On July 5, the American Association of Suicidology (AAS) reported that New Mexico’s suicide rate is the highest in the nation based on the raw numbers of suicides in 2018. The New Mexico Department of Health disputes the number one ranking but nonetheless reports that based on its own calculations New Mexico’s suicide rate is the second highest in the country.
According to the New Mexico Department of Health, the AAS uses raw data to analyze suicide rates, while the New Mexico Department of Health’s method for comparing suicide among different populations is to use “age-adjusted rates.” Looking at age-adjusted death rates in 2018, the New Mexico Department of Health found that New Mexico had the second highest rate of suicide of 24.95 suicides per 100,000 residents, behind Wyoming, which had 25.23 deaths per 100,000 residents.
The New Mexico Department of Health (DOH) reported a total of 535 New Mexico residents committed suicide in 2018. The year 2018 is the most recent year for which nationwide data is available for comparison and includes increases in more than half of the age categories. The comparison includes both male and female populations, and across other demographics.
According to the American Association of Suicidology (AAS), the national average for suicides is 14.8 suicides per 100,000 people.
In 2017, New Mexico was 4th in the nation with 491 suicides which is a rate of 23.5 suicides for 100,000 residents. New Mexico was behind Montana, Wyoming and Alaska at the time.
In 2018, New Mexico had a 9% increase in the number of suicides. The number of suicides in the state went from 491 to 535 in one year. The increase in suicides in the state for the year resulted in the state being listed as number one in the country with a suicide rate of 25.6 suicides per 100,000 people.
The American Association of Suicidology reported one more suicide in New Mexico than New Mexico’s Department of Health. According to the association’s data, Wyoming in 2018 was second in suicides in the country with 147 suicides resulting in 25.4 suicides per 100,000 people.
The 3 other top contenders for highest suicide rates , like New Mexico with small populations, had substantial drops in suicides from 2017 to 2018. Montana saw 46 fewer suicides, Wyoming saw 10 fewer, and Alaska saw 16 fewer. The reduction in suicides in the other states is in sharp contrast to New Mexico, which had its highest number of suicides since the state began keeping track of suicides in 1999.
SUICIDE METHODS IDENTIFIED
The New Mexico Department of Health has identified 4 major categories for the commission of suicide: fall, firearm, poisoning, and suffocation. The statistics released by the New Mexico Department of Health showed that every category defining the cause of death increased, but interestingly, made up the same percentage as the year before.
In both the years of 2017 and 2018 a firearm was used in a little more than half of the suicides. Suffocation was the cause of death in just under 30%. Poisoning was the cause of death in 13% to 14% of deaths. Falls made up less than 2% of the suicides reported.
MALES HAVE SIGNIFICANTLY HIGHER SUICIDE RATES
The statistics released by the New Mexico Department of Public Health (DOH) for 2018 are summarized as follows:
The number of suicides rose in 5 of the 9 age groups. Three-quarters of the New Mexico residents who killed themselves were male.
The number of women who died by suicide increased 22% from 109 in 2017 to 133 in 2018.
The number of men who died by suicide increased 5% from 382 in 2017 to 402 in 2018.
For youth ages 5 to 14 the suicide rate increased 88% from 2.5 deaths per 100,000 to 4.7. The hard numbers remain small with 7 suicides in this age group in 2017 and 13 in 2018. The state’s rates of suicide jumping in the youngest age group is also nationwide trend.
For people ages 25 to 34, the rate increased 25% from 29.6 to 37.9 deaths per 100,000. In 2017 there were 84 suicides in this age group, and there were 108 in 2018.
For people ages 35 to 44, the rate increased 13% from 27.1 to 30.6 deaths per 100,000. In 2017 there were 67 suicides, and there were 77 in 2018.
For people ages 55 to 64, the rate increased 49% from 19.5 per 100,000 to 29.1. There were 54 suicides in 2017 and 80 in 2018.
For people ages 65 to 74, the rate increased 9% from 29.7 to 32.5 deaths per 100,000. There were 63 suicides in 2017 and 71 in 2018.
The four remaining age groups had a decrease in the rate of suicides.
There was a substantial increase in the number of suicides among Native Americans. In 2017 there were 47 suicides reflecting a rate of 24.6 per 100,000. In 2018 there were 67 suicides reflecting a rate of 37.9 per 100,000.
