FARGO, N.D. - A three-year federal grant used to fund youth suicide prevention programs in North Dakota is expiring, and the state's application for another grant was denied, raising uncertainty about the program's future.
"Unless we can find another grant, we won't have very much to work with," said Gail Erickson, suicide prevention director for the state health department.
The evaporating pool of funds has put plans to expand suicide prevention programs statewide in limbo. It also raises concerns about whether resources will be available to address the potential effects on the suicide rate of the economic downturn and return of soldiers from Iraq and Afghanistan.
Suicide is the second leading cause of death among North Dakotans ages 15 to 24 and the 10th leading cause of death overall, according to the Department of Health.
The suicide rate in North Dakota climbed from 10 deaths per 100,000 people in 2000 to 14.5 in 2007 before dropping back down to 13.4 last year, state statistics show.
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(The Health Department cautions about drawing conclusions from the statistics, because the total number of suicides is low - 86 last year. A change of just a few deaths can produce what appear to be "dramatic spikes" in the suicide rate, it says).
On an even more positive note, the suicide rate among those ages 10 to 24 dropped from 18.5 deaths per 100,000 people in 2006 to 10.6 last year.
That age group was targeted by a three-year, $1.2 million grant the state received in 2006 from the U.S. Department of Health's Substance Abuse & Mental Health Services Administration.
The grant paid for community-based suicide prevention projects on each of the state's four American Indian reservations, as well as two rural projects in Harvey and Watford City, Erickson said.
Like the Health Department, the Standing Rock Sioux Tribe in south-central North Dakota also was denied its application for another three-year suicide prevention grant.
However, the tribe was able to get a one-year, $400,000 emergency grant to keep its program going until the next application period, said Randy Bear Ribs, tribal health director.
Most of the grant money has been spent on case management and paying for transportation to get clients to meetings with mental health professionals, which is a struggle on the reservation, he said.
"It's something we really need because it's an ongoing process when you deal with these things. Not getting funding really puts a standstill to a lot of their progress," Bear Ribs said of the Health Department.
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The department was pleased that the state Legislature last spring allocated $250,000 for the 2009-2011 biennium for suicide prevention programs not targeted at any specific age group, Erickson said. But that funding will be stretched thin and doesn't include money for a position to administer the program, she said.
Of particular concern at the statewide level, Erickson said, was a near-doubling of the suicide rate, from 15 to 29.9 deaths per 100,000 people, among those ages 55 to 64 between 2006 and 2008. That exceeded the rate for the 25- to 34-year-old age group, which historically has had the highest suicide rate.
The state has no suicide prevention programming aimed at older age groups, Erickson said.
"At least from our trend numbers, it would indicate that we need to look at other age groups as well," she said.
"I guess I get concerned with the people who've been deployed coming back," she said. "Nationally, they're saying that that's a high-risk group of people, and we have a lot of folks that have been deployed."
In a report earlier this month, a coroner in Elkhart, Ind., told msnbc.com he believes the rising number of suicides in his county is linked to the lingering recession. "They left notes specifically stating that the reason they did this was because of the economy," John White was quoted as saying.
While some U.S. communities like Elkhart were hit by recession as early as 2005 or 2006, major North Dakota companies, such as Bobcat in Bismarck and Gwinner and Case New Holland in Fargo, largely staved off mass layoffs until this year.
"In the last two years, I'm not sure that the economic downturn has touched North Dakota to the degree that it has in other places," Erickson said. "So, it remains to be seen now what some of the spinoff ... is going to be."
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North Dakota suicide rate 15th in nation
North Dakota tied with Vermont for the 15th highest suicide rate in the nation in 2006, the most recent year of nationwide comparative data available from the National Center for Health Statistics.
Both states reported 14.2 suicides per 100,000 people that year.
Wyoming led the nation with a rate of 22.5 deaths per 100,000 people, followed by Alaska at 20.1 and Montana at 20. South Dakota had 16 suicide deaths per 100,000 people, while Minnesota had 10.7.
North Dakota men were four times more likely than women to commit suicide in 2008.
