ERIE, Pa. (AP) - A man once asked Patty Puline’s brother for $10, and he gave him all of the money in his wallet.
Her brother put his beloved dogs to sleep. He started going to church and got baptized. He went to his former employer and returned tools, and he started making amends with neighbors and others he had harmed, Puline said.
What Puline said she didn’t know more than 20 years ago was that these were signs that her brother was likely planning to commit suicide.
Anthony Torrelli did so, at age 40, in 1993.
“Some of the signs are going to be innocuous and are not going to make a lot of sense to you,” she said.
Puline, the injury prevention coordinator for the Erie County Department of Health, has been talking a lot lately about the signs of someone contemplating suicide and the risk factors.
It’s timely work.
The 50-year average for suicides in Erie County had been 25, but has climbed considerably in recent years, Erie County Coroner Lyell Cook said. The annual average for suicides in the county was 32 between 1993 and 2002, then rose to 37 between 2003 and 2013, according to data from the Erie County Coroner’s Office.
There were 49 suicides in 2013, up from 38 the previous year and the highest number in more than 20 years.
“Another troubling factor is now we’re getting people in the middle of their lives,” said Cook, noting that the average age of suicide victims has slowly increased.
The average age of a suicide victim in 2013 was 51. It was 46 in 2012, according to Cook’s data.
Failed relationships cited as top reason
Nearly 80 percent of those who committed suicide in 2012 were males, according to the most recent figures from the U.S. Centers for Disease Control. Guns are the most common method of suicide for males, while poisoning is the most common method for females, according to the agency’s data.
There are many reasons why people commit suicide, which makes combating the problem a challenge, said Rita Wheeler, program and volunteer coordinator for the Mental Health Association of Northwestern Pennsylvania.
“There’s no one reason people commit suicide. If it was that easy, it would be easier to fix,” she said.
Cook has often said he has never investigated a suicide that was due to the weather, the economy or politics.
“Every year we try to find a common thread. The vast majority are because of failed interpersonal relationships,” he said.
A small percentage are due to terminal illness, while a few others are believed to have been driven by factors including job loss and substance abuse, Cook said.
About 30 percent, locally and nationally, leave behind a note, he said.
Economics plays a role in some suicide attempts in Erie County, but it’s not the main reason for the recent increase, said Mandy Fauble, vice president of clinical operations for Safe Harbor Behavioral Health.
Many factors play a role, including overall health, mental illness, substance use, feelings of hopelessness and stress, she said.
“Depression is a significant factor in suicides,” Fauble said. “Twenty-five percent of all adults experience depression at one time or another. Substance abuse is also a big factor. A large percentage of all completed suicides have alcohol or drugs in their system.”
Cook said he has seen a decrease in the percentage of suicides in which alcohol was a factor, and an increase in suicides with drugs as a factor.
Since so many people suffer depression, and relatively few of them attempt suicide, it can be difficult for friends and family members to tell when a loved one is thinking about killing themselves, Fauble said.
There are some warning signs.
“If a person starts talking about not wanting to live or that people would be better off without them, that’s when you need to work up the courage to ask if they are thinking about suicide,” she said.
Puline said she believes “the means makes the difference” in driving the rise in suicides. That includes access to guns and prescription medication.
Suicide by drug overdose accounted for more than one-third of all suicides among women nationwide in 2010, she said.
“You have to make it harder to have the means and the method, so talking and getting their feelings out is what really helps. Unfortunately, (for my brother), ours was too little too late,” she said.
Among the risk factors for suicide are mental disorders, substance abuse, family history of suicide, a lack of social support, a lack of health care, job loss and a loss of a relationship, according to the National Suicide Prevention Lifeline. Another risk factor is previous suicide attempts.
Puline said in most cases, a suicide occurs after many attempts are made. A person will try it until he or she finally commits, or gets drunk or takes enough pills to drive them to kill themselves, she said.
“So there’s a bigger connection with guns and drugs and suicides,” Puline said.
Efforts to prevent suicide
Puline said she sought a grant for suicide prevention programs in Erie County four years ago after assessing the work of Safe Kids Erie, which addressed bicycle safety and fire hazards, among other things, and finding gaps in meeting the needs of the community.
“We discovered no one was doing anything about suicide. For every 12 homicides, we had 48 suicides,” she said.
Since getting the grant, Puline and others have developed programs targeting teenagers to the elderly. They’ve distributed brochures, spoken to students and trained staff at about 10 area schools and given talks at local senior centers and veterans organizations.
Puline said other ongoing programs, including those dealing with gun safety and the collection of old and unwanted medication, are also helping, as is the Erie County Suicide Prevention Task Force and its Facebook page, which provides people a vehicle to speak anonymously.
She also said that Fauble, of Safe Harbor Behavioral Health, is “doing a terrific treatment” by offering depression screenings, and has even offered some free screenings recently.
Wheeler, of the Mental Health Association of Northwestern Pennsylvania, developed a pledge card for her clients at the Mental Health Association. The card has contact information on it, as well as a line for the recipient to write down a contact person of their choice. The person is asked to sign the card, which pledges that the person will make a call if they are feeling suicidal or making plans to commit suicide, and carry it with them.
“We created it because we wanted to prevent suicide. When we hand the cards out people will say, ’I’m not suicidal.’ We understand that, but you don’t know when the topic might come up or when they might be in that position,” Wheeler said.
Funding for the grant supporting suicide prevention efforts in Erie County runs out at the end of June and was not renewed. But Puline said she thinks those involved in the effort have made some headway, and she believes there is a strong group of people in place to keep fighting the problem.
Puline said she received a phone message at her office one recent morning from a man who was upset and contemplating suicide. She called him back, did an assessment and contacted Fauble, who stepped in and provided help.
The man responded to treatment, Puline said.
“I asked him how he found out about us and he said he found one of our brochures,” she said. “I guess the fact is now that the coalition is going strong, we’re starting to get calls, and I feel good about that. What if we save that one life today? Wasn’t that a good thing?”
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Information from: Erie Times-News, https://www.goerie.com
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