Washington County work links suicide, evictions

Epidemiologist who studied data found common factors and proposed practices that have reduced the county's high rate.

When Kimberly Repp saw how high Washington County's suicide numbers were each year, she vowed that she would do something about it.

Repp is the supervisor of the county's public health program and the county's epidemiologist, which makes her responsible for tracking and responding to diseases that affect public health, such as annual flu outbreaks.

She never imagined that she would be investigating suicide.

But in the mid-2010s, Washington County had one of the highest rates of suicide in Oregon.

The number of people dying by suicide in Washington County began climbing dramatically in 2009. That year, 55 people died by suicide. The numbers continued to climb until they hit a peak of 96 people dying by their own hand in 2012, or approximately 18 per 100,000 people. That is well above the national average of 13 per 100,000.

"That's not just kind of bad," Repp said. "That's just ... astronomically bad."

Starting in 2014, Repp began accompanying the county's death investigators to death scenes to see what clues or evidence would be present in the room where a person was last living. She visited more than 200 scenes in a two-year period.

From that, she developed a list of 46 risk factors that contributed to a person's death by suicide. Since 2015, those risk factors have helped county officials expand the types of people and places that Washington County and partner organizations target for suicide trainings, prevention and intervention efforts.

As a result, the county's suicide rate has fallen by 40 percent in three years.

"That data has given us the information we need to make tangible interventions in our community," Repp said.

Among the list of risk factors are what one might expect: depression, social isolation and problems with drug addiction or family or money.

But one leaped out to Repp, and others; a quiet social problem that drastically affects increasing numbers of poor people in recent years: eviction.

Eviction was a prevalent risk factor in 104 suicides in Washington County between 2014 and 2018. That included people experiencing an eviction in the last two weeks of their life or in recent years.

"I was really, really surprised by how prevalent eviction, as a crisis, and ongoing housing issues were ... directly impacting our suicide rates in Washington County," Repp said.

In response, Repp worked with the Washington County Sheriff's Office, which delivers court-ordered evictions, to have the phone number for a crisis line printed at the top of all eviction paperwork that a renter is given.

Members of the Washington County Mental Health Response Team, which intervenes when people are experiencing mental health crises, also will go with a sheriff's deputy who is serving an eviction if they know that the person is likely to be extremely upset.

Since the intervention, those who die by suicide in Washington County with eviction as a risk factor has fallen by 25 percent each year.

Oregon has one of the highest suicide rates in the nation, ranking 14 out of 50.

The rate of suicide among Oregonians has increased by 35 percent between 2000 and 2017. In 2017, 825 Oregon residents died by suicide, according to the Oregon Health Authority.

For all ages, suicide is the eighth-leading cause of death among Oregonians. For Oregonians ages 10 to 34, it is the second-leading cause.

Approximately 1 percent of suicides — roughly five to 10 people per year — are associated with eviction or the loss of a home.

Evictions are stressful, especially to low-income people who do not necessarily have money saved to pay for moving costs, a security deposit and first and last month's rent.