Creative Commons / Hartwig HKD

With recent high-profile suicides in the news, if it seems like self-harm is on the rise in America, you may be right. Suicides are up 25 percent since the year 2000 across the U.S., including 45,000 in 2016 alone, according to a new Centers for Disease Control study.

A potential "suicide contagion" of copycat suicides was feared after the two recent high-profile suicides. Kate Spade, 45, famed in the '90s for her handbags, was found dead of suicide in her New York City apartment on June 5. Then famed food show TV host, Anthony Bourdain, 61, took his own life on June 8 in Strasbourg, France.

"With recent high-profile deaths by suicide, this is a time to stand together and resolve to do more," said Dr. Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention, in a statement after Bourdain and Spade's suicides. "Suicide affects all of us – we all face challenges and have mental health to manage. We are working diligently to prevent suicide. The need for more research and a greater national investment in suicide prevention is clearer than ever."

Mental health issues are often cited as a cause of suicide. The CDC found 54 percent of the U.S. residents who kill themselves are not diagnosed with mental illnesses, but not all mental illnesses are reported or diagnosed. But that doesn't tell the whole story.

 

"There is never a single cause for suicide. Suicide is the result of many factors that come together such as an underlying mental health condition, life stressors, and access to lethal means," said the American Foundation for Suicide Prevention. "We must do more to prevent such tragic deaths through greater awareness of mental health, common risks and warning signs, and effective interventions and treatments."

Montana had 29 suicides per 100,000 deaths, the highest in the nation, according to the CDC study. Overall, the national average in the U.S. is 13 suicides per 100,000 deaths. From 1999 to 2016, suicide rates rose in 49 of 50 states, in half of the states rising by more than 30 percent.

Suicide is now the second leading cause of death in the U.S. for people aged 15-34, the study found. Every 13 minutes, someone commits suicide in the U.S.

Taken into consideration along with the opioid crisis, suicide is a serious problem, one that some scientists say requires a national response. A "National Resilience Strategy" has been proposed by John Auerbach, president of Trust for America's Health, and Benjamin Miller, chief strategy officer of Well Being Trust.

"The United States is facing a triple set of epidemics - more than one million Americans have died from drug overdoses, alcohol, and suicides between 2006 and 2015," they write, adding that suicide would best be addressed by "emphasizing a cultural shift to focus on identifying and providing targeted prevention strategies to high-risk individuals and groups."

Others want new technologies to be used to predict who is at most risk for suicide and target them with support. Kaiser Permanente's models for suicide risk tested extremely successfully, by combining an electronic review of a patient's medical records for 90 days with a depression questionnaire, Kaiser's research scientists said.

Suicide contagion?

The recent deaths of Spade and Bourdain brought the subject of suicide to the forefront of national discourse. Celebrity suicides often spark fears of a suicide contagion, or rash of copy-cat suicides, like in 2017, when the death of Soundgarden's Chris Cornell was quickly followed by that of Linkin Park's Chester Bennington.

The most well-known suicide contagion came after '90s grunge star Kurt Cobain killed himself with a shotgun at age 27 in 1994. The news was followed by reports of copycat suicides around the country by Cobain biggest fans. In 1997, two French girls, Aurelie, 13, and Valentine, 12, killed themselves with one of their father's .22-caliber rifle, inspired by Cobain. Friends said the girls were obsessed with Nirvana and secretly planned to reenact Cobain's suicide for months.

Statistically, teenagers are most commonly susceptible to suicidal ideation. In one case, Boston-area woman Michelle Carter, 20, was convicted of involuntary manslaughter at age 18, for successfully urging her 17-year-old boyfriend to kill himself over text messages.

The Netflix series "13 Reasons Why," recently renewed for a third season, has proved controversial for its depiction of teen suicide. Parents of three teen girls who committed suicide, Bella Herndon and Priscilla Chiu, both 15, and Lily Mae Sharp, 13, have said their children had recently been watching the program.

