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The Suicide Clusters Threatening Mountain Towns

The Suicide Clusters Threatening Mountain Towns

In 2017, the suicide rate in Durango, Colorado, was three times the national average. After 32 deaths in two years, the town’s leaders banded together and instituted a range of changes with the goal of stopping the contagion. Their efforts may help other mountain towns to put an end to the grim “suicide belt” moniker for good.

Outside Online | September 4, 2018

By Kate Siber

Click here to read the story on Outside magazine’s website.

Five years ago, Aleah Austin moved with her family from LaCrosse, Wisconsin, to Durango, Colorado. The then-ten-year-old was sad to leave her family’s deep roots in the Midwest, so to help ease the transition, her parents signed her up for Durango DEVO, a popular local nonprofit program that teaches kids as young as two years old how to ride mountain bikes.

Aleah showed up at practice with a clunky Giant with 24-inch wheels, and she was well behind the other fifth-graders, who had new 26-inch bikes and years of experience. She’d get frustrated and upset, but two of her coaches, Tricia Shadell, then 33, and Tina Ooley, then 40, both racers, stayed in the back with Aleah and patiently encouraged her. “It doesn’t matter what everyone else thinks,” they’d say. “It’s just about what you think.”

Over the years, as many girls hit adolescence and dropped out of sports, Aleah stuck with it, and she and her coach Tricia became particularly close. Strong and beautiful, Tricia always seemed upbeat and had a way of making each of the girls feel special. “I came here and was, like, so afraid of mountain biking,” Aleah says. “Trish taught me how to ride downhill and keep my feet on the pedals and stand up and go off jumps and stuff.”

Standing 5’10”, with dark wavy hair, Tricia was a beacon of athleticism and fun. She had what seemed like a full life as a bike racer, coach, and massage therapist. Intensely extroverted, she was a wellspring of enthusiasm. She wore outrageously colored pants and tutus on her rides. When the girls rocked out to Taylor Swift, Tricia was the first to throw glitter all over the place. When they were at a restaurant and a live band struck up, she would make them get up and dance. The girls worshipped her.

Aleah was a 14-year-old high school freshman last November 2017 when she found out that Tricia Shadell had died by suicide the evening before. Tricia had posted a cryptic message on Facebook just before she died, and word quickly spread through the small town. Aleah’s mom, Amee, heard about Tricia’s death from another teacher and called her husband, Jason, who was driving his daughter to school.

Aleah is small for her age and reserved, her heart-shaped face framed by an unruly halo of light-brown curls. After hearing the news, she stared out the passenger’s side window, expressionless. She didn’t cry. Jason detoured away from the high school and dropped her off at Amee’s office. Shocked and numb, Aleah sat with her mom, her wide eyes beginning to tear up. “I didn’t really understand,” Aleah says now. “It didn’t seem real.”

Later that day, Aleah met up with her mountain biking friends. They were confused, angry, sad. Their faces streamed with tears, but Aleah’s mind was consumed with questions. Why? When? How could Trish have killed herself? She always seemed so happy.

The next morning, DEVO’s founder, Sarah Tescher, sent an email to parents. She also organized a candlelight vigil that evening at a gazebo downtown. Friends gathered silently and cried in the flickering gloom. For weeks, it was as if no one in the outdoor community quite knew what to do with their feelings—guilt, devastation, anger, disbelief. But the worst was the concern for the children who knew Tricia.

“For the kids, Tricia was a sparkly unicorn,” Tina Ooley says. “She really was. That’s what the girls saw. To have this happen, they questioned everything.”

*

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Tricia Shadell’s death was one of 19 suicides in Durango and the surrounding La Plata County in 2017, a figure almost three times the national per-capita average. The year before, 13 people took their own lives; in 2015, 12 did. (Figures are based on the coroner’s records, but suicides are sometimes miscategorized or unreported.) Locals are desperate for answers, but there are few discernible patterns to the deaths over the past few years. They were mostly Caucasian, but also included Hispanic, Native American, and Asian people; men, women, and boys; an elementary school teacher, a construction worker, a retiree, an eighth-grader. They ranged in age from 12 to 85.

