Yesterday at 1 pm, we learned that the incidence of suicide is up in America in a report from the Centers for Disease Control (CDC), an agency in the U.S. Department of Health and Human Services.

This morning, we awake to news that Anthony Bourdain, the witty and prolific travel and food expert, took his own life. Earlier this week, Kate Spade, fashion designer and creative force, took her own life.

The loss of these two bright lights, gone from our lives to suicide within a few days of each other, gives me the sad compulsion to say something, again, about the state of mental health and behavioral health services in America.

In a larger context, it’s about life and social connections in America right here, right now.

What do we know we know?

  • Suicide rates are rising in nearly every U.S. state, as the map shows. The outlier is Nevada, the only one of 49 states where the rate of suicides fell from 1999 to 2016.
  • Nearly 45,000 Americans age 10 or older died by suicide in 2016.
  • Suicide is the 10th leading cause of death in the U.S. and one of only three leading causes of mortality that are increasing.
  • 54% of suicides are among people who were not diagnosed with a mental health issue.
  • There is no single cause the CDC can point to for suicidality.

Two of the 45,000 deaths by suicide that will be counted in CDC’s 2018 mortality census will be those of Kate Spade and Anthony Bourdain.

Countless celebratory articles and memorials have been published this week, from Advertising Age to Women’s Wear Daily, on the life and legacy of Kate Spade. My own fashion life has been blessed with Kate’s accessories and office supplies; I carry her iconic black nylon backpack regularly to business meetings, and love her cleverly-designed work. A postcard from a recent purchase in her store hangs on my inspiration board and reads, “She is quick and curious and playful and strong.” This is pinned next to images of Botticelli’s Venus, Andy Warhol’s Campbell’s Soup dress, and a journaling card from Studio Calico that reads, “You’re as happy right now as you’ll ever be.” (pictured here)

Health Populi’s Hot Points:  Why now, in the U.S., do we see the rate of suicides growing? As CDC notes in the new report, there is no one cause for each person’s decision to take their own life. The list of underlying dark forces is long….and pervasive in America. Some of the evidence-known factors contributing to suicide are:

  • Financial stress – job, money, legal issues, housing problems
  • Relationship stress
  • Lack of social connections
  • Substance misuse
  • Physical health problems.

The lack of civil discourse in America is at fever pitch, and certainly contributes to health citizens’ stress. The American Psychological Association’s Stress in America survey identified “political stress” as a thing that emerged during the 2016 Presidential election cycle, and has contributed to ill health, sleeplessness, depression and anxiety.

One thing is clear: the CDC researchers found that more than half of people who died by suicide did not have a known diagnosed mental health condition at the time of death. This speaks to the need for mental and behavioral health services to be moved into primary care settings as an integral part of a medical exam and intake, to benchmark and track a person’s mood and screen for anxiety and depression.

Lack of mental health service parity and access challenges continue to plague Americans’ wellbeing. There are fast-growing digital channels to tele-mental health, and accessing these services at a distance can help people get the services they need while reducing the feeling of taboo they may have to getting care in-person.

That taboo was apparently some of the challenge that Spade faced in worrying that her brand might be tarnished if people found out she reached for mental health services. That’s such a huge shame on American society and the U.S. healthcare system.

One heartbreaking quote, something that rang true to me, I heard this morning: “Suicide is the ultimate self-medication for pain.”

Take note of the resources available to all of us to prevent this ultimate self-medication: 1-800-273-TALK (8255).

I mourn for Kate and Anthony, for their families and friends, and for those of us touched by their gifts.  Their stories weren’t over yet. But we can continue to learn from them, revel in their wit and knowledge that they both left in their wake.

This Op-Ed in today’s Wall Street Journal was a lovely tribute to “Kate Spade, Entrepreneur,”  reminding us of her contribution to making our lives more joyful and colorful. The last two paragraphs will resonate:

Spade’s success is a reminder that the wonder that is the U.S. economy rewards—and needs—creativity of all kinds…Mental illness is a scourge that afflicts millions, but the world’s good fortune is that it didn’t afflict Kate Spade before she could leave such a large legacy.

As for Bourdain’s legacy, as he said in this bittersweet quote, “I’m not going anywhere…it’s been an adventure…But I wouldn’t have missed it for the world.”

Rest in peace, Kate and Anthony.