“'13 Reasons Why' is the most toxic program ever marketed to children," said the Parents Television Council, which has a petition to get the show off Netflix, in a statement. "Academic research demonstrated a 26 percent increase in the Google search term for "how to kill myself" following the Season 1 release."

Netflix CEO Reed Hastings' responded to concerns about the third season renewal at a recent shareholder meeting, saying "'13 Reasons Why' has been enormously popular and successful. It’s engaging content. It is controversial. But nobody has to watch it," according to Deadline.

Suicide stats by the numbers

Causes of suicide can vary widely, but in 2015, general causes in the U.S. broke down as follows:

Relationship problems ­– 48%

Crisis in past or upcoming two weeks ­– 29%

Problematic substance use ­– 28%

Job/financial problem ­– 16%

Physical health problem ­– 22%

Criminal legal problem – 9%

Source: CDC

How to get help

Anyone with thoughts of harming or killing themselves is urged to call the National Suicide Prevention Lifeline Talk at 1-800-273-TALK (8255), visit http://www.suicidepreventionlifeline.org or text "START" to 741-741.

Veterans and their loved ones can call 1-800-273-8255 and Press 1 or send a text to 838255 to get support.

'Suicide contagion is definitely a real issue'

Chris Kernes, licensed family and marriage therapist, is co-founder of LARKR, an app providing immediate therapeutic services. She discussed 'suicide contagion' and how people can help those at risk.

Metro: Is there a suicide contagion happening right now after the deaths of Kate Spade and Anthony Bourdain?

Kernes: Suicide contagion is definitely a real issue and there is a lot of research around it. ... With regards to Anthony Bourdain and Kate Spade, I don’t believe that Kate Spade’s suicide had any influence on Bourdain. Anthony Bourdain has been very publicly open with his personal struggles and previous addiction. What’s important is that we didn’t know his current mental state or headspace in his last moments. There are many factors to consider. Something could have happened in his personal life, maybe he was taking a medication and stopped taking the medication or maybe he relapsed. There’s a lot of variables to consider.

Metro: What can people do to prevent those who may susceptible to depression from self-harm?

K: You have to understand what suicide is and why it's happening. There's a lot of misconception about suicide that we need to debunk and destigmatize. The more you don’t know, the more you are incapable of helping someone who may be suffering from those thoughts. We should be open-minded and listen to those who may be struggling.

As far as signs of suicide, a lot of people will talk about it in passing and some won’t. There are subtle ways that people can communicate warning signs. A lot of times they have a feeling of hopelessness and loneliness that they can’t bear anymore.

Do they have history of harm already? Have they ever attempted self-harm? Do they have constant self-loathing or self-hatred? Has there been an increase drug use or unsafe sex? Are they abusing a drug? These are questions that you should contemplate when you think someone is in danger.

Additionally, speak up if you’re worried about a friend or family member and don’t judge them. Say that you’ve been concerned and noticed differences in how they’ve been doing. Ask questions and be curious about their state of mind. However, be intentional when you do those things. When people begin to tell you how they are doing, truly listen to them.

Ask people how can you help them even if you don’t understand exactly how they are feeling.

Metro: Are suicide, depression and self-harm more common in the era of smartphones and Facebook, quicker to spread or easier to hide?

K: Social media has a lot to do with the depression and self-harm. People are constantly posting things online for people to see, we have fewer filters now. Because of the overstimulating access to technology, anyone can post anything. Some things can be triggering for people or a reminder about how unsatisfied you are with your own life. You end up comparing yourself to people and now you feel more inadequate.  

Metro: How does your app LARKR help?

K: LARKR is an on-demand option for therapy especially for someone who needs help right then and there. The app significantly minimizes the top three barriers that keep 50 million Americans who suffer from mental illness from receiving care – price, accessibility, and stigma.  Its platform connects users with professional therapists across the country. The app also offers proactive mental wellness features including guided meditations, a daily mood tracker, and a daily good deed challenge, since altruistic acts are shown to improve mental health.