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On a Tuesday night in March, the emergency room at Carolinas Medical Center was packed, much busier than usual for a week night.
The reason was unusual too: Ten patients had attempted suicide.
“I can't believe it's not related to the economy,” one doctor told a visitor.
As it turned out, March was one of CMC's busiest months ever for treating patients who had tried to kill themselves or had been seriously thinking of suicide.
It is probably not a coincidence that March was also a low point for the recession. The stock market hit 12-year lows. Charlotte-area unemployment had doubled over the year before. And home foreclosures spiked in Mecklenburg County, with more than 1,000 filed – a first for any N.C. county in one month.
Area emergency physicians and mental health professionals can't say for sure, but they believe the recession could be responsible for the despair that may be causing more people to consider suicide. And while there was some improvement in April, health professionals are encouraging people to seek help and watch out for one another.
“You don't have to go through something like this by yourself,” said Grayce Crockett, director of Mecklenburg Area Mental Health.
Crockett's agency, along with other Mecklenburg mental health organizations, is encouraging people who need help to contact professionals through hospital emergency rooms or crisis hot lines.
The latest state and national statistics on suicide are old, from 2007. But Crockett said anecdotal information “raises red flags” about an upward trend during the current recession.
“I think we could easily see the rate go up for 2009,” Crockett said. “But … we can't wait until we see the data. We need to take action now.”
Dr. Stephen Colucciello, vice chairman of emergency medicine at CMC, worries that “things could get worse as people become more hopeless, depending upon the economy, their savings, their health insurance, their employment.
“Hopelessness is a big factor in suicidal ideology,” Colucciello said. “As hopelessness grows, so do the needs of the mental health system.”
Neighbors, friends and relatives should be alert for warning signs, Crockett said.
“We all know someone who has lost a job or their house is being foreclosed or they're in some type of life stress,” she said. “We need to be checking in and asking people how they're doing and waiting to get more than ‘I'm fine.'”
Alarming spike
Charlotte police, doctors and mental health providers say local data on suicide and suicide attempts back up what they have been noticing in their daily work lives. Police sent a countywide alert in early April, making note of the alarming trend.
In the first 18 days of April, police responded to 81 reported suicide threats or attempts, a 55 percent increase from the same period last year.
Bill Cook, director of Mecklenburg's Mobile Crisis Team, said the ailing economy contributed to the increase. His team, which responds to the homes of people in mental health crisis, has received calls from people who have threatened suicide after losing their jobs.
In March, Carolinas Medical Center referred 122 patients to the county's psychiatric hospital, 33 percent more than in March a year ago, Colucciello said. Most of those referrals involve patients who have attempted suicide or had suicidal thoughts, he said.
The county's psychiatric hospital, CMC-Randolph on Billingsley Road, treated more than 1,500 patients in March, a 9 percent increase over March of last year, according to Jennifer Ziccardi, assistant vice president at CMC-Randolph. That was more than any month since CMC began managing the center in the mid-1980s. Not all patients are treated for suicide attempts, but an increase in patient volume does indicate greater need for mental health services generally.
“March was extremely intense, and it was related to the economy,” Ziccardi said. “Our (patient) volume was the highest ever and the acuity (seriousness of illness) was very high in the ER.”
The county's Behavioral Health Call Center, also called the suicide hot line, handled 19,000 calls in March. That is 3,000 more than in March 2008 and more than in any month since the hot line began in 1997. The trend continued in April.
Presbyterian Hospital saw a 3.9 percent increase in March among patients who attempted or considered suicide, compared to March 2008. April saw a bigger increase, 9 percent more than April last year.
Bruce Melosh, director of behavioral health services for Presbyterian, said he's noticed an increase in suicide attempts and threats among middle-aged and older men who have lost jobs, are worried about losing their jobs or have lost money in the stock market.
One man in his 60s was unemployed and also had health problems that made it difficult for him to find work, Melosh said. “After repeated attempts at finding employment, he became increasingly frustrated and depressed and wanted to die because he was facing going to the homeless shelter,” Melosh said.
Another retired man in his late 60s said he had lost more than $100,000 in the stock market, Melosh said. “He had finished his career and thought he was pretty well set. (But the loss left him) distraught, depressed and anxious about the future.”
Women attempt suicide more often than men, but men are more likely to succeed when they try, said Colucciello, author of a medical school textbook chapter on suicide. Men take their lives at nearly four times the rate of women. Men over age 65 have the highest rate of suicide.
“People who lose their jobs, that has a lot to do with their self esteem,” Colucciello said. “A job loss makes them feel less valuable.
“They say life is not worth living, there's nothing to look forward to, they'd be better off dead,” he said. “A perfect storm of circumstances comes together for a moment where a person says ‘I can't go on anymore.'”
Calls for help
Mental health professionals worry that the stigma associated with mental illness prevents some people from seeking help.
Charlotte lawyer Mickey Aberman, whose clients include owners and managers of large businesses, knows that's true.
“I've been dealing with some folks whose businesses have failed, and some of them are in really bad shape financially,” Aberman said.
Recently, Aberman has spoken with several despondent clients, including at least four who mentioned suicide. Some have been accustomed to mid-six-figure incomes and now have trouble paying bills. Pride wouldn't allow these men to visit a therapist, but they had no qualms about calling Aberman for “legal advice” and then steering the conversation toward their feelings of hopelessness. “They can rationalize that they aren't really asking anybody for help,” Aberman said. “They're just getting some legal advice.”
Along with coaching clients about life insurance, finances and bankruptcy, Aberman has tried to refer them to professionals who can help with emotional issues. He shares common-sense thoughts that sound a lot like therapy.
“I tell them it's always bad to make a decision when you are feeling strong emotions,” he said. “It's just never a good time to make a big decision.
“Most of these folks are bright people, and they've got the capability to support themselves, and they've got people who care about them. So it's mainly a matter of just coming up with a plan to weather the storm. Sometimes that means going to family members … and doing what you would want them to do if you were doing OK and they needed help.”
Karen Garloch: 704-358-5078.