INADEQUATE BEHAVIORAL HEALTH SERVICES
New Mexico Department of Health spokesman David Morgan explained that studies have found that in New Mexico there are 2 major contributing factors to high suicide rates:
1. New Mexico’s has a high rate of “adverse childhood experiences” that are associated with depression and higher rates of self-harm and suicide.
2. Limited access to behavioral health services. Behavioral health services are especially unavailable in the more rural parts of New Mexico.
Studies have found that New Mexico’s relatively lax firearm laws and higher rate of gun ownership are reflected in the state’s suicide rates. In 2017, 261 people killed themselves with a firearm and in 2018, 280 people used a firearm to take their own life.
According to Morgan, the New Mexico Department of Health (DOH) reestablished a coalition of advocates and organizations who will meet and discuss how to address suicide. The first meeting of the New Mexico Suicide Prevention Coalition occurred in October, 2019. Attending were upwards of 60 people from across the state from state and county agencies, nonprofits, higher education and behavioral health groups. The group discussed suicide awareness, prevention, intervention, post-vention, crisis services and surveillance.
The DOH is also working with emergency departments in various hospitals to implement a “secondary suicide prevention program” to provide treatment and support for patients who can be discharged and go home.
In an email to the Albuquerque Journal, DOH spokesman Morgan had this to say:
“The intervention includes a safety intervention plan that is patient centered, includes discussion on limiting access to lethal means, connects the patient to a crisis response center, and provides a quick referral to a behavioral health clinician. the intervention also provides support post discharge in the form of caring phone calls and/or letters to express concern to the suicide attempt survivor.”
DESTRUCTION OF NEW MEXICO’S BEHAVIORAL HEALTH SYSTEM
It should come as absolutely no surprise that behavioral health services in New Mexico are limited and are especially unavailable in the more rural parts of New Mexico. The New Mexico Department of Health (DOH) is no doubt reluctant to talk about the biggest reason for poor behavioral health care in New Mexico and suicide prevention efforts. All New Mexico residents can give a big thanks and shout out to our former Republican Governor “She Who Shall Not Be Named” who was in office for a full 8 years and who almost single handedly destroyed New Mexico’s behavioral health care system.
The single cruelest thing that former Republican Governor “She Who Shall Not Be Named” did was when she ordered an “audit” of mental health services provided by nonprofits in New Mexico. She did so based on questionable information. The audit eventually devastated New Mexico’s behavioral health care system.
In June 2013, under the direction of the former Republican Governor, the Human Services Department (HSD) cut off Medicaid funding to 15 behavioral health nonprofits operating in New Mexico. In 2014, more than 160,000 New Mexicans received behavioral health services, with most of those services funded by Medicaid. After the audits were completed, the former Republican Administration said that the outside audit showed more than $36 million in over billing, as well as mismanagement and possible fraud. Under the orders of the Republican Governor, Human Services Department agency brought in 5 Arizona providers to take over from New Mexico providers.
In early 2016, following exhaustive investigations, the Attorney General cleared all 15 of the healthcare providers of any wrongdoing and exonerated all of them of fraud. Even though the New Mexico Attorney General found no fraud and cleared the nonprofits of fraud, the damage had been done to the nonprofits. With the Medicaid funding freeze, many of the 15 nonprofits could not continue and just went out of business leaving many patients without a behavioral health service provider especially in rural New Mexico. Lawsuits against the state were initiated by the mental health care providers.
Three of the five Arizona providers brought in by the previous Republican Administration in 2013 to replace the New Mexico nonprofits pulled out of the state. New Mexico’s mental health system is still struggling to recover.
BERNALILLO COUNTY’S EFFORTS TO REBUILDING BEHAVIORAL HEALTH CARE
There is grounds for hope to address New Mexico’s high suicide rates and its happening in Bernalillo County. On Feb. 26, 2015, the Bernalillo County Commission approved a 1/8 % gross receipts tax increase on a 3-2 vote to fund new behavioral and mental health services to improve access to mental and behavioral health care services in the county. The tax generates approximately $20 million annually. The intent of the tax is to invest the funding “in proven ways to better manage the high cost of addiction, homelessness and mental health problems”. According to a county commission announcement, “these issues impact families throughout the community and drive up the cost of public services, especially at the Metropolitan Detention Center.” The gross receipts tax costs shoppers one cent on a $10 purchase of goods and services.
The 1/8th% gross receipts tax is be used for the purpose of providing more mental and behavioral health services for adults and children in the Albuquerque and Bernalillo County area. The intent is to provide a safety net system for those in need of mental health not otherwise funded in New Mexico.
