At Sherwood’s Marjorie Stewart Senior Community Center, a group of six to eight elderly people gather every Thursday in a room filled with knitting magazines and books.
In addition to creating crafts like coloring turkey outlines or pom-pom snowmen, they converse about insurance issues while seated around a square table. regarding dying. regarding cremation. and occasionally regarding suicide.
Their interactions are facilitated by 79-year-old Stephanie Jones. Although she is not a therapist, she has experienced the majority of the topics they cover at her age. Additionally, she stated that she recalls her own experience overcoming suicidal ideas when they are mentioned.
Jones remarked, “If I can pull it off, perhaps I can talk them out of it.”
Older individuals desperately need that kind of intervention. According to research, males over 85 had a roughly five-fold higher risk of dying by suicide between 2018 and 2022 than the overall population, making them by far the most likely age group in Oregon to die by suicide.
Even though that demographic is vulnerable nationwide, Oregon has a particularly serious issue: according to America’s Health Rankings, which creates state-by-state health analyses in collaboration with the nonprofit United Health Foundation, the state had the fourth-highest suicide rate among adults 65 and older between 2020 and 2022, the most recent years for which data is available.
Adults who lawfully take their own life with a doctor’s help and deadly drugs are not included in the number of people who die by suicide in Oregon.
Suicide prevention initiatives for older persons are still underfunded and sometimes disregarded, despite the state’s gradual shift toward focusing more attention and resources on suicidality, especially among youngsters aged 24 and under.
The Adult Suicide Intervention and Prevention Plan, published by the Oregon Health Authority in 2023, contained numerous suggestions tailored to the needs of senior citizens. But the state did not provide cash for the proposal. The current attempts are more disorganized and frequently motivated by personal passions rather than a planned approach.
According to Kera Magarill, an older adult behavioral health expert with Washington County, our senior citizens are invisible in many ways. Additionally, ageism and the stigma associated with mental health are a double punch when it comes to mental health.
Many factors make older persons especially vulnerable, according to experts and advocates: separation. loneliness. persistent sickness or suffering. the sense of burdensomeness. access to deadly weapons. a propensity to meticulously organize suicide attempts. a harder time getting over suicide attempts.
White men in Oregon have a disproportionately high suicide rate, as do those living in rural locations, where it can be more difficult for people without automobiles or with mobility issues to escape solitude.
According to Josephine County’s older adult mental health specialist and suicide prevention coordinator, Angela Franklin, cultural views on aging also don’t help.
“In our dominant culture, we really segregate our older adults,” she remarked. Additionally, we mistakenly think that sadness and depression are typical aspects of aging.
At the Marjorie Stewart Senior Community Center, Stephanie Jones (right) collaborates with Greg and Patricia Eastwood to create a thankfulness board. Weekly community-building workshops, which Jones facilitates, have been shown to strengthen relationships and enhance the mental well-being of senior citizens.One of the Oregonians, Dave Killen
For Calla Lilly, 77, sadness is definitely not a natural state. She enjoys dressing up in dazzling attire and laughs often. However, she claimed that last year, loneliness made her less cheerful.
Lilly claimed she could sense her mental health declining when she was lounging in her jammies at her Sherwood home. Although she wasn’t quite suicidal, she could sense that the longer she remained alone in her home, the closer she got.
Lilly claimed that she was able to leave the house by happenstance after seeing an advertisement for the Marjorie Stewart Senior Community Center. She now goes to the center every week for lunches and other group events, as well as Jones community-building seminars.
“My entire life has changed,” she added. I’ve been going here all my life.
However, it is challenging to develop and finance additional resources like the center. As a side project, the center’s manager, Maiya Martin Burbank, established community-funded mental health services.
She saw how crucial the programming could be since, in less than 15 years, she lost four elder family friends—whom she regarded as uncles—to suicide.
However, Martin Burbank noted that few senior centers in the state offer comparable programs. Funding for suicide prevention is scarce. Additionally, it has historically prioritized youth when it is present.
Experts from throughout the state created the Youth Suicide Intervention and Prevention Plan in 2014 and 2015. Legislators started allocating a portion of the state budget toward it in 2019.
According to Robert Lee, a senior policy consultant for the Oregon Health Authority, the plan is currently receiving $10.5 million in the 2023–2025 biennium, which is roughly half of what is required to properly support it.
Although there was a modest spike in 2022, youth suicides generally declined from 2018 and 2021. However, there hasn’t been the similar decline in adult suicides, which made up almost seven-eighths of all suicides in Oregon between 2018 and 2022. Oregon Health Authority data shows that 715 individuals over 24 died by suicide in Oregon in 2018. So did 774 in 2022.
The Oregon Health Authority has started paying attention. Debra Darmata was hired in 2020 to create an adult plan that would run concurrently with the youth strategy. About 130 people were assembled by Darmata, who worked until 2023 to create a 294-page paper that included a section on preventing suicide among older adults.
One of the report’s main recommendations was to urge physicians to evaluate suicidality. Those who work with senior citizens should receive more training. Increase the number of avenues for social interaction. Encourage peer-to-peer initiatives. Enhance a community’s postvention resources following a suicide death.
Despite Darmata’s efforts, state financing has not been provided. Nonetheless, some governmental funds have been allocated through alternative means to attempts to prevent adult suicide.