“People are, like, what the hell is going on in our community?” says Jessica Reed, a child therapist and mountain bike coach with DEVO. “Why is everyone so sad?” The question has ricocheted not only inside therapists’ offices but also on group bike rides, hikes among friends, and barstools across this mountain town, which is known for its natural beauty and regularly makes best-places-to-live lists like Outside’s.

Suicide has become a national concern. A June report from the Centers for Disease Control and Prevention found that suicide rates rose by more than 30 percent in half of all states since 1999. The problem is especially severe in Rocky Mountain states, which have some of the highest suicide rates in the country outside of Alaska, earning the grim moniker of the “suicide belt.” The picture-perfect resort towns of the mountain West are no exception, and several have struggled with their own suicide clusters. The rates in these communities may not be consistently higher than the surrounding rural areas, but the incongruity of suicide in a vacation paradise can be jarring. As a result, the phenomenon has garnered media attention over the years as reporters grapple with the reasons behind these spikes. In 2009, the Denver Post found that the rate in Aspen and Pitkin County, where Hunter S. Thompson died by suicide in 2005, had jumped to three times the national rate and two times the state rate. In 2016, National Geographic reported on the suicide death of a 57-year-old Telluride ski bum, one of three that unfolded in the county over just two weeks in 2016. And early this year, Mountain Town News reported on the rise in suicides in Vail and surrounding Eagle County: 15 in 2017, more than three times the national average.

Theories abound as to why these towns are affected, though they remain speculation. Like Durango, these are places where the cost of living is high, good jobs are scarce, and people are financially stressed. There are fewer mental health resources than one would find in a big city. (It’s common for parents to find that every child therapist in town is booked and not taking new clients.) Others blame the play-hard, party-hard vibe in idyllic mountain towns that can lead to substance abuse (a risk factor for suicide), as well as social media, the culture of relentless athletic one-upmanship, and the obsessive pursuit of fun. “It can be sort of this FOMO rat race,” says Cara Kropp, a special education teacher, mountain bike coach, and friend of Tricia’s. “People don’t want to be around nonstoked people.”

During previous suicide clusters in the United States, much has been made about the correlation between altitude and suicide found around the world, including Sardinia, Turkey, Ecuador, and South Korea. Some researchers theorize that lower levels of oxygen at altitude may result in lower serotonin levels, a condition associated with suicide, and higher levels of dopamine, linked with reward centers of the brain and risk-taking behavior. Others believe that in the United States, the correlation is related to cultural factors, including easier access to guns and the ingrained value of self-reliance, which can lead to isolation and a reluctance to get help.

Ultimately, however, no one knows why a suicide cluster pops up here and not in a similar place at the same time. Part of it is simply that the phenomenon feeds on itself—in other words, suicide can be contagious. Research suggests that the friends and family bereaved by suicide—in comparison to someone who died of sudden natural causes—have a 65 percent increased risk of taking their own lives. Children who have lost a parent to suicide are three times more likely to take their own lives.

“It’s this unfortunate positive-feedback loop,” says Laura Warner, director of health promotion services at San Juan Basin Public Health in Durango. “It could happen anywhere. This is not unique to Durango in any way.” The question is: What can we do about it?

*

I have lived in Durango for 13 years. One of the reasons this feels so strange and upsetting to residents, including me, is that many of us adore this town. I grew up in big cities, thinking I’d always live in one, but I have never felt happier or more like myself since moving here. The idea that people are suffering deeply right around me makes me feel guilty and appalled at my own obliviousness.

The last time I saw Tricia, it was at a party late last summer celebrating the opening of a new bike shop. She was back in town after a six-month stint in Crested Butte, where she had been recuperating after a messy divorce. She had always been a classic free spirit, flitting off on trips and chasing shiny new ideas. At age 16, Tricia left her hometown of Memphis to become a climbing bum in Yosemite, eventually becoming a massage therapist and yoga instructor. Over the years, she tried living in a tepee, opening a flower shop, and fostering puppies. Her friends described her as a yes-to-adventure person and full of surprises.

That night at the party, Tricia was lightly buzzed and seemed distracted, but she always commanded a presence. As we both poured beers at the keg, I asked her how she was. Tricia stopped and looked at me with her glossy brown doe eyes. “Heartbroken,” she said. I wasn’t expecting such a candid answer. I didn’t know what to say.

