more goes out than comes in. You dont expect to have to borrow from your parents at this age. You would hope that they would be able to borrow from you if they needed to but thats just not the way that its turned out. The Princeton study also notes that a higher proportion of middle-aged suicides are among people who have less than a university education, suggesting they are more likely to be in lower income jobs and more severely affected by growing economic inequality. Rosston sees that in Montana too. I actually review every single suicide that occurs in the state and we see that a very high percentage about 8020PRC20Report20Butte-Silver of the people who take psychotropic medication in Montana have never even spoken to a psychiatrist, he said. Also, theres a stigma when it comes to mental illness. We have that kinda cowboy mentality, frontier mentality of taking care of your own, and people see depression as a weakness. The words I often see when I review suicides is that the person thought they were a burden. That they werent serving a purpose anymore or theyre tired of dealing with things. When you feel that way, youre not going to ask for help. Originally found athttp://www.theguardian.com/us
Financial despair, addiction and the rise of suicide in white America
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