Suicide risk factors
By, Heather Muller, The Eureka Reporter, February 25, 2007
On Feb. 3, 2006, Michelle Roskopp lost her long battle with drug addiction, with mental illness, with physical illness and with the circumstances of her short, troubled life. She committed suicide a month before her 37th birthday — a death her mother said “could have been delayed but probably not prevented.”
Why did Michelle die?
The story goes that when Michelle died, her boyfriend was threatening to kill himself after learning she had prostituted herself to buy crack cocaine, according to Michelle’s mother, Fortuna resident Susie Spitzer.
“She said to him, ‘What are you going to do, how are you going to do it?’ So he took the gun and put it in her mouth. And she said, ‘What are you going to do next?’ and he said, ‘Pull the trigger.’ He started screaming at her, just screaming for her to pull the trigger. ‘Pull the trigger, pull the trigger,’” Susie said.
“So she did.”
Though Michelle’s suicide came as a shock to those who knew her, her death at the age of 36 was not entirely unexpected.
“She was sick,” Susie said, “really sick. At that point, she weighed only about 85 pounds.”
Not long before Michelle’s death, her mother received a phone call from a Las Vegas hospital saying that Michelle had just walked out of the emergency room, against the advice of a physician.
She had been diagnosed with extremely severe lupus, was suspected of having hepatitis B and C, and had refused a test for HIV — all of which her mother, a 30-year registered nurse, believed Michelle had.
Certainly physical illness wasn’t Michelle’s only serious problem. She had been diagnosed with schizophrenia as a child, and in recent years had lost her marriage, her job, her home and her two children to habitual drug use.
“I want to emphasize that although she did have some emotional problems, she was not always a bad person,” her mother said. In fact, she was a graduate of the University of Nevada, Las Vegas, and worked as a designer for a major Las Vegas casino. She was by all accounts a good mother to her children.
That was before the drugs.
“She turned into a crack whore,” Susie said. “Saying that makes me want to vomit, but it’s an honest statement.”
So what killed Michelle Roskopp?
The short answer is that she did. But the long answer could be even more troubling.
According to reports from the Humboldt County Coroner’s Office, as much as 60 percent of the 141 people who died from suicide in Humboldt County from 2002 through 2006 suffered from a diagnosed mental illness — depression was most common, followed by bipolar disorder and schizophrenia.
Drugs and/or alcohol were named as factors in 45 percent of suicides during the same period, with prior attempts and/or threats documented in 41 percent of deaths.
Isolation — one of the most common explanations of suicide in sparsely populated rural areas — was identified in less than one-fourth of all deaths.
But probably the most startling statistic gleaned from the coroner’s reports was the high number of suicides in which serious chronic or fatal illness was said to be a factor.
For 61 people — 43 percent — at least one of a list of dire, debilitating conditions was named, ranging from chronic pain to terminal cancer.
Among the risk factors regularly documented in coroner’s reports were five circumstantial or event-based factors, including difficulties relating to various losses — of a relationship, of status and even freedom stemming from serious criminal charges, of a place to live, of a job or of a loved one.
Michelle had almost all of these things working against her. Her risk assessment, if such a thing is even possible, was off the charts.
But in many other suicides in which medical illness was said to be a factor, the person who died did not appear to be otherwise at risk.
According to coroner’s reports, the average number of 10 risk factors in suicide deaths in Humboldt County was three.
But of the dozens of suicide deaths in which only one or two risk factors were identified, the overwhelming majority — more than 60 percent — were chronically or terminally ill.
That wasn’t the only difference between the two groups.
The seriously ill also tended to kill themselves in noticeably different ways. Gunshot deaths were slightly more common in that group, and hanging deaths — which accounted for 23 percent of the deaths of healthy individuals — were practically nonexistent among the physically ill.
And while people without medical problems were almost eight times more likely to hang themselves than those with, the second group was four times more likely to die from a prescription drug overdose, a means readily available to the seriously ill.
