Rhode Island leads the nation in the percentage of its residents who attempt suicide, according to a study released Thursday by the Centers for Disease Control.
One in 67 Rhode Islanders made a suicide attempt in the previous year, compared to one in 200 people nationally, according to the CDC study. It looked at confidential surveys from 2008-2009 to create a state-by-state look at suicidal thoughts and attempts.
Suicide was the nation's 10th-leading cause of death in 2008, claiming the lives of 36,000 people.
Rhode Island's high rate of suicide attempts likely reflect of jobless rates, substance abuse and other factors that can prompt people to consider ending their lives, mental health advocates told The Associated Press.
Counselor and suicide prevention specialist Vivian Reddin points to studies showing that Rhode Island has higher than average rates of substance abuse and mental illness. Throw in one of the nation's highest unemployment rates and the CDC's findings aren't surprising, she said. Suicide is personal to Reddin. Two of her siblings took their own lives.
"With unemployment comes depression, loneliness and, for some, suicide," she said. ""Look at people abusing prescription drugs, or using illegal drugs, or drinking. We've got a problem with all these things here."
Yet the state's high rate of suicide attempts is puzzling considering that Rhode Island boasts one of the nation's lowest suicide death rates. The state's suicide rate is 9 percent, according to the American Foundation for Suicide Prevention, compared to a national rate of more than 11 percent.
Taken together, the statistics indicate that while a relatively high percentage of Rhode Islanders attempt suicide, a relatively small number succeed.
That could be a sign that mental health programs are working, according to Denise Panichas, executive director of the Samaritans of Rhode Island, a suicide prevention group which operates a suicide hotline.
"It makes me think that people are getting services and those services are working," she said. "It's not a bad thing these people aren't dying. It means they're getting help."
There could be other lesser factors at play as well, according to Lawrence Price, a psychiatrist at Butler Hospital in Providence who specializes in mood disorders. He said it's possible Rhode Islanders feel more comfortable reporting a suicide attempt.
The method used in suicide attempts can also make a difference, Price said.
He said suicide rates tend to be higher in states with higher gun ownership — not because gun owners are more likely to suffer from depression, but because guns are faster and deadlier than other methods such as drugs, carbon monoxide or hanging. People are more likely to survive an attempted overdose or even a hanging than they are a gun-shot wound.
"As a clinician, one of the first questions I ask is 'do you have access to a fire arm?'" Price said. "Suffocation is often difficult to do... overdoses are notoriously unreliable as a way of killing yourself. Shooting yourself is not that difficult."
While firearms are the most common means of suicide nationally, in Rhode Island the leading method is suffocation, according to a report by the Suicide Prevention Resource Center.
Vivian Weisman said she's less concerned about the findings in any one study and more concerned about what the high levels of suicide attempts say about the state's mental health system.
"Whatever the numbers are, the question is, 'How do we help people be well?'" said Vivian Weisman, executive director of the Mental Health Association of Rhode Island. "Are we doing what we should be doing as a state go get people the help they need?"