Like other towns that have experienced suicide clusters, Durango has mobilized, but solutions to an issue this complex take a long time to implement and longer to reap results. One reason for optimism is that Durango is in a position to learn from communities that have experienced these clusters before and have taken action. The solutions they’re trying could improve suicide-prevention efforts nationwide.

Last May, after a series of suicides of both students and staff members at the Durango schools, San Juan Basin Public Health organized a suicide-prevention forum. They expected about 100 to 200 people to show up. In the two weeks before the event, two more people took their lives in Durango, including a 14-year-old. More than 700 people turned up at the summit. “People were desperate to talk about it and to try to get some answers,” says Claire Ninde, director of communications at San Juan Basin Public Health. “They wanted information, but they also wanted to do something.”

The keynote speaker, Susan Becker, a psychology professor at Colorado Mesa University, offered what’s called “brief suicide intervention training” for how to talk to people who are struggling. Be direct and compassionate. Ask whether they’ve had suicidal thoughts and, if so, whether they have a plan. Experts believe that up to 80 percent of suicidal people give signs, such as withdrawing from loved ones or favorite activities or sleeping too much or too little.

On a broader scale, one of the biggest challenges communities face is a lack of coordination among civic institutions, mental health organizations, and nonprofits, a problem that can result in people falling through the cracks. Since the summit, San Juan Basin Public Health, with the help of a $156,000 grant from the state, established a team of locals to design a community-wide suicide response plan, which will coordinate schools, the police and fire departments, grief support groups, and many other organizations and agencies.

The Colorado Office of Suicide Prevention, along with a consortium of national nonprofits and other organizations, also identified La Plata County and five others as study areas for a comprehensive prevention initiative. The goal is to develop a plan that would reduce suicide by 20 percent across the state by 2024 and could be emulated in other areas across the country.

“We’re hoping to show you can have a statewide impact on suicide rates by doing community-level work,” says Sarah Brummett, director of the Colorado Office of Suicide Prevention. “Suicide is an incredibly complex issue—there are no vaccines, no seatbelts—and it’s going to take everyone moving in the same direction.”

Another challenge communities face is that residents can be reluctant to seek help because of the considerable stigma around mental illness—and even if they want help, they often don’t know where to go or call. So San Juan Basin Public Health launched a campaign called Let’s Talk, spreading the word about local resources through posters, social media, and giveaways at places like the after-prom party and in counselors’ offices. It also initiated hour-long suicide-prevention seminars similar to the one taught by Susan Becker at the summit.

One of the most fraught issues around suicide clusters is unskillful media coverage, which studies suggest can spur copycats. The Durango Herald has been criticized for its coverage, so the newspaper retooled its policy last year in an attempt to lower the risk of contagion. “We know it’s critical to cover suicide, because it’s a public health issue, and sharing those stories can take away the element of taboo,” says Amy Maestas, editor of the Herald. “It helps people get help. But the question is: Do we share that on social media? Because then it becomes something you can’t control.” Among other measures, the Herald now closes down comments on all suicide stories and doesn’t post them on social media. The paper also covers the topic in different ways, such as a feature on locals who overcame suicidal thoughts or survived an attempt.

The Durango school district hired extra counselors, and the middle schools and high schools are staging suicide-prevention screenings. The school district has also established a more concerted response when suicides do occur. The schools bring in counselors and mental health experts but also move back into routines as quickly as possible. To prevent glorifying suicide, they no longer allow memorials, including shrines and ceremonies, at schools. (The school district also doesn’t allow memorials for students who die of other causes.)

Not everyone is a fan of the new policies. Amee Austin, Aleah’s mom, opted her daughter out of the suicide-prevention screenings. “To me, school is about reading, writing, and arithmetic,” she says. “You don’t go to school to do therapy.” And for Aleah, acting like nothing happened after the death of a 13-year-old classmate in 2016 felt odd. “Even the people who didn’t know him, it was like, why?” she says. “Why are we carrying on?”

Grieving is at the crux of suicide prevention on an individual level, even though community outpourings of grief can embolden copycat suicides, especially if they are highlighted in the media. But how do you mourn a loss and honor the deceased without ennobling suicide itself?

