Each time James Dixon crosses the St. Johns Bridge, their eyes search for something specific: the County’s suicide prevention signs — beacons of hope that remind people in distress that there is help.
As the County’s Black youth suicide prevention coordinator, Dixon is always vigilant and thinking about how to help people struggling in silence. As they drive across the bridge, they’re also looking out for anyone who appears to be struggling along the way.
“This extends beyond the scope of my occupation, as it is the work of a concerned community member that motivates me to drive change and possibly save a life,” Dixon told the Board of Commissioners Thursday, Sept. 28, during a proclamation recognizing September as Suicide Prevention Month.
“Every year we bring together many of the advocates who work on the front lines of suicide prevention in our community for this proclamation, and I wanted to say how grateful I am for the work that is done,” Chair Jessica Vega Pederson said. “I just really appreciate the work you do and the way you walk alongside people when they need you the most in doing this work.”
The National Alliance on Mental Illness has found that suicide is often the result of an untreated mental health condition. Suicidal thoughts, much like many forms of mental illness, can affect everyone, regardless of their age, gender or background.
According to the Centers for Disease Control and National Institute of Mental Health, nearly 46,000 people died by suicide in 2020 – nearly two times the amount of homicides that year. Suicide was the 12th-leading cause of death in 2020.
“Anyone and everyone can be touched by traumatic impacts of suicide or thoughts of suicide, be it through family, friends or themselves,” said Canada Taylor Parker, Multnomah County’s suicide prevention coordinator. “It is an intersectional public health issue.”
Some groups at higher risk of suicide
The highest rates of suicide in the U.S. are among American Indians/Alaskan Natives, followed by non-Hispanic white people, according to NAMI. Seventy-nine percent of all people who die by suicide are male.
Suicide is the second-leading cause of death for people ages 10-45 in Oregon. And while youth suicide rates have decreased in recent years, suicide rates continue to increase for youth of color and the LGBTQIAS2+ community. People who identify as transgender are up to nine times more likely to attempt suicide as the general population.
“I have heard the statistic before, that the second-leading cause of death for people aged 10-45” is suicide, Commissioner Susheela Jayapal said. “And yet every time I hear it, I am just startled by it. How can it be the second-leading cause of death and, in my opinion, get as little attention as it does?”
For Commissioner Sharon Meieran, the mental health crisis among young people is personal. One of her own teenagers — who identifies as trans and queer — once attempted suicide. With their permission, Commissioner Meieran told their story to shed light on and reduce the stigma surrounding suicide.
“I asked and they gave permission to be able to talk about it, because it’s so important to destigmatize,” said Commissioner Meieran, who previously convened a youth mental health forum. “The numbers are real, and they haunt me.”
Youth involved in the legal or foster care systems also have a greater risk of dying by suicide. Those experiencing homelessness, poverty and abuse are also at higher risk. Among adults, stressors that can increase risk include housing concerns, economic status, health conditions and relationship issues.
Suicide is also on the rise among Black youth. Between 2018 and 2022, that group saw the largest increase of suicides among people ages 10 to 24.
This year, Multnomah County joined a statewide pilot program called the Black Youth Suicide Policy Institute, in partnership with the Substance Abuse and Mental Health Administration (SAMHSA). The coalition is working on creating a statewide framework to addressing suicide among Black youth.
Sofie Fashana, a member of the Institute, has seen these issues firsthand. As a recent college graduate and a former residential assistant at her university, she said she often encountered people in distress.
An immigrant and a person of color, Fashana has also seen how the mental health system is not historically designed for people with backgrounds and experiences like hers. She has repeatedly seen the system’s shortcomings, especially when she has tried to help other young people.
In one example, she said, a student in distress came to her seeking help. Her school’s solution was to send law enforcement. “As an African American myself, that is not easy – that is not a solution,” she said. “And as a peer, that’s not fair, also.”
Through her membership in the Black Youth Suicide Policy Institute, she says she has found other Black people who share her passion and drive for making the mental health system more culturally responsive.
Fashana told the Board there’s an opportunity to see youth who feel unseen and unheard and give them their dignity back. She’s hopeful the mental health system can evolve to better serve people of all backgrounds – especially youth of color.
Commissioner Julia Brim-Edwards recognized the compounding effects of the COVID-19 pandemic, as well as major developments around racial justice and climate change, in worsening the sense of isolation felt by young people in recent years.
“In my other life as an elected official with the Portland School Board — we support more than 45,000 youth — I don’t think there’s been a more critical time in the last several decades,” Commissioner Brim-Edwards said. “Mental health resources and youth suicide prevention has never been more important.”
Get Trained to Help
Multnomah County takes a public health approach to suicide prevention. By improving access to food, healthcare, housing and behavioral health support, the County aims to improve the root causes that put people at greater risk.
Scott Vu, Multnomah County’s behavioral health prevention coordinator, is charged with leading a regional suicide prevention training program in partnership with Clackamas and Washington counties.
“We want to provide hope through action,” Vu said.
The program, known as Get Trained To Help, provides free trainings for community members to recognize the signs of suicide and help those in crisis. Registration is easy — class listings are searchable by training type, date, location, format, (in-person or virtual) and language.
Classes include basic, one-on-one suicide prevention training known as Question, Persuade, Refer (Q.P.R.), Mental Health First Aid for youth and adults, and an advanced, two-day Applied Suicide Intervention Skills Training (ASIST).
To learn more about how to help someone in distress, or to sign up for a class, visit gettrainedothelp.com.