SALEM — Oregonians die by suicide at a rate well above the national average.
Gov. Kate Brown and the Oregon Legislature have taken notice. This spring, a number of proposals are before the Legislature to bolster state and local officials' ability to respond to and prevent suicides — including one that would bring Oregon in line with most states by requiring every public school district to adopt a suicide prevention plan.
Suicide prevention is a wide-ranging topic in the Capitol. Some proposals would take on the issue head-on, requiring more reports, training and planning around instances of suicide. But other legislation regarding public schools and gun control also is connected to suicide, key Democrats say.
“For me, it needs to be under the broader umbrella of behavioral health issues that we're seeing in our schools,” Brown said in an interview last month.
Brown originally proposed more than $13 million in new money for suicide prevention efforts over the next biennium. Investments in mental and behavioral health through a $2 billion public education bill that lawmakers are working on now could address that need, she said last week.
“Honestly, I think in terms of my budget, we didn't invest significantly enough around behavioral health supports for our teachers and our schools around the state,” Brown said.
Although the evolving education package faces significant hurdles, some specific legislation dealing directly with suicide appears to be on a fast track through the Capitol.
Bills already have passed the Senate — on unanimous votes — to beef up reporting requirements for many suicides.
Legislation put forward by Sens. Sara Gelser, D-Corvallis, and Rob Wagner, D-Lake Oswego, would require school districts, colleges and universities to notify the Oregon Health Authority when a student dies by suicide. The state agency would then provide assistance to schools as needed.
Gelser and Wagner also want to require county and tribal governments to notify schools and other local programs and agencies about the suicide of a person under the age of 25 who has had contact with them.
Another bill that advocates are hopeful about is Senate Bill 52 — often referred to as Adi's Act, after Adi Staub, a transgender Portland teen who died by suicide in 2017. The legislation, introduced at the request of Basic Rights Oregon, would require every public school district in the state to develop a “comprehensive” suicide prevention plan for students in every grade level, from kindergarten through 12th grade.
Suicide prevention plans would have to account for what SB 52 calls “high-risk groups” — including LGBTQ students, students experiencing homelessness, students with disabilities and mentally ill students — as well as addressing suicide within the general student population.
David Westbrook, chief operating officer of Lines for Life, a nonprofit group that provides resources for people experiencing suicidal thoughts, said Oregon is one of just three states that doesn't require school districts to have a plan for preventing youth suicides.
“Clearly, we are behind the times on that,” said Westbrook, who also is a member of the Oregon Alliance to Prevent Suicide, which has recommended many of the policy changes that legislators are now considering.
Like Gelser and Wagner's reporting bills, SB 52 unanimously passed the Senate last month. Westbrook said he expects it to have an easy path through the House as well.
Gelser also has proposed Senate Bill 707, forming a state advisory committee to look at how to reduce the suicide rate among Oregon youth. The committee, which Gelser sees as a continuation of the Alliance to Prevent Suicide, would work with the Oregon Health Authority and make recommendations.
As a state representative in 2014, Gelser successfully pushed to create a position for a youth suicide intervention and prevention coordinator within the Oregon Health Authority. The former coordinator, Ann Kirkwood, worked on creating a five-year plan to address youth suicide in Oregon. Gelser said she believes Kirkwood's work has saved lives.
The Alliance to Prevent Suicide, meanwhile, provides input from health care professionals, suicide survivors and others.
“The suicide alliance, without a big budget, has made an enormous difference,” Gelser said.
SB 707 passed out of committee Tuesday, April 2, and could receive a floor vote in the Senate soon.
Other proposals face a murkier future.
A proposal by state Rep. Alissa Keny-Guyer, D-Portland, to add an adult suicide intervention and prevention coordinator has not advanced this session, to Westbrook's disappointment. It received a public hearing in February, but it was not scheduled for a work session before a March 29 committee deadline.
Senate Bill 141 would set up a $4 million grant program for hospitals throughout Oregon to provide “caring contacts” for patients who are discharged from the hospital after a suicide attempt. The idea is to keep people struggling with suicidal thoughts in contact with a health care professional.
The late American psychiatrist Dr. Jerome Motto pioneered the practice of staying in regular contact with patients for months or years after a suicidal episode, sending them brief but encouraging letters at regular intervals. Studies have shown these “caring contacts” are effective in lowering the suicide rate among recipients.
Senate Bill 808, introduced by Sen. Lew Frederick, D-Portland, adds a recurring educational requirement for health care professionals, teachers, school administrators, social workers, therapists and others. They would have to complete at least three hours of continuing education on suicide risk — how to recognize warning signs and respond when a person is having suicidal thoughts, for instance — every six years to be licensed in Oregon.
Because SB 141 and SB 808 would create new state programs, the Legislature will need to figure out how to pay for them if they become law. To move forward, the bills have to pass through the Legislature's budget-writing committee. There, they will vie with dozens of other requests for state money.
Westbrook is glad to see that the Legislature is talking seriously about suicide.
“I think two things are happening,” Westbrook said. “One is that the stigma around talking about it is lifting somewhat. And two is that it really is a major public health crisis that I feel like, in some ways, folks are just now waking up to.”
The suicide rate in Oregon is higher than it is in neighboring Washington and California, and only 14 states have higher suicide rates, federal statistics show. In 2017, 825 Oregonians died by suicide, according to the U.S. Centers for Disease Control. On average, that's one person nearly every 11 hours.
Among 15- to 34-year-olds, suicide is the second-leading cause of death in Oregon, the American Foundation for Suicide Prevention says.
Gelser sees mental illness, addiction, domestic and gun violence, homelessness and other social problems feeding into Oregon's suicide problem.
“All of those things are part of it,” Gelser said.
She added, “I believe we need a significant investment in behavioral health services and mental health services. We need to invest in families. We need to invest in drug and alcohol (programs). I mean, all of these things loop together over time.”