Marin officials harness data to prevent suicides

Marin County officials are moving to obtain more specific data about residents who die by suicide and to make it easier for the public to access the statistics.

The county has created a suicide prevention data dashboard and a Suicide and Overdose Fatality Review Team to conduct detailed death investigations in select cases.

“We recognize that many people might think that suicide is a topic that should be avoided, that you might actually stimulate people to consider suicide if you’re talking about it more openly,” said Dr. Matt Willis, the county’s public health officer. “It’s really the opposite.”

“By shining a light on this topic and opening the conversation, we hope to raise awareness and to signal to people who may be struggling with suicidal thoughts that there’s help available,” he said. To reach the suicide and crisis hotline, dial 988.

Todd Schirmer, a county behavioral health official, wrote in an email that the “Suicide and Overdose Fatality Review (SOFR) process allows communities to track near real-time trends, determine who in the community is most at risk, and consider systemic changes that could potentially prevent future suicides and overdose deaths.”

The dashboard can be found at marinhhs.org/suicide-prevention-data-dashboard. It illuminates who is at highest risk of suicide in Marin. Men make up 49% of the county’s population and account for 74% of its suicides.

“It tends to be older men, above age 45, and white men,” Willis said. “For most elements of health, we see that lower-income residents, communities of color are disproportionately impacted in a negative way. Suicide is an exception to that pattern, and it needs to be described specifically to understand that.”

White residents in Marin are far more likely to commit suicide than African-American, Asian or Latino residents. While white residents comprise 70% of the county’s population, they account for 88% of its suicides.

African American residents comprise 2% of Marin’s population and 2% of its suicides. Latino residents comprise 17% of Marin’s population and 7% of its suicides.

The dashboard also shows that women in Marin are much more likely than men to visit a hospital emergency room because they purposely injured themselves. Women make up 51% of the county’s population but account for 65% of the reports of self-harm.

White residents are less likely to inflict self-harm than people of color in Marin. African American residents have the highest rate, accounting for 7% of the county’s self-harm incidents, despite their small share of the overall population.

Age is also a factor when it comes to incidents of self-harm. Marin residents between the ages of 15 and 24 committed 45% of the self-harm injuries.

Willis said one reason for the differences between men and women when it comes to suicide and self-harm is the means by which men and women typically attempt suicide. Drug overdose is the leading means for women, while men are more likely to use a firearm.

“For people who use a gun,” Willis said, “it’s highly lethal.”

Veterans in Marin are at four times greater risk than non-veterans of dying of suicide, and firearms are used in 60% of veteran suicides.

Willis said many of the facts highlighted by the dashboard are not unique to Marin. The county’s new Suicide and Overdose Fatality Review team, however, will attempt to tease out more specific warning signs by focusing intensely on a few local cases.

Schirmer wrote that the team “hopes to learn about individual and systems factors, missed opportunities, and ultimately, ways that the untimely death could have been avoided, to help inform prevention and intervention efforts.”

“This process is critical in the county’s goals to reduce suicide and overdose deaths,” he said.

The team has received training and technical assistance from Dr. Kimberly Repp, the chief epidemiologist for Washington County in Oregon, a nationally recognized expert in suicide fatality review. Repp analyzed more than 200 Washington County suicides across 47 risk factors and circumstances. The county has had a 40% reduction in suicides using this approach.

Risk factors that Repp identified occurring in the two weeks preceding death included relationship problems, substance use and criminal legal problems. At the time of death, common risk factors were a mental health problem, intimate partner problem and social isolation.

Also, a majority of those who died by suicide had contact with the health care system within two weeks of their deaths.

“Once we have a better sense of what events are occurring in a person’s life when they begin considering suicide,” Willis said, “we can predict risk and offer support associated with those types of events rather than waiting.”

Willis said the recent installation of stainless-steel nets on both sides of the Golden Gate Bridge appears to be paying dividends.

“2023 was the first year where we haven’t had any Marin County residents die by suicide from jumping off the bridge,” he said.

Between 2018 and 2022, 14 Marin residents died after leaping off the span.