Arkansas rose from No. 16 to No. 10 in the latest national ranking of suicides per capita, a climb that activists believe a bill filed last week can stymie by establishing a national suicide hotline call center in the state.
In 2015, 557 people killed themselves in Arkansas, which is one of only two states without a suicide hotline call center. The other, Wyoming, had the most suicides per 100,000 residents in 2015, the most recent year with completed federal data.
When Arkansans in crisis call the National Suicide Prevention Lifeline, they are routed to call centers in other states -- usually Tennessee.
That's a problem, said Rep. Bob Johnson, D-Jacksonville, who sponsored the legislation.
"If I'm calling some place in Memphis, they don't have a clue about what I need or where I can go for help in Batesville, Ark.," Johnson said.
House Bill 1775, filed and assigned to the House Committee on Public Health, Welfare and Labor on Tuesday, instructs the Arkansas Department of Health to "establish and maintain to the extent that funding is available" a suicide prevention hotline.
The center would be staffed 24 hours a day and take about 1,000 calls that the national hotline handles from Arkansas each month.
The national hotline has 159 call centers across the U.S., and statistics from the U.S. Centers for Disease Control and Prevention show that the states with the lowest suicide rates have more call centers than those with the highest rates.
The 10 states with the least suicides per capita have an average of five call centers. The states with the most suicides have an average of one.
Meg Mirivel, a spokesman for the Arkansas Department of Health, said in-state call centers can provide callers with resources tailored to them, like community mental health centers, emergency departments and private mental health centers.
A call center won't be a fix-all, but it's a great first step, said Tyler West, an American Foundation for Suicide Prevention Arkansas chapter board member. He added that getting people in crisis through the first 20 minutes when they're considering self-harm increases their chances of living to 80 percent.
Call centers "are the first line of defense against a really complex problem," he said.
Suicide was the highest injury-related cause of death in Arkansas in 2015, according to the CDC. Suicides were nearly double the number of homicides.
It was the 10th-leading cause of death overall in the state and was even more prominent among the younger sectors of the population. It was the second-leading cause of death for people ages 25-34, and the third-leading cause of death for those ages 15-24.
Veterans kill themselves at an even higher rate. They account for about 8 percent of the population but about 19 percent of suicides. Former service members also accounted for 30 percent of the hotline calls.
Among a host of mental health and suicide prevention groups that support the bill are several veterans organizations: the Arkansas Veterans Coalition, Central Arkansas Veterans Mental Health Council and Veterans Impact.
"I've been to more funerals for veterans who died by suicide than I can count," said Tanya Phillips, who served in Iraq with the 39th Infantry Brigade of the Arkansas Army National Guard. Phillips is now chairman of the Central Arkansas Veterans Mental Health Council and is the coordinator for the Arkansas Suicide Prevention Network.
Phillips speaks from experience when she talks about suicide prevention. After her tour in Iraq, she returned stateside with debilitating back pain. Her job was cut while she was overseas, and her husband left her.
There were days when she could hardly get out of bed and suicide crossed her mind, but her three children gave her a reason to persevere, she said.
"Suicide is not always about wanting to die," she said. "Sometimes it's an ambivalence about living or dying. They don't care whether they live or die."
Call centers can help people find reasons to live, Phillips said.
Johnson said Thursday that he hadn't heard of any opposition to his bill yet, but he suspects it will come and likely will center on how to pay for the call center. It would cost about $688,100 a year to run and evaluate.
The Arkansas Department of Health plans to pay for the program with a combination of its federal and state injury prevention funds, a spokesman said.
Additionally, the state stands to miss out on about $1.2 million in federal grant money if a call center isn't established. The state currently receives $750,000 annually for youth suicide prevention, but an upcoming rule change would require the state to implement a call center to continue receiving the money.
The federal government offers $450,000 for adult suicide prevention but because Arkansas doesn't have a call center, it doesn't qualify to receive it.
The American Foundation for Suicide Prevention estimates that each suicide costs the state $1.2 million in lifetime medical and work-loss costs, which puts the state's total cost from suicides in 2015 at $685 million.
West, the foundation board member, said the call center would pay for itself simply by reducing the number of emergency room visits.
"It's time for us to implement some evidence-based strategy," he said.
Metro on 03/05/2017