Federal and local officials have joined with advocates and the media to raise awareness about Oregon’s startling suicide rates and the need for broad and accessible services to help those at risk.
“For much of my life, the answer has been not to talk about suicide, but that silence hasn’t worked,” Sen. Jeff Merkely, D-Ore., said Friday at the Multnomah County Health Department Headquarters, where people gathered to rally for awareness.
Because of that silence, Merkley said, it might appear opioids, firearms or traffic deaths are the state’s biggest killers. But suicide trumps them all. Change requires breaking the silence and improving access to affordable mental health treatment. The expansion of Medicaid, which the Trump White House and congressional Republicans have targeted, is making that possible.
“We came within a single vote of losing Medicaid expansion. One vote — that’s how close it was, to be replaced by joke plans that wouldn’t cover mental health,” Merkley said. “We have to do better, not worse. And together we’re saying to Oregonians, ‘If you’re suffering, there’s help.’”
Merkley was joined by Sen. Ron Wyden, D-Ore.; Multnomah County Chair Deborah Kafoury; County Commissioner Sharon Meieran; Health Department Director Patricia Charles-Heathers, Ph.D.; and leaders from Lines for Life and the American Foundation for Suicide Prevention.
More than 50 years ago, Congress sent the first Community Mental Health Act to President John F. Kennedy, Jr., who proclaimed people with mental illness “need no longer be alien to our affections, or beyond the help of our communities.”
“It’s time we honor those words,” Chair Deborah Kafoury said during Friday’s event.
Kennedy vowed to reduce the number of people in mental institutions by 50 percent or more and replace them therapeutic centers in communities across the country. Advocates and lawmakers fulfilled the first part of that commitment. The nation dramatically reduced the number of dedicated mental institutions. But fulfilling the second and more important part of that promise has been elusive.
“From where I sit, it’s easy to see the enormous gaps that opened up when institutions — rightfully — closed,” Kafoury said. “And we see people fall into these gaps every day. They fall into the emergency room, they fall into the state hospital, or they fall far too often in jail.”
Multnomah County has tried to fill those voids on its own. Last year, the County’s crisis hotline took more than 70,000 calls. Its urgent walk-in clinic saw more than 4,000 people. Some 2,000 others met with mobile crisis responders funded by the County, so they could be connected to social and medical services — and avoid a trip to the emergency department. And nearly 900 people were trained on how to identify signs of suicide and ways to intervene.
“This is a dedicated workforce who make a difference, from our busy crisis call center, to our mental health consultants, to our peer team who bring lived experience to helping others,” said Charles-Heathers, the Health Department’s newly appointed director. “Mental health is as essential to us as physical health.”
Crisis services are one piece of a health system that too often, without adequate state and federal support, struggles to reach people soon enough or get them the right help.
“Breaking the silence around suicide demands speaking loudly and honestly about what works,” said Sen. Wyden, whose brother lives with schizophrenia.
“For years, not a night went by when we weren’t worried he would hurt himself or someone else,” he said. When his brother cut his own wrists, Wyden said, he didn’t know what to do. Was it a call for help? Or a real suicide attempt?
“Back then no one knew a lot about how to handle that,” he said.
As the ranking Democratic member of the Senate Finance Committee, Wyden has fought Trump Administration attempts to roll back Medicaid coverage. Medicaid, the largest single payer of mental health services nationwide, provides low-income Americans with access to behavioral health services. Its expansion allowed more than 300,000 additional Oregonians to get these mental health services.
Wyden is pushing the Federal Communications Commission for a national three-digit phone hotline — similar to 9-1-1 for all emergency services — that’s dedicated to mental health crises and suicide prevention
“What we need in America and in Oregon is one true lifeline just for reaching out and preventing suicide,” he said.
Stephen Canova knows what it means to lose people. He’s lost six friends to suicide. He knows what it’s like to consider suicide — he tried to kill himself, too. He also knows a phone line can be a lifeline — he works for the suicide prevention hotline Lines for Life.
“I’m one of the incredible lucky ones who had a support system in place,” he said. “So many people we talk to are not as lucky as I was. It’s conversations like this that reconnect people who are in crisis, with hope.”
Angela Perry found hope, too.
“My entire life, my brain has told me I don’t matter,” she said.
Since childhood, she has struggled with a chronic physical illness, and severe depression and anxiety. Because of Medicaid’s expansion, Perry was able to obtain affordable health insurance despite her medical history. Today she sits on the Board of the American Foundation for Suicide Prevention.
“I still have a long way to go. The stigma and shame is extreme. I have an amazing support system, but I still feel ashamed and think I don’t matter and no one would miss me if I was gone,” she said. “I still struggle every day. But I matter. I have a voice and I’m going to use it.”