The state received a Zero Suicide federal grant offering about $700,000 annually from 2020 to 2025 and a Centers for Disease Control and Prevention grant, which is providing $855,000 per year for five years for suicide prevention programs for older adults and veterans in rural areas. The funding, which was funneled through the Oregon Health Authority, has been used to support county health departments’ suicide prevention initiatives, regional suicide prevention organizations, and initiatives to improve social connectivity among older and rural persons.
Additionally, an Older Adult Behavioral Health Initiative funded by the Oregon Health Authority employs 24 specialists, including Franklin and Magarill, as well as a project director.
However, Darmata stated that she would anticipate the cost of funding the entire adult suicide prevention plan to be around $10 million annually, which is similar to the juvenile scheme.
Sometimes people think we re saying we want a larger slice of the current pie, which would require taking resources and funds from youth, said Laurel Wonder, who works with the Older Adult Behavioral Health Initiative in Multnomah County. In reality, though, we’re stating that we require a larger pie.
With even limited additional funding, Nirmala Dhar, the older adult behavioral health lead strategist at the Oregon Health Authority s Behavioral Health Division, said she could increase public messaging targeted at older adults. Right now, only 13% of adults over 65 nationally know about the 988 suicide crisis line, according to a summer 2023pollconducted by survey research firm Ipsos for the National Alliance on Mental Illness.
Dhar also said she d like to see more emphasis on training doctors on suicide prevention, especially gun safety. One 2002 review in the American Journal of Psychiatry found that on average, 77% of adults age 55 and older had seen their primary care physician within a year of their death by suicide and 58% had done so within the month before their deaths.
In 2017, the Oregon Health Authority encouraged the Legislature to pass abillthat would have required doctors to take continuing education courses on suicide risk assessment. But several medical organizations argued it would be too onerous, and by the time the bill passed, it had been amended so that the courses were no longer mandatory. Dhar has held trainings at 7 a.m. and after 6 p.m. to try to reach busy doctors but often, she said, they don t come.
Suicide prevention advocate Angela Perry said she often noticed signs of suicide risk during her two decades working in home caregiving, including patients withdrawing from loved ones, a hesitancy to do once-loved hobbies and stockpiling of medications.
Her personal experience helped her recognize those signs, she said, having lost loved ones to suicide and experiencing chronic suicidal ideation herself. Perry wants to be sure that doctors who might not be as attuned to this are equipped to talk about depression and suicide risk too.
Everything was always the physical approach, Perry said. What medications do you need? How do we adjust the medications? Instead of, How are you doing as a person?
She said she tried to help her patients become less lonely by encouraging them to connect more with their families. Similarly, Dhar said increasing social connection is a priority for the state.
Marjorie Stewart Senior Community Center Manager Maiya Martin Burbank began running community-funded mental health programs as a passion project after losing four older family friends to suicide.One of the Oregonians, Dave Killen
Oregon does have a few programs in place already that target social isolation, including the Oregon Health Authority-funded Senior Loneliness Line. The phone line encourages anyone 55 and up to call if they re in need of a friendly voice, even if they re not in crisis.
Yvette Garza, a clinical assistant director at Lines for Life who oversees the Senior Loneliness Line, said it receives about 1,200 calls a month, with some seniors ringing every single day. She said she s noticed a distinct change in mood over time among some of the regular callers.
When they first start calling, they called talking about having thoughts of suicide because of loneliness and isolation, Garza said. Then, after building this rapport and establishing a good professional relationship with our clinicians, they end up feeling safe.
In parts of Oregon, older adults can also access a depression management program called the Program to Encourage Active, Rewarding Lives, or PEARLS. Susan Jay Rounds, who coordinates the state and federally funded program in Josephine and Jackson counties, often visits older adults homes. She helps them identify sources of stress or anxiety, brainstorm potential solutions and make an action plan.
But Jay Rounds makes 50-mile round trips to see most of her clients. Her wait list is 21 people long and growing. Adults in other parts of the states may not have access at all. And even for those who can participate in PEARLS, Jay Rounds said many still can t get the additional support they need because of the limited number of counselors, psychologists and psychiatrists accepting Medicare.
Our situation feels more dire, she said, especially because Oregon s population is aging.
The vastness of the need is clear to Martin Burbank, the Sherwood center manager. But she also knows that helping older adults out of despair is possible. The center typically has about 22 people in mental health programs in each two-month cohort, she said; just last week, she helped a woman sign up for PEARLS, which is offered through her center too.
Sometimes, when people first come to her, they are talking about ending their lives, Martin Burbank said. They make safety plans on the initial triage calls. And then, as they build community and attend mental health programs, she sees a shift.
A few weeks into these programs, there s a physical change, Martin Burbank said. A lot of times they re like, You know what? I m good. I m here.
If you are struggling with thoughts of suicide, you can find support by calling the Suicide and Crisis Lifeline at 988 or 1-800-273-8255. The Senior Loneliness Line is available at 503-200-1633 and 1-800-282-7035. More resources can be found atspeakingofsuicide.com/resources.
Aviva Bechky covers politics and education for The Oregonian/OregonLive. They can be reached [email protected] on X at@avivabechky.
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