The number of suicides in Benton and Franklin counties appears to be flat or on the decline compared to recent years, but the local Crisis Response Unit is seeing more people who are more seriously ill.
"We are seeing more people and getting more phone calls," said Kyle Sullivan, clinical supervisor for the crisis unit. "Things have just been very busy here."
Numbers from the two county coroners show a slight dip in the number of suicides in 2012 compared to 2011.
Benton County Coroner John Hansens said his office ruled 25 deaths suicides in 2012. There were 29 in 2011. Franklin County Coroner Dan Blasdel recorded three suicides in 2012 compared to 13 in 2011.
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So far in 2013, there have been five suicides in Benton County and four in Franklin County. Hansens said for Benton County, that's a comparable number to recent years.
Sullivan said crisis response unit staffers performed 209 face-to-face evaluations in January 2011. That number rose by 10 in January 2012, and by January of this year, had jumped to 258.
Face-to-face evaluations are performed when someone may be an imminent danger to themselves -- for example, if someone has overdosed on medications and is brought to a hospital emergency department. Before that person can be released, a mental health professional has to talk to them and make sure a safety plan is in place that could include referral to treatment, having friends or family in the person's home to watch over them or, usually as a last option, admission to psychiatric hospital, Sullivan said.
In the Tri-Cities, the number of people needing hospitalization has been rising, but there aren't enough psychiatric beds to go around.
"The number of beds we have in psychiatric facilities is extremely limited or the facilities are overwhelmed or closed to admissions," said Ed Thornbrugh, director of the Benton Franklin Department of Human Services. "It's often hard for us to get people into an in-patient resource."
And with the state seeing budget deficits for the past several years, there's less money available to pay for mental health services in communities. The human services department has had to prioritize the state money coming in to pay for hospitalization and crisis services leaving no money available for outpatient care.
"We're seeing some folks from crisis to crisis to crisis and not providing stabilizing care," Thornbrugh said.
He said hope is on the horizon in the form of the Affordable Care Act and the new health insurance exchange being created in Washington, and that is scheduled to be up and running by 2014. The idea is that uninsured state residents will be able to buy affordable insurance through the exchange and that will allow them stable, consistent care.
"The key is what we do between April and January," Thornbrugh said.
The support of friends and family is more critical than ever until the exchange is running, Thornbrugh said. And that means not shying away from discussion when it looks like a loved one might be struggling with depression or thoughts of suicide.
"The whole idea of suicide or self-harm is not rare," Thornbrugh said. "It is almost a universal experience."
But most people want help and don't follow through on those thoughts, he said.
"A lot of people are afraid if they ask (about suicidal thoughts) they will give the person the idea," Thornbrugh said. "The reality is that asking gives a release and opens the door to help. Question, listen and refer them to somebody who is more comfortable."
Experts say people who are thinking about suicide typically show warning signs and that suicide attempts rarely are spontaneous.
The American Foundation for Suicide Prevention include as warning signs indicators of depression such as hopelessness, desperation and withdrawal; talking about wanting to die; giving away possessions; or acquiring a gun or pills that might be used in a suicide attempt.
"The emotional crises that usually precede suicide are often recognizable and treatable," the foundation's website said. "Although most depressed people are not suicidal, most suicidal people are depressed. Serious depression can be manifested in obvious sadness, but often it is rather expressed as a loss of pleasure or withdrawal from activities that had been enjoyable. One can help prevent suicide through early recognition and treatment of depression and other psychiatric illnesses."