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Editor's note: The Mail Tribune and KTVL join newsrooms statewide in addressing the suicide crisis this week in the hope of saving lives. This is Part 1 of a three-part series. Part II is "Give Them Hope."Part III is "A Survivor's Story." Watch for coverage on KTVL on Tuesday and Friday.

If you’ve thought of killing yourself, you’re not alone.

About 1 in 22 people in Jackson County will think about suicide in the coming year, prevention experts say. Though only a fraction will carry it through, their numbers are growing at an alarming rate.

Jackson County had a record number of suicides in 2018, with 73 people taking their own lives compared with 57 the year before.

Suicide does not discriminate.

“It affects the young, the elderly, the middle-aged,” says Jackson County Medical Examiner Tim Pike, who investigates suicides and other types of sudden or unexplained death. “There is no box you can check to say, ‘These are the suicidal people.’ It’s professionals, students, police officers, nurses, doctors, transients.”

Family members and friends left behind often don’t want information about a loved one’s suicide to become public, Pike says.

“It’s a private moment. Part of it is the stigma. They think, ‘My son or daughter took their life and I don’t want my neighbors to know.’ We understand their need for privacy,” he says.

People are often afraid to talk about suicide, or to bring the subject up when a friend or family member seems troubled, says Jackson County Mental Health Suicide Prevention Coordinator Kristin Fettig.

She says it’s a myth that asking someone if they are having suicidal thoughts will plant the idea in their mind, triggering a suicide.

“It’s actually the opposite,” Fettig says.

Asking about suicidal thoughts shows the person that others care and are willing to listen and help, she says.

“A lot of it is recognizing signs in a friend or co-worker,” Pike says. “A lot of people are afraid to say, ‘Are you OK? You’ve been through a tough time. Do you want to go get a coffee?’ You don’t have to have all the answers. Just let them vent or talk.”

Fettig recommends listening and showing empathy — without offering quick-fix solutions.

She offers free training to businesses, churches and community groups about how to recognize and respond to the warning signs of suicide. To request a training, call 541-774-8201.

For people who are feeling suicidal, the most important step is to ask for help.

“That’s difficult. But once they do, they are connected to another human being,” Fettig says.

Reaching out can range from calling the local or national suicide prevention line to talking to a trusted person. Taking those steps can be especially hard for a person who has withdrawn from others and feels disconnected, she says.

“It’s something that’s really common with people that are thinking about suicide. They feel like other people around them won’t be able to understand. And so because of that, they start to feel this disconnect,” Fettig says.

Fettig and other experts hope that talking openly about suicide will help destigmatize it and save lives.

Suicide by the numbers

Jackson County’s suicide death rate is higher than the rest of Oregon and America: 33 per 100,000 people, compared with 19 statewide and 14 nationally, according to recent statistics.

Rural states in the West typically have the highest suicide rates, with Oregon ranking 14th. States with the lowest suicide rates are clustered in the northeastern United States plus California.

Gunshot wounds are the leading cause of suicide deaths in Jackson County, claiming 40 of the 73 lives lost in 2018. Overdoses were a distant second at 14.

Males are significantly more likely to die from a suicide attempt than females, in part because their method of choice is guns.

In 2018, 59 males died by suicide compared to 14 females in the county.

Fettig says societal roles often make it harder for men to reach out for help. Women are often more comfortable talking about their emotions.

Pike says while men are more likely to use guns, females also die from gunshot wounds.

Pain, loss of hope factors

Pike remembers a particularly difficult case of a young woman who shot herself in 2018 after suffering childhood sexual abuse.

“She suffered chronic abuse throughout her life. Her self-worth was taken from her early on,” Pike says.

In that case, the woman left behind a suicide note, he says.

Investigators and loved ones find suicide notes in about 25 percent of local cases, he estimates.

Pike says no one knows why Jackson County had a record number of suicides in 2018, but he did see an increase in the number of victims who expressed a loss of hope.

One woman who killed herself left a note in her backpack saying she had been traveling the country looking for the good in people, but couldn’t find it, he says.

“When you see that, it hurts,” Pike says. “We live in a world that dehumanizes people. We put people in categories. People feel, ‘I don’t have a place in society.’”

While many people think of suicide as primarily affecting the young, the most deaths occurred in the 31-40, 61-70 and 71-80 age groups in Jackson County in 2018.

People in their 30s may be experiencing disappointment about how their lives are turning out, Pike says.

Or they may be under added stress from working and parenting, Fettig theorizes.

Pike says suicide among older residents is often related to health and quality-of-life problems.

Some people facing a terminal illness or a degenerative disease want to go out on their own terms, he says.

Others grow depressed about not being able to take part in activities they once enjoyed.

“They might think, ‘I used to be able to hunt and fish. Now I can’t get out of my chair,’” he says.

As friends and family move or pass away, older adults often become lonely, which can lead to suicide, Fettig says.

“Isolation seems to be a big factor,” she says.

While dealing with suicide is a part of their jobs, both Fettig and Pike have experienced the loss caused by suicide on a personal level.

Fettig lost a close friend to suicide in 2011.

“It’s devastating,” she says, noting grief over a suicide is a tangled mix of emotions, from sadness to confusion.

Pike, who served in the military before joining the Jackson County Sheriff’s Office, has had several friends he served with die from suicide. He recently lost another close friend to suicide.

“It rattled me. I think, ‘Why didn’t you pick up the phone and call me?’ To a degree, I can understand survivor’s guilt. ‘Why didn’t you tell me or talk?’ I didn’t see it in my friend. If you suspect something, do something. Try to get them to talk or tell someone who you think can intervene,” Pike says.

Reach Mail Tribune reporter Vickie Aldous at 541-776-4486 or valdous@rosebudmedia.com. Follow her at www.twitter.com/VickieAldous.

Don’t ignore warning signs

Warning signs of suicide include:

-- Talking about wanting to die

-- Talking about being a burden to others

-- Talking about feeling hopeless or having no purpose

-- Displaying extreme mood swings

-- Showing rage or talking about seeking revenge

-- Withdrawing from others

-- Acting recklessly or looking for ways to kill oneself

If someone exhibits warning signs of suicide:

-- Don’t leave the person alone

-- Remove guns, alcohol, pills, sharp objects and other items that could be used in a suicide attempt

-- Call the Jackson County Mental Health 24-hour crisis line at 541-774-8201 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255)

-- Take the person to an emergency room or seek help from a medical or mental health professional

-- If suicide seems imminent, or the person has attempted suicide, or that person may hurt someone else, immediately call 911.

Kristin Fettig explains the importance of talking openly about suicide.