CAPE COUNTY SUICIDE RATE ABOVE THE NATIONAL AVERAGE

Bob LeFebvre worries about the suicide rate in Cape Girardeau County.

So far this year, nine suicides have been recorded in a county with a population of approximately 62,000. The national average is 12 suicide deaths per 100,000 people.

"Unfortunately, we're well above the national average," said LeFebvre, director of psychological rehabilitation services at the Community Counseling Center in Cape Girardeau.

In 1994, eight suicides were recorded, said Cape Girardeau County Coroner John Carpenter. "So there's been no big increase or decline," Carpenter said.

By mid-September, the tally stood at three. But on Oct. 3, Jerald Amos Nelson, 44, killed his estranged wife and himself in New Wells; on Oct. 30 an 18-year-old Jackson woman shot herself to death in Cape County Park South; on Nov. 3, Delwin L. Wilkinson, 42, killed himself after holding his ex-wife and family members hostage.

And just Thursday, a Cape Girardeau man ended his own life.

LeFebvre said suicide rates tend to be "far higher in areas where there's little support or perceived support."

In rural areas like Southeast Missouri, residents may have little access to counseling services and few prevention programs may be available, or they may be isolated from neighbors and friends. Nationally, suicide rates are higher in western states than in the east.

"Isolation is a central factor that contributes to suicide," LeFebvre said. People who feel cut off from or have withdrawn from friends, family and co-workers are more at-risk for suicide.

Suicides also tend to occur more often "in an environment where people are witnessing other suicides," he said.

The "contagion effect" is especially strong in school environments, where students who commit suicide may be made martyrs. "It may be just enough to push (other students into) thinking in that direction," he said.

For that reason, LeFebvre said, prevention programs are important. Talking about suicide will not "plant the idea" in people's minds, he said. In most cases, such discussions let people know help is available or how to help a friend or loved one who is considering suicide.

Suicide is a complex phenomenon. "I think there's a convergence of things that happen," LeFebvre said, and much depends on the way the individual "thinks and feels and the way they cope with life."

"Suicide occurs in a context where there's a loss: They've lost a loved one or self esteem or money," he said. "You combine that with an overall environment that they happen to be living in" in which they are, or feel they are, isolated or without support.

LeFebvre called suicide "an adjustment factor" that ends the psychological or emotional pain the individual is suffering. "The act for most of us is an irrational act. But for someone in such intense pain that they don't see any other way out, it becomes a rational act."

Suicidal people develop a "restricted, tunnel-vision kind of thinking," he said, and are not capable of realizing their pain will end with time.

"Most of us realize that suicide is a permanent solution to a temporary problem, and that's why it doesn't make any sense," he said. "But the person who's suicidal doesn't see it as a temporary problem."

Depression is a factor in many suicides, LeFebvre said, but not everyone who is depressed commits suicide. A study of suicide notes shows several common themes, including frustration with work or loved ones, a long-term perception of hopelessness or futility and feelings of isolation and anger. For some people, "trigger events" such as the loss of a job or a divorce may precipitate a suicide attempt, he said.

"It's kind of like having a low-grade fever in your life for a couple of weeks. Then you develop a full-blown infection, and you're in a genuine medical crisis," LeFebvre said.

When someone decides to commit suicide, his will to die is stronger than his will to live. That feeling, though intense, doesn't always last long. In some cases, LeFebvre said, a few minutes' delay or distraction can short-circuit the impulse to commit suicide.

"People aren't suicidal to the point of being lethal but for a few minutes," he said. "If they have to even think for 15 minutes on how they're going to do it, they'll give it up; their will to live is stronger than their will to die."

People who survive suicides show a great deal of ambivalence as well, he said. "It's not uncommon for someone to jump off a bridge, and while they're lying there in a mess, tell rescue workers, don't let me die," he said.

About 40 percent of the 2,000 yearly calls to the counseling center's crisis line are suicide-related. Most are from people who say they have been thinking about suicide. Some are from concerned people whose friends or co-workers have mentioned suicide. Very few are from people "actually on the threshold" of committing suicide, LeFebvre said. "Most people get help before they get to that point," he said.

LeFebvre worries that suicide and violence are becoming more acceptable solutions to problems in general.

Suicide rates are highest among the elderly, but young people are quickly catching up. For the most part, women attempt suicide more often, but men succeed more often. That's changing, however, as women have more access to guns and use them more often in suicide attempts.

The center can organize support services for people who have lost loved ones to suicide. LeFebvre can be reached at 334-1100.