Oregon is working to increase access to resources for people struggling with their mental health.
For decades, Oregon has had a higher rate of suicide deaths than the national average, with rural communities in particular typically seeing higher rates of suicide deaths compared to metro areas.
“In these small counties, just even a couple, it has big impacts on the community,” said Thad Labhart, clinical director with Community Counseling Solutions, a regional behavioral health services provider.
Behavioral health refers to the emotions and behaviors that affect a person’s well-being. CCS has served Eastern Oregon for decades and now operates in Morrow, Grant, Umatilla, Gilliam and Wheeler counties.
May is Mental Health Awareness Month, and the Oregon Health Authority published a press release in recognition of it, stating that one in five people will experience a mental health condition in a given year.
And sometime in their lives, about half of all Americans will meet the criteria for a diagnosable mental health condition, according to the release. Even the half who don’t meet the criteria can still struggle. Almost everyone will face challenges in life that impact their mental and emotional well-being at one time or another.
“In many of our communities, societal or cultural norms discourage people from reaching out, or even admitting that we may need some help,” said OHA Director Sejal Hathi in the release. “Mental Health Awareness Month is a critical opportunity to highlight that mental health is health.”
The norms around mental health can be especially high barriers in rural communities.
Earlier this year, Union County’s Center for Human Development hosted an event to offer connection and support for people struggling with mental health and loss of loved ones. The event came after a few people in the county died by suicide.
Despite its history of limited access to mental health resources and high rates of substance abuse, in more recent years Oregon has expanded its behavioral health supports, Labhart said, including those available in Eastern Oregon.
A rural-urban divide
In 2019, Oregon’s overall suicide rate hit an all-time high: 20.3 deaths per 100,000 compared to the national average of 13.9, according to the Oregon Violent Death Reporting System through the Oregon Health Authority. In Union County that year, with six suicide deaths, the rate was even higher than the state average, at 23.5 per 100,000.
Since then, there has been an overall decrease in the rates, said OHA suicide prevention coordinator Meghan Crane. In 2021, nationally the rate was 14 suicide deaths per 100,000 population, while Oregon had 19.5 per 100,000.
“While we’ve seen this kind of leveling off of suicide in Oregon,” Crane said, “that doesn’t mean that there are not communities across the state that have not seen these reductions and that one suicide is too many and that suicides highly impact our communities.”
Research shows suicide deaths are higher in rural areas, where risk factors like isolation and mental health stigma may be higher at the same time that feelings of belonging and connectedness may be lower, in part due to the geographic spread of rural communities.
Industries such as agriculture and forestry — which are often stressful, a risk factor for suicide — typically have higher rates of suicide, too, and those careers are more common in rural areas. To address the specific needs of people in farming, ranching, fishing and forestry, Oregon State University runs a 24/7 AgriStress Helpline. It can be reached by call or text at 833-897-2474.
Expanding access to training
Organizations across Oregon offer public trainings in an effort to increase knowledge around suicide. One common training is QPR (Question, Persuade and Refer), a method of talking to someone at risk and encouraging them to seek professional help. Another is ASIST — Applied Suicide Intervention Skills Training, which is basically a more in-depth training or second step to the QPR approach.
In Wallowa County, as of April 17, residents can take ASIST classes. The training is designed to equip people to help others as they struggle with suicidal ideation to manage those feelings and thoughts in a healthy way.
The course, lasting 14 hours over two days and available to anyone age 16 and up, increases participants’ ability to provide suicide first aid. The next class will be this summer, though dates have not been announced.
Wallowa Valley Center for Wellness reached out to Incite Agency for Change, a Corvallis-based business focused on mental health support, to provide the ASIST training and bring it to Enterprise.
“I think a big part that we see (with) a lot of intervention work out there, sometimes we miss that really important piece of a person just needing to unload,” said Charlette Lumby, Incite Agency for Change’s co-founder. “They need to talk about what’s brought them to that space or place. And even if we don’t understand, have someone sit in that space who wants to try to understand.”
Normalizing mental health support
Decreasing stigma is one of the most important ways to prevent suicide deaths, Labhart said.
Around the time of Oregon’s deaths by suicide peak in 2019 — and 2018 for youth suicide rates — CCS also adjusted its approach, adopting a framework called Zero Suicide, Labhart said. The shift helped the nonprofit incorporate scientifically backed practices to screen patients for risk factors of suicide as well as increase the wraparound support for at-risk people.
Still, he said, a major barrier in getting people to access mental health resources in rural counties is that when everybody knows what truck you drive, they can see when you’re parked in front of the mental health services.
Offering telehealth visits is one way CCS works around that barrier. Staff members will also visit patients in their homes or offices, and CCS employs people who specialize in working with veterans, older adults and frontline workers.
“What we have to try to change is people willing to talk about it, and people willing to try to get help, or helping your neighbor try to get help,” Labhart said, “because very few suicides do we take a look back on and go, ‘That was surprising.’ ”
One of the most predictive risk factors is access to lethal means, he said. Guns are the most-used mechanism for suicide deaths in Oregon, making up 53% of the deaths from 2018-2021, according to the Oregon Violent Death Reporting System. Gun ownership is embedded in rural culture, Labhart pointed out.
Part of the Zero Suicide approach, then, is to offer counseling to people on how to limit their own access to those lethal means while they know they’re particularly vulnerable. CCS staff are trained to have those conversations.
“Literally just one person in a given setting can change the course, and it just has to be around tone and stigma on normalizing it and that it’s OK to get help as much as it is getting help for your blood pressure or your sore back,” Labhart said. “We talk about suicide screening. We think about it like taking blood pressure at the doctor’s office. It’s that normalized for us — we’re just going to screen you every time.”
When I tried getting help two years ago community concealing solutions therapist told me she could not talk to me when I was in the office. Her reasoning was because I had private insurance and not state insurance. This person didn’t show any empathy in spite of me crying my eyes out. At that time I was suicidal and I just needed someone to listen to me for even 5 minutes but that didn’t happen. Thankfully I was able to reach out the the suicide hotline but I can truly say that because of this person being so focused on the rules of the job and not being human a life could have been lost that day.
Where do we get help in Polk County, Oregon