“Part of it is we don’t grieve well in this culture,” says Kati Bachman, a grief counselor in Durango. “We are taught to be alone in it, which I think increases the suicide rate. But if people are allowed to sit down, listen to each other, and feel what they’re feeling, they’re empowered.”

After Tricia’s suicide, Sarah Tescher hired a therapist to meet with the kids, but none opted to see her. They wanted to talk to the coaches they knew, even though not everyone was trained or comfortable with talking about suicide and mental health challenges. Now the organization is encouraging staff to attend training sessions for educators and coaches on mental-health first aid. “Some of the girls who are the quietest were the ones who were most affected, it seemed,” says Tescher, who also organized the vigil. “You could just see it in their faces. They were so sad, which concerned me.”

*

While it has been painful to watch waves of grief ripple through my town, it has also been inspiring to see businesses and individuals of all kinds respond with creative ideas for supporting each other. Last July, rafting outfitter Mild2Wild started Raft for Hope, an annual fundraising float to benefit a local church program that pays for mental health counseling for those with financial concerns. In January, high school senior Brooke Buccowich started a campaign to benefit the Second Wind Fund, which finances therapy sessions to at-risk youth across Colorado.

Over the holidays, chiropractor Haley Arias hosted a Christmas party for those bereaved by suicide and launched the Living Forward Foundation, which will offer scholarships and outdoor adventure–based trips for the children of people who have died by suicide. “I don’t think people realize until they’re older how much suicide is going to shape their life,” says Arias, whose father took his own life 11 years ago. “The best thing we can do is give kids a place to feel safe and grow that self-confidence and resilience.”

Tina Ooley started hosting monthly social gatherings, such as a prayer flag–making party and a workshop for making spoke cards for bike wheels, just to offer a space to socialize without necessarily talking about suicide. “My hope is that we can get people thinking about how they can consistently connect and keep the web strong, and not just in times of tragedy,” Ooley says. “Why can’t we come together regularly?”

The sad irony of suicide prevention is that individuals and communities typically take significant action only after tragedies. But when communities do take action, it can make a real difference. In 2016, for example, Summit County, which encompasses Breckenridge, Keystone, and other resorts, experienced 13 suicides—more than three times the national average. In response to the death of a particularly prominent community member, locals started Building Hope, a community initiative that has helped organize disparate agencies and started numerous other initiatives, such as a stigma-reduction campaign showing successful locals talking about their mental health challenges, a popular grant program for therapy sessions, and a mental health navigator who helps residents deal with insurance and find care. Last year, the suicide rate fell to four, although it’s too soon to attribute the change to any particular program.

When I talked to Betsy Casey, program manager for Building Hope, she echoed what other public health experts have told me: that relationships—between community institutions and on a personal level—are the key to preventing suicide.

Over the months that I researched this story, I grappled with my own role and responsibility. At first I tried to be a detached observer and meticulously follow the guidelines for journalists covering suicide—don’t glorify the dead, don’t describe the means of death, don’t depict community outpourings of grief—to the extent that I was too paralyzed to write.

Then I started to have dreams about those lost to suicide, as if the feelings that came up after listening to so many people cry in my office needed to come to the surface. After one particularly vivid dream, I awoke in a state of intense horror and compassion—I felt like I had been punched in the stomach and had the wind knocked out of me. I was rattled and teary for the rest of the day. I realized that the only way to really understand the issue was to allow myself to be touched by the messiness and devastation of it all. Many of the people I talked with also wanted to help but, like me, were afraid to say or do the wrong thing. Perhaps it’s better to talk about it imperfectly than not at all.

What struck me most while reporting this story was the sheer courage of those who face mental illness, which is one of the leading factors in completed suicides. One friend of Tricia’s, an avid endurance athlete who survived an attempted suicide, described pulling herself out of the despair as being harder than climbing Everest 100 times. To add to the difficulty, people who are struggling often face the fierce headwinds of stigma and shame.

And yet the vast majority of people who contemplate or attempt suicide survive and get better. The CDC estimates that for every one completed suicide, there are approximately three hospitalizations, nine emergency room visits, 27 nonmedically treated attempts, and more than 200 people who experience suicidal ideation. Ninety percent of those who survive an attempt will not die by suicide in the long run. Every single person I spoke with believed that we need to talk more openly about mental suffering. According to the National Institute of Mental Health, 16.2 million adults—or 6.7 percent of the U.S. adult population—experienced at least one major depressive episode in 2016.

