The suicide rate among middle-aged North Dakotans rose by 70 percent in a decade, one of the sharpest increases in the nation, according to a government report issued Thursday.
Officials said they were not surprised by the increase from 1999 to 2010, but they said it's hard to pin down why that happened among those North Dakotans who are 35 to 64 years old.
"I wish I knew why, but it's not something I can say 'Yep, this is the reason,' " said Micki Savelkoul, director of the state Suicide Prevention Program in the Health Department. "So many factors play into why somebody ends their life by suicide. It's something we're still trying to figure out."
Theories suggested by others include a lack of adequate mental health services, the disruption caused by oil development and mental health problems among National Guard members who served in Iraq and Afghanistan.
The Centers for Disease Control and Prevention issued the report, which was based on death certificates. The federal agency said the national suicide rate for those who are 35-64 increased 28 percent between 1999 and 2010, when there were nearly 18 suicides per 100,000 people in the age group.
In North Dakota, there were 47 suicide deaths among that age group in 2010, or more than 20 per 100,000 in population. That was up from 28 suicide deaths, or nearly 12 per 100,000 people in the age group, in 1999.
In nearby Wyoming, the suicide rate among the middle-aged rose by nearly 79 percent in that same time period.
Officials noted that in a sparsely populated state, a small increase in the actual number of suicides can translate into a large percentage increase.
Cindy Miller, executive director of First Link, which answers calls for help placed from within the state, said the operation received 1,416 suicide-related calls last year, up significantly in the past few years.
Miller said officials do not know why the suicide rate among middle-aged North Dakotans has risen.
"I just don't think there's an answer exactly why. Every single person in every single situation is different," Miller said.
Mary Weiler, chair of the North Dakota chapter of the American Foundation for Suicide Prevention, said the jump in the suicide rate for middle-aged North Dakotans may be because people in that age group were never properly diagnosed and treated for mental illness when they were younger. The stigma attached to mental illness prevents many people from seeking help, she said.
Weiler said that was the case with her daughter, Jennifer, who took her own life at age 33 in October 2005.
"She was really embarrassed to even consider that she might have a mental illness and also frightened to reach out and get help just due to the stigma of it," Weiler said.
State Sen. Tim Mathern of Fargo, policy director at Prairie St. John's Hospital, which provides treatment for mental illness and drug and alcohol addiction, said he thinks the increase in the suicide rate is due to a lack of adequate treatment services, a growing number of National Guard veterans who served in Iraq and Afghanistan, and economic problems caused by the oil boom in western North Dakota.
"Suicide is really a reflection of not receiving mental health treatment," Mathern said, adding that more transitional facilities are needed for people who cannot stay at home but do not need to be hospitalized.
Officials at the North Dakota Department of Human Services said Thursday that the state's federal mental health block grant dropped slightly from about $849,000 in 2003 to about $730,000 in 2010. However, state spending on the public mental health system has grown from nearly $13.6 million in 2003 to nearly $17.3 million in 2010.
Mathern said the boom in oil production in western North Dakota has driven up rent and other living costs. Some long-time residents who are not making money from oil jobs are having a tough time paying higher rents and making ends meet, he said.
"Our economic upturn has, for some people, very negative consequences," Mathern said.
Miller said whatever the reason for the increase in middle-aged suicides, the rising rate is a reminder that people should call for help if they are contemplating suicide. People should also be ready to help when they see signs that friends and relatives are thinking of suicide, she said.
She said people can call the Suicide Prevention LIFELINE 24 hours a day at 1-800-273-8255.