Parents in the four Colorado counties with the highest rates of youth suicide used these words to describe their emotional state: paralysis, exhaustion, desperation and surrender.



By surrender, the parents meant leaving their jobs to watch over their kids or “outright moving to other communities” to run away from a rash of youth suicides, according to a year-long report released Thursday by the Colorado attorney general’s office.



The in-depth review included dozens of interviews with youths, parents, and school and health officials in La Plata, Pueblo, Mesa and El Paso counties.



“One especially troubling theme is the perception among participants that suicide is starting to seem normal in their communities,” the report says. Young people and adults said they were beginning to feel that if others who died by suicide “could not get help for their problems, then they, too, may not be able to find help.”



Here’s how to get involved with suicide prevention, or find help



Colorado Crisis Line: A statewide hotline. 1-844-493-8255, or text TALK to 38255.

From 2015 through 2017, 222 Colorado youths died by suicide. Almost 68 percent of them were male, although far more females attempted suicide, according to hospital data included in the report. In 2014 and 2015, the most recent years the data was available, 816 girls and 249 boys were hospitalized after a suicide attempt.



In La Plata County, where the rate of suicide among 10- to 18-year-olds has doubled in recent years, public health officials realize it’s no longer productive to keep reinforcing the “grim” facts about suicide, said Laura Warner, interim deputy director of operations for the San Juan Basin Public Health in Durango. “Our community is at a point where everybody knows the scary statistics,” she said. “This is not an awareness problem.”



Instead, they are focused on messages about how to find help and build trusting relationships, Warner said.



“The main insight that we gained from this is understanding how traumatized our community is,” she said.



Colorado’s “public health crisis”

Outgoing Attorney General Cynthia Coffman a year ago launched the $173,000 review, an effort to learn how to prevent youth suicide and where to focus spending. The counties selected for a deep-dive review had experienced recent suicide clusters or rising suicide rates among middle school and high school students and had high rates of suicide across all age groups.



Suicide deaths in Colorado have increased almost every year since 2009, reaching a new high of 1,156 in 2016. Colorado that year had the fifth-highest suicide rate in the nation and has been in the top 10 states since 2009.



Coffman, calling suicide a “public health crisis,” said she hoped the study would “shed light on the very real impact of suicide loss and help to provide coordinated and comprehensive prevention efforts going forward.”



Colorado has ranked in the top 10 states with the highest suicide rates since 2009. The Attorney General’s Office selected four counties to study that have seen a rapid rise in youth suicide or cluster of suicides among middle and high school students.

The most-common methods of suicide for teenagers in Colorado were asphyxia, firearms and overdoses, the report found. Girls were most likely to die by asphyxia, while boys were more likely to use a gun. Among boys who took their own lives, 52.3 percent used a firearm, compared with 17.9 percent of girls.



Here’s how to get involved with suicide prevention, or find help



Colorado Crisis Line: A statewide hotline. 1-844-493-8255, or text TALK to 38255.

In La Plata County, suicide deaths by firearm were higher than the state average. About 50 percent of suicides of youths ages 10-18 and 67 percent of suicides of those ages 19-24 involved a gun, according to the report.



Local public health officials attribute those findings to the fact that many in Durango and the rest of the county own firearms for hunting or ranching. “There is certainly some cultural aspect to that,” Warner said. The county has joined the Gun Shop Project, an outreach effort that teaches gun retailers and gun-range owners how to recognize the warning sides of suicide and how to help a customer.

From 2003 through 2017, La Plata County, whose population is about 55,000 people, lost to suicide six 10- to 18-year-olds, nine 19- to 24-year-olds, and 117 people ages 25 and older.



The report found that in all four counties, adult suicide affects teens more than previously considered. “When a young person dies by suicide, the impact on that community is incredible,” Warner said, but she noted that one of the report’s key findings is that communities “need to address how to prevent suicide across the age spectrum.”



Weak economy, lack of health care are risk factors

Each of the four counties cited a weak economy and poor job opportunities as suicide risk factors. Also, focus groups in the counties noted a lack of access to health insurance and social activities.



Youths reported that social media and technology, including cyberbullying, make it difficult to take a break from constant interaction and bombardment of information. Adults, they said, don’t understand the “technological world of youth,” so their efforts to help are lacking.



Beyond social-media information overload, young people said they are overwhelmed by other stressors, including school shootings; relationships and sex; divorce; substance abuse; and academic performance. “Both youth and adults expressed that youth have no time to decompress and no break for their brains, especially with the current bell-to-bell instruction in most schools and the pace of extracurricular activities,” the report said.



Overall, adults’ response to suicide is “confusing and inadequate,” youths said. “They sense that adults are fearful of saying the wrong thing, and, unfortunately, this leads to no conversation about suicide at all, or an intense reaction where conversations feel like an inquisition of one’s potential suicidality,” according to the report.



In addition to holding focus groups and interviews in the four counties with the highest rates of youth suicide, the review — conducted by Health Management Associates — also included Douglas and Larimer counties, where youth suicide rates were lower. The review team looked at mental health resources, school policies on suicide prevention and “postvention” after a student’s suicide.



Researchers noted an increase in “e-suicide notes” on Snapchat. On Facebook, a search of the word “suicide” turns up a host of prevention resources, and a small amount — 5 percent — of “harmful” results, the report said.



El Paso Country struggling with high rates

More males than females die by suicide, but girls are far more likely than boys to be hospitalized after a suicide attempt. This chart shows a county-by-county breakdown of youth suicide attempts.

In El Paso County, the adult suicide rate is higher than the state average and the suicide rate among youths is on the rise. From 2003 through 2017, the county lost to suicide 117 youths ages 10-18 and 196 people ages 19-24.



Toxicology reports were available for 93 of the teenagers who died by suicide. Among them, 14 had marijuana in their system, six had alcohol and six had amphetamine.



El Paso County has created a youth-suicide prevention work group, which includes subcommittees of young people searching for ways to get youths involved in positive social activities through school, faith-based programs or community recreation centers.



They also are focused on training more faith-based leaders in mental health first aid and creating “authentic” relationships between adults and youths, said Meghan Haynes, teen-suicide prevention planner for the El Paso County Public Health Department.



There is no simple answer for why El Paso or the other three counties have the highest youth-suicide rates in Colorado, said Kelsey Leva, youth health and development planner for the public health department. “It’s a complex issues with lots of pieces involved,” she said. “For us, the takeaway is that we have a lot in common with the other counties.”

MORE: Read the full report here.



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