Responses adjusted when suicide calls come in

It is a quiet Sunday in Cape Girardeau.

Teenagers play basketball in a park; tourists stroll along the floodwall under a dazzling cobalt sky; cascades of vibrant pink and white petunias spill out of baskets hanging from apartment balconies and Victorian verandas. The entire city seems to be in bloom.

A woman's voice interrupts the soft hum of static over a police scanner: "We have a report of a male subject who has cut his wrists and neck. He is bleeding a lot but is breathing."

The dispatcher's words are a stark reminder that for some, darkness can overshadow even the sunniest day.

One pretty morning in late May, a Cape Girardeau man's financial problems became too much for him to bear, according to a probable-cause affidavit.

While hospitalized in St. Louis with a self-inflicted gunshot wound, George Joseph, 48, admitted to a detective he shot his wife and son to spare them the pain of financial ruin before turning the gun on himself in a failed suicide attempt, the affidavit states.

Joseph now faces two counts of first-degree murder and one count of armed criminal action.

On a lazy Sunday morning, residents in the 1200 block of North Spanish Street were awakened by the sound of police knocking on their doors, ordering them to evacuate because a man had detonated a homemade explosive device in his car.

Police said David Salzmann, 44, was trying to take his own life.

Salzmann sustained non-life-threatening injuries and was charged with assault on a law-enforcement officer, unlawful possession of a weapon and violation of an order of protection.

Salzmann, Joseph and the anonymous victim from the scanner report are not alone.

By the numbers

Darin Hickey, public information officer for the Cape Girardeau Police Department, said police responded to 58 attempted or completed suicides in town in 2012, up from 56 in 2011.

Between Jan. 1 and June 30 this year, officers responded to 34 suicides or attempted suicides, an increase of five over the same period last year.

Both nationwide and in Missouri, suicide is the tenth-leading cause of death, according to statistics from the state Department of Health and Senior Services and the federal Centers for Disease Control and Prevention.

The state's report on rural health shows that between 1999 and 2009, Missouri saw 12.9 suicides per 100,000 residents, with the rural rate -- 13.9 -- significantly higher than the urban rate.

During that period, the suicide death rates for Cape Girardeau, Bollinger, Scott and Stoddard counties fell into the 9.6 to 13.4 range, with Perry, St. Francois and Ste. Genevieve counties higher, at 13.5 to 17.0 suicides per 100,000 people.

The reason for the disparity was unclear. One possibility is access to mental-health care, which may be more readily available in larger cities.

Another possibility is simple math: The smaller the sample size, the more one or two incidents affect data. For instance, if two people commit suicide in a county with a population of 10,000 people, the suicide rate will increase by 20 per 100,000, but if two people commit suicide in a county with a population of 200,000 people, the rate will increase by only 1 per 100,000.

Moment of crisis

While the statistics -- and their interpretation -- may be useful for mental-health professionals or politicians trying to figure out the best way to address a public-health issue, numbers mean little to someone facing a crisis.

Hickey recalls talking a man down from a bridge.

In the span of three days, the man's mother died; he was evicted because the house he had been renting was sold out from under him; his pregnant girlfriend broke up with him; he lost his job; and another driver hit his car, totaling it, Hickey said.

"In three days, this dude lost everything," he said. "That doesn't even begin to talk about bad days."

While that may be an extreme example, everyone has a breaking point, said Micah Harris, a crisis worker and licensed clinical social worker with the Community Counseling Center.

Harris compared individuals' stress tolerance to drink cups: Some may be smaller, and some may be larger, but "eventually, if you've had enough, we're all going to overflow."

While a personal crisis may trigger a suicide attempt, victims often have underlying mental-health issues, Harris said.

"There's obviously some kind of mental-health issue there to push a person to that point of wanting to attempt suicide," he said. "Most people have been dealing with things for years."

Sgt. Ryan Burckhardt, a crisis negotiator for the Missouri State Highway Patrol, said substance abuse is another factor he sees often.

"Alcohol and drugs are usually involved somehow in it," Burckhardt said. "It could be a domestic-related situation, could be maybe they lost their job -- who knows what it could be?"

First responders

Police often are the first responders when someone attempts suicide, Hickey said.

"When you need help, who do you call? You call a police officer," he said. "Even if we can't help, we know who to call."

Officers' responses depend on the circumstances.

"Every situation's different, because if there's a weapon involved, the officer has to think about the subject's safety, their own safety and the general public's safety," Hickey said. "Depending on the method, it can be very dangerous for lots of people."

Gunshots, for instance, may injure or kill bystanders, Hickey said, while gas can cause explosions that endanger the occupants of neighboring buildings.

Each case is unique, but the priorities are the same, Hickey said.

"The officer's response is, 'How can I help this person and get them the help they need?'" he said.

Burckhardt said some people just need a friendly ear, while others need help solving specific problems.

"The basics involve just trying to win the trust of the person you're talking to," he said. "Sometimes they just want somebody to talk to without having any sort of judgment passed on them."

Burckhardt tries to open a dialogue with the people he helps. If he can get to the problem that motivated the suicide attempt, he can bring in resources to help solve it, such as an attorney to help someone facing serious legal trouble or a parent to reassure someone who feels unloved.

Sometimes victims just need to stay alive long enough to see the tide turn.

For instance, a few weeks after being taken to the hospital, the man Hickey met on the bridge bumped into his rescuer. He told Hickey he had reconciled with his girlfriend, found a place to live and landed a new job.

"In about a month, he got turned around," Hickey said.

Treatment

In Cape Girardeau, police usually take suicidal individuals to Southeast Hospital, which offers psychiatric care, Hickey said.

The department also works closely with the Community Counseling Center, he said.

Lt. Jerry Bledsoe of the Scott County Sheriff's Department said deputies' responses depend on the circumstances.

For instance, a man recently backed a truck up to his front door and connected a dryer vent hose to the exhaust system in an attempt to fill the house with carbon monoxide, Bledsoe said.

"We talked to the guy and had him agree to go to the hospital with the EMS for some counseling," he said.

When people don't want inpatient treatment, finding appropriate care for them can be difficult, Harris said.

"In order for us to have an involuntary commitment, we have to have a hospital bed that has accepted the client," he said.

The closure of some mental-health facilities has made those beds harder to find in recent years, Harris said.

If inpatient services are not immediately available, "we just keep calling until we find a bed," he said. "It may take hours."

After a patient is stabilized and released from the hospital, follow-up care -- such as outpatient therapy, counseling, group therapy or medication -- is available on a sliding scale based on the patient's ability to pay, Harris said.

No pattern

Suicides do not follow any predictable pattern, Hickey and Burckhardt said.

"It's just hit or miss, really," Burckhardt said. "You could go three months without a call. You could get a dozen calls within a month. There is no rhyme or reason."

If someone is threatening suicide, police always are ready to respond, Hickey said.

"We don't want to see anybody hurt in any way, shape or form," he said. "We're there to help."

epriddy@semissourian.com

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