Cathleen Allison/Nevada Appeal
Once a month in a corner room of the Dayton Community Center, a suicide support group meets around a box of tissues.
On the overstuffed couch near a lit candle, three women share their experiences as survivors of suicide, of a husband, a close relative, a family friend.
"It's a different type of grieving and it has its own process," said Marianne Garvey, a Dayton school nurse who started the support group after losing her sister-in-law to suicide in November. "We have to accept our own unique cycle for grief."
The Dayton group may be small, but the members are far from being alone in their grief. According to an MSNBC report released in November, seven Nevada counties were among the top 50 nationwide for suicide rates.
Nye County was the highest in Nevada, at No. 8 among 3,060 U.S. counties. Lyon County ranked No. 23 with 29.1 deaths per 100,000 people. Carson City was No. 32 with 27.6 deaths per 100,000 people.
Nevada's rural counties tend to have higher suicide rates than the metropolitan areas. They also have less access to mental health services, a distressing fact for suicide prevention experts, who say that more than 90 percent of people who die by suicide have a diagnosable mental illness, such as depression, or a substance abuse problem.
Meanwhile, some Nevada counties have experienced an increase in the number of suicides - Lyon County recorded 18 suicides in 2009, up from 11 in 2008, according to the sheriff's office - as mental health services were scaled back amid state budget cuts.
But as a result, said Misty Allen, coordinator of the Office of Suicide Prevention in Nevada, more private and public organizations are beginning to discuss how to address, and fund, suicide prevention in the state.
"This is a problem across the nation," Allen said. "To sit down at the table and discuss strategies, improve awareness - suicide can be preventable, but we have to decrease stigma to do that."
After the report on Lyon County's suicide rate came out in December, the Healthy Communities Coalition in Dayton initiated meetings to address the problem.
Christy McGill, director of the coalition, said some ideas presented at the meeting this month, which about 60 people attended in Silver Springs, included training teachers to identify suicidal behavior and working with the state unemployment office to give out-of-work Nevada information on mental health services.
"We wanted to make sure that we got the awareness, that talking about suicide was not going to make anyone commit suicide," she said.
The suicide belt
Nevada's suicide rate is consistently among the highest in the country. In 2006, the most recent year for which complete data are available, the state had the fourth highest rate, with 19.5 deaths per 100,000 people. That's more than 400 deaths by suicide a year and nearly double the national rate of 11.1 per 100,000 people. Nationwide, 33,000 people kill themselves each year.
The problem is pervasive throughout the Mountain West. In 2006, the 10 states with the highest suicide rates were, in order, Montana, Alaska, Wyoming, Nevada, New Mexico, South Dakota, Arizona, Oregon, Colorado and Idaho. Utah was No. 15.
"A frequently observed, but poorly understood fact, is that Nevada is smack dab in the middle of a very large 'suicide belt.'" said Matt Wray, a former assistant professor of sociology at the University of Nevada, Las Vegas who is now an assistant professor at Temple University. "There are competing explanations. The states all have this history of boom and bust. Ranching and mining and then defense spending. That's been it for the most part. Things like drought have played a big role in it."
High rates of alcohol and drug abuse and a high divorce rate also play a role, said Rebecca Jankovich, a Reno psychologist.
"If you've had something to drink, and you're thinking about killing yourself, you won't have the impulse control to talk yourself out of it," Jankovich said. That is especially true in teenagers, she adds, who are more impulsive by nature.
Between 1999 and 2002, more than 94 percent of those who died by suicide in Clark County tested positive for alcohol or drugs at time of death, according to Wray.
But there are other factors, especially social isolation for those who live in the rural areas, said Esther Margolius, a clinical social worker who helped Garvey start the Dayton suicide support group.
"Even though we're offering this resource there's going to be a lot of people who can't get to us because of it being rural," Margolius said. "In Reno people can jump on a bus or take a taxi (to a support group)."
A circle of support in Dayton
At the Dayton support group, the first of its kind in Lyon County, Tammie, who asked that we not give her full name, says she still has trouble talking about her husband's death.
"I still don't tell people exactly what happened," Tammie said. "I'm ashamed of it."
Garvey said that, before losing her sister-in-law last year, her first experience with suicide was learning the daughter of a family friend had killed herself.
"I was unable to call and say anything," Garvey said. "There were so many things I could have said or just called and said, 'I don't know what to say,' and I've done that with other deaths, but I just didn't know how I could say anything to these parents who had lost this young girl to suicide."
Garvey said the friendship ended because she couldn't confront talking about suicide.
"I wasn't equipped," she said.
And that's part of the reason why Garvey said it's important for survivors of suicide and those who may be at risk to talk about it - to confront the problem instead of ignoring it.
"I don't feel like to total failure, but I feel like I let her down," Garvey said of her sister-in-law. "And I don't want people to think that, because I loved her a lot."