‘The dam starts cracking’: Stagnant suicide rate requires deeper look into county’s mental health
County officials find pandemic’s mental toll hard to measure
That number represents the number of suicides that took place in Nevada County in 2019 and again in 2020.
In a year of financial strain and social distancing, suicide rates remained unchanged in Nevada County between 2019 and 2020.
Across the country, things were different. Nevada County Behavioral Health Director Phebe Bell said the national suicide rate dropped 5.2% in 2020.
Bell said while the suicide rate can reflect acute stress, it is not the only barometer for the community’s mental wellness.
NEVADA COUNTY population: 99,755 (U.S. Census 2019)
EL DORADO COUNTY, population: 192,843 (U.S. Census 2019)
SUTTER COUNTY, population: 96,971 (U.S. Census 2019)
PLACER COUNTY, population: 398,329 (U.S. Census 2019)
YUBA COUNTY population: 78,668 (U.S. Census 2019)
According to the Family and Education Resource Center, a 51-50 is the number of the section of the Welfare and Institutions Code, which allows a person with a mental challenge to be involuntarily detained for a 72-hour psychiatric hospitalization.
“We are not seeing the level of extreme distress that we were worried we would have seen by now,“ Bell said in April.
Bell said although suicides are down and crisis calls appear to be stable, the current population her office serves has been affected by the isolation of the pandemic and the stress of transitioning back to normal.
SUICIDAL THOUGHTS VS. SUICIDE
According to its website, the Nevada County Behavioral Health Office collaborates with existing social service providers to offer outpatient counseling, medication services and case management to those struggling with mental illness. Crisis data is collected by Bell’s office internally, as well as externally through local law enforcement, hospitals and treatment centers.
Nevada County Behavioral Health is geared toward meeting the needs of those in the community who are seriously disenfranchised — Medi-Cal patients with significant mental illness and substance abuse.
That said, the local, private mental health care providers responding to the needs of those whose situation does not merit state intervention are operating at capacity.
Sierra Burton of Sierra Family Therapy said she has hired five additional clinicians in Nevada County alone since the pandemic hit in March 2020.
“Our intake calls doubled. I hired 50% more clinicians and currently we’re all full again,” Burton said. “It’s been really intense.”
Burton said even though numbers indicate suicide rates remained unchanged between 2019 and 2020, the severity of people’s “personal issues” has observably increased.
“We’re talking severe depression, anxiety, substance abuse, self harm, suicidal ideation — those kinds of issues,” Burton said.
Considering the long-term fallout of the pandemic is overwhelming, Burton said.
“I feel, metaphorically, a little like how the dam starts cracking and you put your finger in that and then in another crack and another,” Burton said.
Kristina DePue is a psychology professor at the University of Nevada-Reno. DePue said noting the difference between suicidal ideation, or thoughts, and suicidality is an important nuance in the community’s mental health assessment.
DePue defined suicidality as actually taking action on intrusive thoughts like “life is better without me.”
“We know actual mental health got worse,” DePue said. “It is interesting that suicide attempts have gone down.”
Those predisposed to subclinical depression are experiencing increased hopelessness and despair due to current environmental factors, she added.
“Subclinical depression, meaning you don’t normally need medication but you’ve got some depression features,“ DePue explained, adding ”When you lose your job, you’re isolated — living alone or with someone else — then you’re inundated with the global pandemic (and the condition is exacerbated).“
DePue theorized that the low suicide rate could be the result of increased access to resources via telehealth.
CRISIS LINE CALLS RISE
Priya Kannall, Mental Health Services Act coordinator for Nevada County Behavioral Health, said her office observed about a 15% decline in total calls to the Nevada County Behavioral Health crisis line from 2019 to 2020, and when comparing the first quarter of 2020 to the first quarter of 2021.
Kannall specified that the Behavioral Health crisis line is a mental health crisis line — as opposed to the Sierra Community House 24/7 line which serves those facing “broader” issues like those in economic crisis or domestic violence crises.
Kannall said roughly one-fifth of the crises line calls to her office in 2020 were made regarding someone with suicidal thoughts or in need of immediate mental health care.
“The majority of other types of calls were by those seeking referrals to mental health or substance use disorder services, or needing assistance with their current mental health treatment plans,” Kannall said.
Kannall said her office provides crises evaluations through a contracted provider — Sierra Mental Wellness Group. That’s how the Behavioral Health department collects data from crisis evaluations that take place at Sierra Nevada Memorial Hospital Emergency Department, the Crisis Stabilization Unit next door, the jail and most recently, the community through the mobile crisis unit.
Crisis assessment averaged 176 a month between November 2019 to February 2020, as well as each month from November 2020 to February.
Bell hopes her office conveys a message of hope to those enduring the crises, provided the region’s extreme mental health needs manage to avoid an increase.
“On a big picture level, it’s a confusing time to understand the mental health needs of our community, when on one hand we have been sad, anxious — we see that in our own lives, family members, friends — at the same time people have been remarkably resilient,” Bell said.
Bell said although the data does not indicate any positive correlation between COVID-19 and suicide — so far — her office is monitoring the situation closely.
“We’re going to pay a lot of attention as we transition out of the more restrictive state,” Bell said. “It’s more important than ever that people know our services are available.”
Rebecca O’Neil is a staff writer with The Union. She can be reached at email@example.com
The Union over the next several weeks will investigate mental health in the region through the lens of law enforcement, housing crises, domestic violence, substance abuse and psychological treatment. If you have a story personally related to one of these topics, contact Rebecca O’Neil at firstname.lastname@example.org
Nevada County Behavioral health: 530-265-5811
National Suicide Hotline: 1-800-273-8255
National Crisis Text Line: Text HOME to 741741
Drug Abuse: 530-265-1437
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