Although the specter of celebrity suicides, such as the recent shocking deaths of fashion mogul Kate Spade and chef, author and TV personality Anthony Bourdain, may be grim indeed, their cut-short lives present the opportunity of discussing two disturbing trends — the national rise in suicides and drug overdoses. And that Baltimore’s Jewish community has not escaped these tragic trends.
Suicide rates have been on the rise in almost every state from 1999-2016, according to a June 7 Centers for Disease Control and Prevention report.
“In 2016, nearly 45,000 Americans age 10 or older died by suicide,” the report said. “Suicide is the 10th leading cause of death and is one of just three leading causes that are on the rise.”
The overall increase in suicide deaths since 1999 is 25.4 percent, with the highest percentage increase, 48.6, in Vermont. In Maryland the suicide rate increased by 8.5 percent in those 17 years. Only one state had a decrease: Nevada’s suicide rate dropped by 1 percent.
Someone dies by suicide every 15 hours in Maryland, according to the American Foundation for Suicide Prevention, with suicide the third leading cause of death for people age 15-34. In 2016, more people died in the state by suicide, 586 according to 2016 CDC data, than by murder, 481 according to the FBI’s 2016 Unified Crime Report.
“More than half of people who died by suicide did not have a known diagnosed mental health condition at the time of death. Relationship problems or loss, substance misuse; physical health problems; and job, money, legal or housing stress often contributed to risk for suicide,” according to the CDC. Nationally, 44,965 people died by suicide in 2016.
For those without a known, diagnosed mental health condition, firearms were the most common method.
Likewise, Maryland’s overdose deaths continue to spike, much of the problem related to the state’s opioid crisis and the prevalence of fentanyl — a drug 100 times stronger than morphine. Opioid-related deaths topped 1,500 in Maryland in 2017, a more than four-fold increase since 2011.
Howard Reznick, manager of prevention education for Jewish Community Services, said the staff at JCS and staff from Sol Levinson & Bros., Inc., meet every few weeks to plan upcoming forums on the opioid crisis in an effort to address the trends, following up on successful events in 2017.
“We’re doing two workshops in October as follow-ups to what we did on addictions and the opioid crisis. And two in the spring,” he said.
Meanwhile, along with the forums and its usual bereavement support groups, Levinson has offered a group especially for parents or loved ones who have lost a child to addiction.
“If you look nationwide, it’s definitely a bigger problem than it’s ever been, and we are seeing those same effects in the Jewish community in Baltimore,” said Matt Levinson, vice president of Sol Levinson & Bros. “We want to continue to provide education and resources in the community for people who are going through a difficult time or to educate parents on how to help their children or see signs ahead of time — we think education is of the utmost importance. And we feel it’s our obligation to the community to help … because it’s an epidemic.”
While in the case of Spade and Bourdain, their suicides were linked with depression and not overdose, certainly many other recent deaths in the news have been.
For Reznick, he said it’s often a difficult task to winnow out the overlapping causes of death between accidental and intentional overdose, or suicides related to someone’s addiction or other issues.
“The cause of death is often fuzzy and often unknown to outsiders,” he said. “The immediate family, or sometimes friends, know and it’s usually a quiet kind of thing. A little bit more we’re seeing at the funeral itself it might be talked about out loud, or you can see in lieu of flowers send money to Narcotics Anonymous or a treatment program. But that is really the exception to the rule.”
When untimely deaths come to his attention, Reznick said he tries to determine the cause, because he is often asked, ‘Is this really a problem for us Jewish folks?’ or ‘How relevant is all this drug talk?’
In addition, Reznick said there is concern, especially for adolescents, that they may be influenced by peers and their environment when it comes to suicide. Like teen pregnancy and gun violence, he said geographic and social networks can be tracked “almost like a flu epidemic.”
“It’s not my area of expertise, but I believe the same can be true for adolescent suicidality,” he said, adding that may be why there was “hubbub” around the Netflix teen drama addressing suicide, “13 Reasons Why.”
He said over the summer, staff members at JCS are training to offer a “13 Reasons Why” workshop for schools, using clips from the show as an impetus for discussions and explorations in the classroom about suicide.
“My clinical contention is when adolescents talk about it amongst themselves period, then I think there is some danger to that,” he said. “But when adolescents are able to talk out loud with adults present then it can be a very positive thing.”
Reznick said that while suicide is “very much frowned upon” in Judaism, that Jewish teachings offer perspectives that address life’s difficulties.
“That to live means — and this is a very Jewish thing — we’re going to have, like Abraham, our forefathers, at least 10 challenges during the course of our lifetime, which are emotional or physical in nature,” he said. “Underneath that, they’re really about our spiritual development.”
Rabbi Jessy Dressin, senior director of Jewish Learning and Life at the Jewish Community Center, said she personally knows many people who are struggling with addiction or are in recovery or who have lost their battle with addiction. She also has many colleagues who have officiated at such funerals.
“I think, unfortunately, it’s a rising problem,” she said. “And I obviously believe that drug use and alcohol use is just many times a consequence of mental health issues. In many ways for me, it’s a manifestation, rather than the problem itself.”
She said there remains a stigma around mental health and addiction issues and that empathy and compassion needs to be shown to people in the same way concern is shown for people with physical illnesses such as cancer, and that the diverse Jewish community has many ways of dealing with and contextualizing the specter of addiction and suicide.
“I feel pretty strongly that it’s not guaranteed that because you’re one kind of Jew there’s one kind of way to understand how Judaism feels about this,” she said.
Meanwhile, she said she has often seen Jewish people in recovery for whom the process leads them to a deeper seeking out and connection to their Judaism.
“I have often been a part of more private conversations to try and navigate the things that people are learning about and encountering around God and higher power and spirituality and recovery,” she said. “That then requires some sort of translation for that person who maybe never saw themselves as connected Jewishly in a spiritual or religious way, but it’s coming up for them in recovery in a non-Jewish way and they’re looking to interpret it.”
CDC Risk and Protective Factors for Suicide
Risk Factors for Suicide
- A combination of individual, relationship, community, and societal factors contribute to the risk of suicide. Risk factors are those characteristics associated with suicide—they might not be direct causes.
- Family history of suicide
- Family history of child maltreatment
- Previous suicide attempt(s)
- History of mental disorders, particularly clinical depression
- History of alcohol and substance abuse
- Feelings of hopelessness
- Impulsive or aggressive tendencies
- Cultural and religious beliefs (e.g., belief that suicide is noble resolution of a personal dilemma)
- Local epidemics of suicide
- Isolation, a feeling of being cut off from other people
- Barriers to accessing mental health treatment
- Loss (relational, social, work, or financial)
- Physical illness
- Easy access to lethal methods
- Unwillingness to seek help because of the stigma attached to mental health and substance abuse disorders or to suicidal thoughts
Protective Factors for Suicide
- Protective factors buffer individuals from suicidal thoughts and behavior. To date, protective factors have not been studied as extensively or rigorously as risk factors. Identifying and understanding protective factors are, however, equally as important as researching risk factors.
- Effective clinical care for mental, physical, and substance abuse disorders
- Easy access to a variety of clinical interventions and support for help seeking
- Family and community support (connectedness)
- Support from ongoing medical and mental health care relationships
- Skills in problem solving, conflict resolution, and nonviolent ways of handling disputes
- Cultural and religious beliefs that discourage suicide and support instincts for self-preservation
For more information and help for people in crisis: Jewish Community Services 410-466-9200; National Suicide Prevention Lifeline 800-273-8255; Maryland 2-1-1 helpline; CDC Suicide: Risk and Protective Factors bit.ly/2I6vYVj. For emergencies call 911.