Kauai is suffering. A 2017 suicide epidemic is increasingly worrying police and service organizations with the death toll so far this year already nearly double the number reported in all of 2016 and far higher than any year since at least 2012.
As of today, 21 suicide deaths have been reported on Kauai in 2017, a figure that has given the island the dubious distinction of passing Hawaii Island, which has historically seen the worst suicide tolls, according to Gina Kaulukukui, a Kauai Police Department program specialist and program director of Life’s Bridges, a grief counseling agency. Kaulukukui is considered the island’s top expert on local suicide issues.
Five years ago, in 2012, Kauai reported 11 suicide deaths; fewer than five in 2013; 15 in 2014; 15 in 2015, and 11 last year — an average of 11 instances per year before 2017. In the same five-year period, Hawaii Island averaged 35 suicides per year, Maui had 24 and Oahu had 107, according to the Hawaii Department of Health.
The 2017 Kauai victims range in age from 20 to 88. Seventeen were men while eight were women. Four victims were 20 to 27, while 15 were 40 to 70. The population centers of Kapaa and Lihue had the greatest concentrations geographically, according to KPD figures. All 21 were island residents.
“Epidemic” can be a charged and risky word, but in the case of suicide on Kauai this year, it’s simply accurate, according to KPD Assistant Chief Bryson Ponce and Kaulukukui. Clearly, many Kauai residents suffer from severe depression and there are not enough treatment resources to reach all.
The death toll, however, represents only part of the picture. Although 2017 figures for people who survived suicide attempts are not yet available, many more people were treated after failed suicide attempts in 2016 (a total of 68) than actually died. If this year’s figures are proportional, it could mean about 125 people have been hospitalized after trying to take their own lives.
The people left behind after a suicide may find themselves angry, frustrated and potentially prone to lash out in frustration and sadness, hurting themselves or others.
Suicide can touch any family or group. For example, Police Chief Darryl Perry and his wife, Solette, lost their 21-year-old son to suicide on Oahu several years ago. After suffering from severe mental health problems beginning when he enlisted in the Army National Guard, the younger Perry took his life by jumping from a bridge.
Solette Perry happened to be driving nearby, Chief Perry recalled, and when she encountered a sudden traffic jam near the bridge, she feared for the worst for her son.
Sitting in his office a few days ago, Perry recalled that he had begun thinking his son was making progress toward recovery when his mood abruptly changed and he rushed out of the house.
“He still plays an important part in our lives,” Perry said.
Defying what have become broadly based assumptions about suicide, only three of the Kauai victims left notes. Suicide experts said the note phenomenon is one of the many myths about suicide. The vast majority of victims don’t leave them.
And suicide on Kauai, like suicide everywhere, is not, contrary to some broad public assumptions, unusually high among teens, though the county did record the suicide of a 9-year-old a few years ago.
“The highest rates right now are for elderly and middle-aged men,” said Julie Cerel, a psychology professor at the University of Kentucky who serves as president of the American Association of Suicidology, the leading organization in the field.
“Youth suicide gets a lot of press,” Cerel said, “because no one expects kids to die.”
Kaulukukui said individual suicides seldom result from a single episode, such as relationship breakup or financial problems. Rather, she said, such incidents can be triggers that prompt a person to act on depression issues that have festered for months or years.
As a matter of policy, KPD does not release the causes of death for specific suicide cases, for among other reasons, concern that people already unstable and contemplating suicide might imitate the means of death if the information was released, said Ponce, who heads the department’s Investigative Services Bureau.
Nationally, gunshots, hanging and drug overdoses are the most common means of suicide, according to Cerel.
Nevertheless, Ponce said that after many years of battling methamphetamine and other stimulants as Kauai’s top drug abuse problem, police have recently begun seeing a spike in heroin overdoses, especially in North Shore communities. He declined to provide specifics saying KPD has several active heroin investigations.
Although Kauai has yet to see significant use of drugs like Fentanyl that are already a national scourge, Ponce said police assume it is only a matter of time.
That this should be happening in an isolated, rural county does not surprise suicide experts, who note that Wyoming, Montana and Alaska have historically very high suicide rates.
“The data are clear that rural states have the highest rates,” said Cerel. “It seems to be related to lack of access to mental health resources, less social support, a culture of not seeking help and people owning firearms.”
Trying to help
What is the worst mistake a community like Kauai could make when faced with a suicide epidemic? Said Cerel: “Not talking about it and hoping it will go away.”
Ironically, disclosure of Kauai’s extraordinary suicide toll this year comes at the start of National Suicide Prevention and Awareness Month. To boost suicide awareness, sign-waving events were held in three locations on Kauai on Friday to call attention to depression, suicide and the need for better prevention. If you drove by and did not realize what was going on, the events were from 4 p.m. to 5 p.m. in Kapaa at the triangle intersection across from Pono Kai, in Lihue at the airport and in front of Kauai Community College.
But as well-intentioned as such events are — walks, marches and other kinds of demonstrations — there is scant proof they actually reduce suicide.
“I don’t know if there is any evidence on this one,” said Cerel. “The important thing is to make sure that people are talking about suicide, how best to help people left behind and how to prevent future deaths.”
Although Kauai boasts a respectable number and variety of local suicide prevention and survival resources, a recurring problem, Ponce said, is that there are so many threatened suicide incidents that, even when police officers commit a victim to a treatment center involuntarily for his or her own safety, there is such a shortage of hospital beds available for mental health patients on island that they can often only be held for a day or two.
What happens then, Ponce said, is that the patient starts on anti-depressant drugs in the hospital, but those drugs require about two weeks to reach full effectiveness, meaning a suicidal person discharged prematurely will be without treatment during the period when the drugs have yet to take effect.
Ponce said police are frustrated by the situation, but that the department realizes that mental health resources are in desperately short supply on Kauai and the treatment community is doing the best it can.
Although none of 2017’s victims was a juvenile, KPD and other officials are hopeful that construction and opening of the county’s adolescent mental health treatment center, which has not yet broken ground, may reach young people considering suicide or address addiction problems before the teens pass into adulthood and enter the highest risk suicide period.
Ronnie Walker, who with her daughter Heather Shadur, lives on Kauai, runs the Alliance of Hope, a national organization that tries to help friends, family members and others who have lost a loved one to suicide. The organization runs a moderated, interactive website to help such people deal with the aftermath of suicide. Walker, a therapist, started the organization after her stepson killed himself.
“When someone takes his or her life, it hijacks the people closest to them,” Walker said. “Grief from suicide is traumatic. It’s much different than the grief we feel from almost anything else.”