Aleah Austin perhaps said it best: “When people are that sad, I don’t think they should feel that they need to hide it. They need to be more open—and we need to be open to helping people.”

I learned how difficult it is to talk about it firsthand when an old friend visited me this winter in a fit of tears and panic. She is smart, athletic, beautiful, successful—and depressed. I was worried about her. Suicide prevention trainings tell you to be direct, but when you’re in the moment, that’s hard. I didn’t want to offend her by suggesting she was struggling more than she said she was—which I realized later was my own internalized stigma. But ultimately my concern for her overcame my fear of awkwardness.

“Have you had any thoughts about hurting yourself?” I asked.

“Are you asking me because you’re in the middle of that suicide story?” she said with an irreverent grin. I felt sheepish.

“Well, yeah, kinda,” I said. “I’ve been learning what the signs are, and you pretty much fit them exactly.” She paused for a beat then turned sincere and thoughtful.

“I have felt suicidal in the past,” she said. “But not now.”

I told her how much I love her and that I would do anything to support her in finding her way, even if I can’t control the conditions in her life or the decisions she makes.

*

About a week after Tricia died, Tina Ooley invited Aleah on a bike ride with Bri Dilley, another friend of Tricia’s. On the north edge of town, the trio switchbacked up a trail through the piñons and junipers.

Part of the difficulty of grieving Tricia Shadell—or anyone who takes their own life—is that it’s easy to ruminate about what could have prevented her death, but the reasons behind any individual suicide are generally complex and inscrutable. Over the years, Tricia struggled with anxiety, depression, and substance abuse. Though she assiduously hid her challenges from the kids, her friends knew and made heroic measures to care for her, including going with her to seek help at a local mental health agency, helping her find an inpatient facility, and even sleeping overnight at her house to make sure she didn’t hurt herself.

During the ride on that warm mid-November day, Tina told Aleah that she could say anything about how she was feeling or nothing at all. At first, she was quiet. The Animas Mountain Trail is a sustained uphill with boulders and babyheads, but Aleah was nailing it, not putting her feet down once until the top. On the way down, they veered onto a little-known trail on the east side of the mountain, where Tina had set up a shrine for Tricia with prayer flags and heart-shaped rocks. After sprinkling some unicorn glitter, they sat down and talked and cried while staring over the river oxbows and tidy streets of Durango far below. They shared their grief and confusion, but also their rage.

Aleah was pissed at Tricia, partly because she felt blindsided—Tricia hid her struggles perhaps too well from the girls. To Aleah and the others, it had seemed like Tricia had this perfect life.

“She was always so excited to come and see us,” Aleah says. “She would always yell on the trail, ‘Yeah, this is so fun!’ It always seemed like she had a really good time.” Now Aleah wondered if there was something not quite genuine about Tricia’s enthusiasm.

“Aleah was also angry because she was thinking about me and all the other kids,” Tina says. “I know when I get angry about Tricia, I’m angry at her because of the kids. I’m angry at her for the suffering she left for other people to hold.” Dilley recalls that when Tricia talked about suicide before she died, she believed people would be sad but that they would get over it. “I don’t think you ever get over it,” Dilley says. In the coming days, Aleah took her friends to the altar, each time bringing something new to leave behind—candles, lavender, a heart-shaped rock. She still has prayer flags hanging in her room that remind her of Tricia.

Aleah has come a long way since those first days of mountain biking. She now bombs down the most technical trails in Durango, mentors younger girls, and can clean sections of trail that even Tina will walk. She credits Tricia with instilling in her a passion for downhill by teaching her how to float off jumps and descend steep sections. (“Boobs to the tube!” Tricia used to yell.) Earlier this year, Aleah rode for the first time in the Iron Horse Bicycle Classic, a beloved local race that wends into the mountains every Memorial Day weekend. This summer and fall, she’s even trying her first downhill competitions. Eventually she wants to be a top racer and go to college at a big school, maybe in the Midwest, but she’s not hemming herself in with too many distant plans or expectations. To Aleah, the future is nothing but possibilities.

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