Twenty-nine people killed themselves in 2018 in Flagler County, two fewer than in 2017, but still by far the second-highest total in Flagler history. The county death rate by suicide is no longer the highest in the state, as it was in 2017, but it remains very high, at ninth highest.
The county’s rate of 26.7 is substantially higher than the statewide rate of 16.9 per 100,000 people, according to figures released by the Florida Department of Health. But that state rate is the highest on record since the department started keeping figures in 1970, tying the same rate in 1976. The last time Florida’s suicide rate exceeded 16 was in the middle and late 1980s.
Twice the number of people who killed themselves in Flagler in 2018 did so with a firearm: 20, compared to 10 in 2017. It is the highest number of suicides by firearm in the county’s history, and the highest number of deaths by firearms, including murders (22) in the county’s history. (Flagler has one of the state’s highest rates of concealed weapon permits.) The county’s total death by firearms rate is the 14th highest in the state, and at 20.3 per 100,000, is significantly higher than the state rate of 13.6.
The county recorded 19 firearm deaths in 2015, and 14 deaths in 2017 and 2014. In all other years, the total deaths by firearms–whether homicides or suicides–was never higher than 12, and usually in the single digits.
Most years either cancer or heart disease are the leading cause of death, with either category accounting for more than 300 deaths a year in the county, and cancer usually in the lead. Unintentional injuries, such as car crashes, falls, electrocution, unintended gunshots and the like are the fifth-leading cause of death. For Flagler County males alone, suicide is the seventh-leading cause of death.
Twenty-four men took their lives in 2018, the same record number as in 2017. The closest number to that was in 2015, when 20 males killed themselves.
One teen male killed himself in 2019, one did so in the 20-25 age range. Four were in the 25 to 34 age range. Nine were in the 35 to 54 range, and the rest, fully half the tally, were older than 54.
In unintended deaths, 21 people died in falls, two were murdered by firearms, down from four in 2014, 14 died in vehicle crashes, down from 26 the previous year and 21 in 2017.
County leaders have been grappling with Flagler’s rising suicide rate, finding few common threads that could explain the spike in the last several years other than a severe shortage of mental health services in the county. But the suicide rate has also been rising in the state, and is up an astonishing 18 percent in the United States since 2000, even as the rate has been falling 29 percent in thre same period in the rest of the world. “The rise is largely among white, middle-aged, poorly educated men in areas that were left behind by booms and crushed by busts,” The Economist reported last November. The opioid crisis has been strongly tied to the country’s suicide rate and its falling life expectancy among the same demographic group. So has a decrease in accessible, affordable mental health services.
“I hope to God this pushes the conversation beyond the local level and more to the national level and we begin to examine and look closely at what we did to mental health and how we treated those who were incapacitated in the 60 and 70s,” Cpollen Conklin, a Flagler County school board member and a leading advocate in suicide prevention locally, said today. “We closed all those facilities, for good reason, but at that point in time all that money was supposed to be pushed down to community health center and that never happened. Initially the fudning was cut under Reagan. And where were you left with? Nothing?”
By default, Conklin said, people struggling with mental health issues end up being channeled through the law enforcement and justice system, to jail or prison–where the proportion of people with mental health issues soars: The Orlando Sentinel found that a third of local jail inmates have a diagnosed mental health issue, while Florida’s Department of Corrections found that close to 20 percent of inmates have mental health issues. In Flagler, sheriff’s deputies routinely carry out Baker Acts, the usually involuntary institutionalization of an individual for mental health issues for up to 72 hours.
“There is a high rate of mental illness among our homeless because there’s nowhere for them to go and get treatment,” Conklin said. “Really, truly, this country needs to have a conversation around providing mental health to individuals. It’s so much more than–can the person on the local level access just a psychiatrist. Because that system is completely broken. But if you have someone with severe schizophrenia or multiple personality disorder and you begin to look at where were people institutionalized when families could no longer handle them at home, there is nowhere. The institutions are far and few between.”
Conklin and Flagler Cares Executive Director Carrie Baird in spring organized the county’s first suicide-awarebness town hall, which drew some 150 people. The stated goal at the town hall was to reduce Flagler’s suicide rate to 67 in the state. Conklin took some heart in the new numbers. “It’s great to see that strides are being made,” she said. “No one wants to be Number 1 in suicide rates but let’s not kid ourselves, we’re not 67 in the state, we still have a lot of work to do, and the scary piece to this is it’s late, lagging data.”
So far this year, a Flagler County Sheriff’s spokesperson said today, the medical examiner has ruled 14 Flagler County deaths as suicides (not including a suicide the sheriff’s office investigated in Palm Coast this weekend), a rate closely paralleling last year’s.
In schools, Conklin said, the district has worked hard to create a three-tiered system of mental health awareness, care and crisis prevention. Tier one is when a student needs a referral for counseling. Tier two is more intensive services, whether through a social worker or a school [psychologist. Tier three is referral outside of school.
“And it’s still not enough,” Conklin said. “We’ve worked really hard over the last two years to bring awareness to this. I think people are talking about this, people are aware. But no more talking. Now we need to have solutions. We need to have providers.”