Humboldt County Director of Health and Human Services Phillip Crandall said that discussion about the causes of suicide tends to center around mental illness — and not for nothing. Virtually every major suicide organization in the country states that probably 90 percent of all suicide deaths involves some type of mental illness, diagnosed or otherwise.
But, Crandall said, “It needs to be remembered that mental illness is not the only thing that moves people to suicide.”
Researchers agree.
Mental illness can interfere with rational thought processes, they say, and drug or alcohol abuse can increase impulsivity. Prior threats or attempts can indicate whether suicide is within the range of possibility for a particular person, and isolation can limit communication with those who might offer solace.
Similarly, event-based risk factors and losses can trigger a suicidal episode — but researchers consider these not so much an explanation of suicide as an opportunity for suicide to occur.
Noted expert E.S. Shneidman did find some commonalities among all suicides.
According to his research, the common goal is a cessation of consciousness, and the common stimulus an “intolerable psychological pain.”
Perhaps most important is the common emotion of suicide — what Shneidman described as a combination of hopelessness and helplessness, a condition that dominated the years leading up to Michelle’s death.
“I don’t think she thought she had a whole lot of options left in life,” her mother said. “It’s like she painted herself into a corner. She felt helpless. She felt hopeless. I think she thought she had burned all her bridges. They say nothing’s over until it’s over, but maybe that wasn’t the case with her.”
It’s difficult to imagine anything more likely to cause hopelessness and despair than the knowledge of a slow and painful terminal illness.
“I don’t think she thought she could come back from that,” Susie said.
And Susie didn’t think so either.
“I just always assumed she would come home when she got sick enough to die, and I would take care of her. That’s what I thought would happen. That’s what I thought our happy ending would be.”
Instead, a few weeks before Michelle’s death, Susie received a letter from her daughter.
“I’m not going to stay away from you any more,” it stated in part. “I need and love you too much. I’m so sorry for all the pain I’ve caused. I love you very much, Mom. Love, Shelley.”
Source: http://www.eurekareporter.com/ArticleDisplay.aspx?ArticleID=20925
On Feb. 3, 2006, Michelle Roskopp lost her long battle with drug addiction, with mental illness, with physical illness and with the circumstances of her short, troubled life. She committed suicide a month before her 37th birthday — a death her mother said “could have been delayed but probably not prevented.”
Why did Michelle die?
The story goes that when Michelle died, her boyfriend was threatening to kill himself after learning she had prostituted herself to buy crack cocaine, according to Michelle’s mother, Fortuna resident Susie Spitzer.
“She said to him, ‘What are you going to do, how are you going to do it?’ So he took the gun and put it in her mouth. And she said, ‘What are you going to do next?’ and he said, ‘Pull the trigger.’ He started screaming at her, just screaming for her to pull the trigger. ‘Pull the trigger, pull the trigger,’” Susie said.
“So she did.”
Though Michelle’s suicide came as a shock to those who knew her, her death at the age of 36 was not entirely unexpected.
“She was sick,” Susie said, “really sick. At that point, she weighed only about 85 pounds.”
Not long before Michelle’s death, her mother received a phone call from a Las Vegas hospital saying that Michelle had just walked out of the emergency room, against the advice of a physician.
She had been diagnosed with extremely severe lupus, was suspected of having hepatitis B and C, and had refused a test for HIV — all of which her mother, a 30-year registered nurse, believed Michelle had.
Certainly physical illness wasn’t Michelle’s only serious problem. She had been diagnosed with schizophrenia as a child, and in recent years had lost her marriage, her job, her home and her two children to habitual drug use.
“I want to emphasize that although she did have some emotional problems, she was not always a bad person,” her mother said. In fact, she was a graduate of the University of Nevada, Las Vegas, and worked as a designer for a major Las Vegas casino. She was by all accounts a good mother to her children.
That was before the drugs.
“She turned into a crack whore,” Susie said. “Saying that makes me want to vomit, but it’s an honest statement.”
So what killed Michelle Roskopp?
