Nevada Focus: Suicide rate in rural areas soars; researchers look for answers

PAHRUMP, Nev. - The black smudges around David Jennings' mouth were just a hint of the painful life he wanted to leave. Odd, his wife thought, but she wasn't quite sure what to do when David said he had wrapped his mouth around his car's exhaust pipe.

Another time, David poured gasoline all over his body and planned to set himself on fire.

So when she saw the note slipped into the family's front door, Kandi Jennings knew.

Eight weeks later, authorities found David's body lying against a tree in an empty lot where the family used to ride bicycles. He had shot himself under the chin; his bicycle nearby.

His death marked the end to a tormented life Kandi had struggled to understand for years.

David's death in rural Nye County also contributed to a puzzling national statistic - rural residents kill themselves at a higher rate than those in urban areas. And the West leads the nation in the rate of suicide.

But why?

In Nevada, home of the nation's highest suicide rate, the majority of people either live in the Las Vegas or Reno areas. Beyond that, lonely highways lead to isolated towns surrounded by miles of desert dotted with sagebrush and an occasional brothel.

Minus the brothels, the scene is similar in many Western states.

That's part of the appeal of the West and at the same time, perhaps part of the reason for suicide.

''It has a lot to do with how isolated everything is,'' said Stacy Holybee, of the state's Crisis Call Center, a suicide prevention agency in Reno.

''There's not a lot of community resources available. It's hard to reach out because it's harder to keep anonymous. If you have any kind of problem that you're facing, you have to go and face people that you see in the grocery store.''

Nationally, the suicide rate of adults in rural areas was 17.94 per 100,000 people in 1995, the most recent numbers from the National Center for Health Statistics. In urban areas, the rate was 14.91.

In Nevada, it's not Las Vegas, the state's gambling mecca, that drives the highest suicide rate in the nation. It's the rural counties. Two-thirds of Nevada's population lives in Clark County, which includes Las Vegas. Yet, the county's suicide rate last year was 18.91 per 100,000 people compared with the rural rate of 25.63, state figures show.

Nevada's overall rate last year was 20.18 per 100,000 people. That's almost double the national rate of 11.31 in 1998, the most recent statistics from the Centers for Disease Control and Prevention.

And in the West, the numbers are higher than in any other part of the country - 12.95 deaths per 100,000 people in 1998, the CDC said.

The South was second with a rate of 12.12, followed by the Midwest with a 10.51 rate. The Northeast was the lowest with a rate of 8.89.

Last year, six people in Nye County - where David Jennings lived and died - committed suicide. The year before, 13 people killed themselves there. Ten people in Elko County killed themselves in 1999. They aren't large numbers, but compared with county population totals, the rate is drastically high.

Fewer than 30,000 people live in Nye County - the third-largest county in the United States with 18,147 square miles of land. Elko County, in Northern Nevada, only has about 46,000 people. It's the fourth-largest county in the nation at 17,182 square miles. By comparison, Clark County has about 1.2 million people.

Nevada has long had the nation's highest suicide rate, but researchers are just beginning to explore the reasons and why life in rural areas leads to more suicides.

Some suspect a link between suicide and the type of people who are attracted to the West and its isolated areas.

''There is a thought that the frontier personality may be more accepting of suicide,'' said Dr. John Fildes, one of the leaders of Nevada's suicide prevention effort.

University of Nevada, Reno associate professor Bill Evans calls the Western lifestyle ''rugged individualism.'' The rural resident may have easy access to firearms, is a more private person and enjoys the isolation.

Two years ago, the CDC set up the Suicide Prevention and Research Center in Las Vegas at the University of Nevada School of Medicine. It made sense to the CDC to conduct suicide research in the state that is ground zero to the problem.

Fildes and other researchers there have been concentrating on Nevada's rate and other Western states.

Answers are few.

''We really just don't know,'' said Evans, who teaches human development and family studies.

That's the feeling U.S. Sen. Harry Reid, D-Nev., has, too. Reid grew up in rural Searchlight, Nev., a town of about 200 people 50 miles southeast of Las Vegas. His father killed himself almost 30 years ago.

''It took me a while to talk about it and to become public about it,'' Reid said. ''I feel better about it, and I know I've made some progress for others.''

Reid drafted the 1997 Senate resolution that called for a national suicide prevention strategy and was instrumental in establishing the suicide center in Las Vegas.

''Obviously the facts are pointing toward this rural living not being all it's cracked up to be,'' he said.

The isolated nature of the region brings more problems - setting up clinics in rural areas, attracting counselors to lonely towns and getting enough money to keep the clinics running.

''Serious shortages of mental health personnel and services are probably what characterizes rural mental health the most,'' said Peter Beeson, president of the National Association for Rural Mental Health in St. Cloud, Minn.

Dr. Larry Buel knows that all too well.

''We have difficulty recruiting and retaining qualified staff because it can be isolated because of the nature of rural Nevada,'' said Buel, director of Nevada's rural mental health clinics.

Four of Nevada's 17 counties - Esmeralda, Lincoln, Eureka and Storey- don't even have mental health clinics. An office is waiting in Lincoln County, only the state doesn't have anyone to work in it.

Residents in those four rural counties must drive to the next county for mental health services. The drive could be 10 minutes, or as long as 150 miles.

Buel said the state doesn't have the money to pay for out-of-state job applicants to come to Nevada to interview or to pay for them to relocate.

''Limited resources and a lot of need,'' Buel said.

William Crider spent only a year as director of the Pahrump Mental Health Center in Nye County. He left in August because he said he didn't have enough money to run an efficient clinic.

''The staff is here to serve all of Nye County. Nye County is larger than most states. The funding is lacking,'' he said.

David Jennings, 42, never went to that clinic. He never told anyone of his thoughts of suicide. A failed business, a lost job and bankruptcy all proved to be too much. He killed himself in January, leaving his wife to explain to their three young daughters why their father died.

Kandi, 30, looks back on their 13-year marriage and realizes there were signs of David's troubles, but she just didn't know how to handle them.

''He came out to Pahrump to get away,'' Kandi says, running her fingers across a quilt that says ''Families are Forever.''

For David Jennings, getting away turned into never coming back.