Since enactment of the tax in 2015, the tax has generated $91.6 million. The county has spent $20 million of the money but has earmarked the bulk of what it amassed for one-time expenditures. Those expenditures include $30 million for a new crisis triage center, $12 million for supportive housing and $4 million for the Bernalillo County CARE campus, formerly known as the Metropolitan Assessment and Treatment Services center, or MATS. The renovations to the CARE campus when complete will create an outpatient behavioral health clinic and living room space for peer-to-peer counseling sessions.
GUEST COLUMN BY COUNTY MANAGER AND CAO OF UNM HOSPITALS
On July 25, the Albuquerque Journal published a guest column authored by Bernalillo County Manager Julie Morgas Baca and Chief Executive Officer for UNM Hospitals Kate Becker. The guest column addressed the $20 million-a-year gross receipts tax dedicated to funding behavioral health services in Bernalillo County passed by county voters in 2014.
Following are edited excerpts from the column:
“… Bernalillo County and its community partners on a daily basis are … delivering the caliber of crisis triage services the tax was intended to support: a broad suite of behavioral health services to meet community needs … and a crisis triage center. These community-based programs, funded to the tune of $24 million over the past three years, have already benefited more than 80,000 people who were not otherwise being served.
… Voter approval of the gross receipts tax spurred the creation of the Behavioral Health Initiative (BHI) in 2015. This landmark collaboration of Bernalillo County, the city of Albuquerque and the University of New Mexico recognized there were significant unmet behavioral health needs in our community.
Over the past five years, the BHI tax has helped fund multiple initiatives, including:
The mobile crisis teams
Law Enforcement Assisted Diversion
The Resource Reentry Program
Community Connections supportive housing
Youth Transitional Living services
Reduction of Adverse Childhood Experiences,
Suicide prevention [efforts]
Behavioral health training and education
Peer Case Management
Peer Support Drop-In Centers and most recently
The Crisis Stabilization Unit located on the CARE Campus
(EDITORS NOTE: For a listing of 9 projects and funding from the Bernalillo County Behavioral Health tax see postscript to this blog article.)
These services provide the full continuum of support required to meet community behavioral health needs. Unfortunately, many of these needs went unmet after the state’s behavioral health safety network was realigned in 2013, and it has taken considerable time to rebuild needed resources.
In addition to funding these critical safety net services, Bernalillo County has worked closely with UNM Hospital to develop the Crisis Triage and Adult Psychiatric Center. This center would help those in crisis who don’t meet the criteria for psychiatric hospitalization, but whose mental health or substance abuse problems might lead them to jail or an emergency room.
… Bernalillo County and UNMH have executed a memorandum of understanding for the crisis triage center, reflecting an appropriation of $20 million from the county, to be matched by $20 million from UNMH. Earlier this month UNMH identified potential sites for the county to review in advance of the design-and-build process.
In addition to this much-anticipated new facility, UNMH and Bernalillo County staff continue to address additional needs, including partial hospitalization, expansion of behavioral health services at the UNM Psychiatric Center, living room model services and expanded behavioral health services for young people.
… [T]here is tremendous need in our community for these services. We are committed to thoughtful, data-driven decision-making, relying on best practices and community involvement to ensure that BHI tax receipts are expended in a way that achieves the result we all wish to see.
The Behavioral Health Initiative can take credit for putting our community on the right track at long last.
Going forward we will not rest on our laurels, and we will never lose sight of our overarching goal: to improve lives and serve the people of Bernalillo County.
The link to the guest column is here:
COMMENTARY AND ANALYSIS
It is a very difficult for any elected official or for that matter any New Mexico resident to acknowledge and make an effort to solve the state’s high suicide rates given that the state is confronted with so many other serious problems it is dealing with including poverty, high crime rates, drug addiction, high unemployment and a poorly performing educational system just to mention a few.
According to the most recent state rankings compiled by US News and World Reports, New Mexico is at the bottom in many of the rankings:
#34 in Health Care
#49 in Education
#47 in Economy
#48 in Opportunity
#47 in Fiscal Stability
#49 in Crime & Corrections
#50 in Child Welfare (Last place for a third year in a row according to Kids Count 2020 Data Book measuring economic well-being, education, health and
family and community)
The County Commission has available millions in tax revenues generated from the behavioral tax assessed. In 2015, when the Bernalillo County Commission approved the tax, it did not develop a plan on how all the money would be used, including not identifying services to be provides, location of facilities and qualifiers to obtain the services offered. Approved programming should eventually cost the county $18.9 million annually, but more than $70 million in tax revenue has accumulated and the amount is growing. The County Commission has now enacted “Request For Approval” (RFP) plan to solicit plans from health care providers and others.