The short answer is that she did. But the long answer could be even more troubling.
According to reports from the Humboldt County Coroner’s Office, as much as 60 percent of the 141 people who died from suicide in Humboldt County from 2002 through 2006 suffered from a diagnosed mental illness — depression was most common, followed by bipolar disorder and schizophrenia.
Drugs and/or alcohol were named as factors in 45 percent of suicides during the same period, with prior attempts and/or threats documented in 41 percent of deaths.
Isolation — one of the most common explanations of suicide in sparsely populated rural areas — was identified in less than one-fourth of all deaths.
But probably the most startling statistic gleaned from the coroner’s reports was the high number of suicides in which serious chronic or fatal illness was said to be a factor.
For 61 people — 43 percent — at least one of a list of dire, debilitating conditions was named, ranging from chronic pain to terminal cancer.
Among the risk factors regularly documented in coroner’s reports were five circumstantial or event-based factors, including difficulties relating to various losses — of a relationship, of status and even freedom stemming from serious criminal charges, of a place to live, of a job or of a loved one.
Michelle had almost all of these things working against her. Her risk assessment, if such a thing is even possible, was off the charts.
But in many other suicides in which medical illness was said to be a factor, the person who died did not appear to be otherwise at risk.
According to coroner’s reports, the average number of 10 risk factors in suicide deaths in Humboldt County was three.
But of the dozens of suicide deaths in which only one or two risk factors were identified, the overwhelming majority — more than 60 percent — were chronically or terminally ill.
That wasn’t the only difference between the two groups.
The seriously ill also tended to kill themselves in noticeably different ways. Gunshot deaths were slightly more common in that group, and hanging deaths — which accounted for 23 percent of the deaths of healthy individuals — were practically nonexistent among the physically ill.
And while people without medical problems were almost eight times more likely to hang themselves than those with, the second group was four times more likely to die from a prescription drug overdose, a means readily available to the seriously ill.
Humboldt County Director of Health and Human Services Phillip Crandall said that discussion about the causes of suicide tends to center around mental illness — and not for nothing. Virtually every major suicide organization in the country states that probably 90 percent of all suicide deaths involves some type of mental illness, diagnosed or otherwise.
But, Crandall said, “It needs to be remembered that mental illness is not the only thing that moves people to suicide.”
Researchers agree.
Mental illness can interfere with rational thought processes, they say, and drug or alcohol abuse can increase impulsivity. Prior threats or attempts can indicate whether suicide is within the range of possibility for a particular person, and isolation can limit communication with those who might offer solace.
Similarly, event-based risk factors and losses can trigger a suicidal episode — but researchers consider these not so much an explanation of suicide as an opportunity for suicide to occur.
Noted expert E.S. Shneidman did find some commonalities among all suicides.
According to his research, the common goal is a cessation of consciousness, and the common stimulus an “intolerable psychological pain.”
Perhaps most important is the common emotion of suicide — what Shneidman described as a combination of hopelessness and helplessness, a condition that dominated the years leading up to Michelle’s death.
“I don’t think she thought she had a whole lot of options left in life,” her mother said. “It’s like she painted herself into a corner. She felt helpless. She felt hopeless. I think she thought she had burned all her bridges. They say nothing’s over until it’s over, but maybe that wasn’t the case with her.”
It’s difficult to imagine anything more likely to cause hopelessness and despair than the knowledge of a slow and painful terminal illness.
“I don’t think she thought she could come back from that,” Susie said.
And Susie didn’t think so either.
“I just always assumed she would come home when she got sick enough to die, and I would take care of her. That’s what I thought would happen. That’s what I thought our happy ending would be.”
Instead, a few weeks before Michelle’s death, Susie received a letter from her daughter.
“I’m not going to stay away from you any more,” it stated in part. “I need and love you too much. I’m so sorry for all the pain I’ve caused. I love you very much, Mom. Love, Shelley.”
Source: http://www.eurekareporter.com/ArticleDisplay.aspx?ArticleID=20925
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