Experts began to warn of dire consequences soon after the pandemic arrived: Mental health crises would intensify. Suicides would increase.
In Oklahoma, those predictions came true.
Last year, 883 Oklahomans died by suicide, according to data provided by the state’s medical examiner’s office.
That’s nearly 10% increase from 2019. It’s also the highest number of suicides since at least 2006, according to an Oklahoma Watch analysis.
Restrictions designed to protect people from COVID-19 have resulted in job losses, financial instability and isolation. With families locked up, police and victim advocates say domestic and child abuse has escalated. Weddings, graduation ceremonies and holiday celebrations have been canceled or postponed. The same goes for funerals, even as the number of deaths from the pandemic increased.
All of this probably affected the number of suicides.
When the Centers for Disease Control and Prevention released preliminary data on suicide this spring, some experts were surprised. The national suicide rate fell nearly 6% in 2020. Experts cited increased access to mental health care, financial support for struggling families and lack of opportunity as possible justifications.
“There is a tendency to do what needs to be done to stay alive during a crisis,” said Dr. Richard McKeon, who leads suicide prevention efforts at the Substance Abuse and Mental Health Services Administration.
Despite the national trend, Oklahoma’s suicide rate in 2020 was well above average. For every 100,000 people in the United States, 13.5 died by suicide last year, compared to 22.3 in Oklahoman.
The state confirmed its first case of COVID-19 in March 2020, and within days, Oklahoma counselors saw an increase in anxiety and depression among patients. In November, Terri White, CEO of the state’s Mental Health Association, told Oklahoma Watch that the economic fallout from the pandemic had increased the risk of mental health and substance abuse disorders, “some of which lead to death, such as suicide and overdose “.
The pandemic is not the only factor contributing to Oklahoma’s high numbers.
Native Americans have the highest suicide rate of any racial group in the United States, especially among youth and young adults, according to reports from the Suicide Prevention Resource Center.
Suicide rates also tend to be higher in rural areas.
The risk of suicide is also higher in places where the prevalence of gun ownership is high.
According to the National Children’s Health Survey, Oklahoma children are among the most traumatized in the country. Left untreated, trauma can lead to serious mental health problems. The most recent State of Mental Health in America report ranked Oklahoma among the worst states for the prevalence of mental illness and access to care for adults and children.
“Our rates have always been higher,” said Shelby Rowe, program manager at the National Resource Center for Suicide Prevention based at the University of Oklahoma Health Sciences Center. “We’re looking at different risk factors, things like our incarceration rates are higher and having a parent incarcerated is a suicide risk factor for the child. And then being incarcerated is also a risk factor. So yes, there are things about public health that will put us at greater risk overall. “
Rural counties recorded the highest suicide rates in 2020. The vast majority were from gunshot wounds, 62%, followed by asphyxiation, mostly hangings, which accounted for 27%.
Suicides increased in 2020 among Native Americans, Hispanics and blacks in Oklahoma. Native American and Hispanic communities have also contracted COVID-19 at higher rates, according to data from the State Department of Health.
Despite a decrease in the overall national suicide rate, McKeon said other states were also reporting increased suicide rates among minority populations, which could signal a national trend.
Rowe, who led suicide prevention efforts at the State Department of Mental Health before moving to the national resource center, said recent racial tensions could be a factor.
Signs of hope
The fallout from the pandemic has left many anxious and fearful, especially as another unprecedented school year begins. The discomfort has also spread with the emergence of the more contagious Delta variant.
But Rowe said there was hope.
Better awareness has led to an increase in mental health programs. The Oklahoma Department of Education has spent $ 35.7 million in federal pandemic relief funds to boost support in schools. Starting this school year, all teachers and school staff will be required to take suicide prevention training.
Lawmakers also passed a bill requiring insurance companies to pay medical professionals the same amount for telehealth visits as in-person visits, which were previously reimbursed at higher rates. This could encourage more counselors to offer online services, thereby expanding care.
Since the pandemic, the State Department of Mental Health has partnered with Owasso nonprofit Eagle Ops to reduce suicides among Oklahoma veterans, which are among the most high of the country. Veterans of the nonprofit organize gun safety presentations at gun shows and other shooting events, and cheer on other veterans with mental health issues to donate their guns to a friend in the military or to the nonprofit organization to keep them safe while they receive treatment.
Despite increased efforts, experts say the repercussions of the pandemic are likely far from over.
The trauma could take years to manifest, Rowe said. For a child abused at home, that pain and anger can slowly build up over time, she said. Others may still be in shock, not yet feeling any emotions that could create future mental health issues.
Rowe predicts that trauma from the pandemic will contribute to suicide rates until at least 2025.
“I would like to have the answers. I think we all wish we had the answers, ”Rowe said. “The only Oklahomans who have the answers are no longer with us.”
Oklahoma Watch is a nonprofit, non-partisan news organization that produces in-depth and investigative content on a wide range of issues facing the state. For more Oklahoma Watch content, visit oklahomawatch.org.