Notwithstanding all the rankings, Bernalillo County’s efforts for behavioral health programs is critical to addressing the city and counties behavioral health care needs and in turn the state’s. For that reason alone, Bernalillo County needs to explore expansion far more outreach programs, especially with our youth to deal with high suicide rates. Such programs need to include working with the city and the Albuquerque Public Schools to offer counseling services to our youth.
According to the Bernalillo County “Public Health Projects” webs site, link provided below, 9 projects that have been approved and committed annual funding of each of those projects are as follows:
1. Transition Planning and Re-entry Resource Center – $1,341,188 in year one; $1,041,188 annually thereafter.
“On a daily basis, the Metropolitan Detention Center (MDC) releases individuals back to the community who suffer from a variety of mental illnesses and substance abuse disorders, among other complications. The lack of a system for coordinated care as incarcerated individuals’ transition from jail to community contributes to recidivism and impedes efforts to generate more positive health outcomes for these individuals. The project includes funding transition planners at MDC and creating a Re-entry Resource Center (RRC) for an effective front door into a network of services.
2. Mobile Crisis Teams – $1 million BC/$340,000 ABQ
“The mobile crisis teams will respond to individuals experiencing a nonviolent behavioral health crisis that necessitates a 911-response Crisis Intervention teams are to be dispatched and will consist of a crisis intervention unit deputy paired with a masters’ level, behavioral health clinician.”
3. Expansion of the County’s Community Connections Supportive Housing Program – not to exceed $1 million.
“This expansion will focus on individuals with behavioral health issues residing in the community who are homeless or precariously housed and is estimated to provide a minimum of 55 housing vouchers with case management service.”
4. Community Connections Re-entry Supportive Housing – $1.3 million from Bernalillo County; $503,000 from City of ABQ
“This project provides intensive case management and services linked with scattered site housing to a target population of homeless or precariously housed persons with mental illness or co-occurring disorders or other disabilities and whose lack of community-based services have resulted in criminal justice system involvement.”
5. Community Engagement Team
“Community Engagement Teams (CET) help people and their families voluntarily cope with the effects of mental illness and substance abuse disorders, whether individual or co-occurring, in the comfort and familiarity of their homes and communities. The CET helps individuals avoid the criminal justice system and emergency mental health systems whenever possible. The CET in Bernalillo County requires an individualized, recovery-focused approach that promotes wellness, self-management, personal recovery, natural supports, coping skills, self-advocacy and the development of independent living skills. CETs can be considered part of a continuum of services rendered outside institution walls that include assertive community treatment, the crisis intervention unit, crisis outreach and support team, public inebriate intervention, and law enforcement response.”
6. Youth Transitional Living Proposal – not to exceed $650,000
“This is a new service intended for at-risk youth who are precariously housed or homeless with a mental health or addiction diagnosis. The funding provides youth transitional living services for clients with behavioral health diagnosis who are not currently under any state Children Youth and Families Department, Bernalillo County or other third party-funded program. This funding is available for non-third-party reimbursement.”
7. Reduction of “Adverse Childhood Experiences” (ACES) – not to exceed $3 million
“Bernalillo County is seeking to develop a cohesive system that utilizes all available resources to assist children who have been identified as at-risk by using adverse childhood experiences (ACE) scoring methodology. The goal is to develop a system that maintains a strong collaboration of professionals who work with children across the full continuum of services for at-risk children and families including primary prevention, identification, early intervention, support and treatment, harm reduction, outreach, and services in children’s homes and within communities. The funding is to pay for services and family supports not currently reimbursed by Medicaid or third-party payers.”
8. Behavioral Health Advisor – up to $140,000 per year
“The behavioral health advisor will provide guidance on the development and implementation of the behavioral health initiative.
9. UNM’s Institute for Social Research (UNM/ISR) Contract – not to exceed $246,553 per year.
“Bernalillo County seeks to implement a behavioral health system that measures the effectiveness of implemented programs and constantly strives to improve the performance of programs
A link to a related blog article is here:
New Mexico’s Disgraceful Legacy Of Being Dead Last In Child Well Being Continues, Despite Gov. MLG’s Pledge To End Child Poverty Within One Year; New Child Well Being Agency Major Step To End The Disgrace