Warning: This article focuses on the sensitive topic of suicide and contains strong language that may offend some readers.
It was Tuesday night when Gabriel Sanborn walked to the neighbor’s farm and sat in a chair next to their hot tub, looking out at the view of Ashland, Oregon below. He probably sat there for an hour, no one’s really sure. Around 2:00 a.m. on February 20, 2019 Gabriel put a rifle in his mouth and pulled the trigger.
He was just 20 years old.
One month earlier, three other southern Oregonians killed themselves: a 56-year-old counselor and father of twins; another 56-year-old man; and Scott Deusebio, a 49-year-old graphic artist and father of a 3-year-old boy. But only Scott Deusebio, who lived in Medford, was mentioned in the newspapers. He was hit by a dump truck on North Phoenix Road in an act that witnesses and the police saw as deliberate.
The other suicides happened without any mention in the media. Given that more people die by suicide than homicide in Oregon, why aren’t we talking about this more—in the news media, in our schools, and around the dinner table?
One reason is obvious: Suicide is a very difficult subject for everyone. Another reason may surprise you: most media outlets are afraid to broach the subject because conventional media wisdom advises against publishing details, like suicide notes or methods used. Editors are afraid of a phenomenon called “suicide contagion,” the idea that direct or indirect exposure might encourage suicide, especially in teens and young adults.
As a journalist who has lost loved ones to suicide, I take these concerns very seriously. As a mom of two young adults, a teen, and a 10-year-old, I struggle with how to talk about these issues in my own family.
It seems to me that the conventional approach—of ignoring suicides when they occur, or saying as little as possible about them—is failing.
Of course we should not glamorize suicide. But the experts I interviewed, as well as the survivors, maintained that not being open about suicide fosters silence and shame around it, making it harder for people to ask for help.
“People are often afraid of the word and they won’t bring it up,” Dan Reidenberg, executive director of the Suicide Awareness Voices of Education, told the Huffington Post. Silence is the wrong approach, according to Reidenberg. “The best way to talk about suicide is openly and honestly,” Reidenberg said.
Colleen Carr, the deputy director of the National Action Alliance for Suicide Prevention, agrees. “The evidence has clearly demonstrated that talking about suicide does not cause suicide,” Carr insisted. “Instead, talking openly about suicidal thoughts and feelings can increase hope and help someone on their journey to recovery.”
As Pam Marsh, state representative for District 5, wrote so eloquently in a Facebook post after a neighbor shot himself on her block: “A suicide feels like a failure of community. Here among us, someone felt so alone, so despairing, so unable to see hope that he took his life. And so we have to ask: What can we do better?”
Suicide rates rise, life expectancy falls
The rash of suicides in Southern Oregon in January and February of 2019 follows an unfortunate statewide trend: Oregon’s suicide rate has been higher than the national average for the past 30 years, according to the Oregon Health Authority. In 2017, the most recent year for which we have statistics, 825 Oregonians died by their own hand.
But what has been happening in Oregon also mirrors a disturbing national trend. For three years in a row the life expectancy rates in the United States have fallen, according to reports by the Centers for Disease Control and Prevention (CDC), the longest sustained drop in expected lifespan since the tumultuous period just before and during World War I. Experts believe that the downward trend in life expectancy in the United States has been fueled in part by higher death rates in young people than ever before. It’s not that older adults aren’t living as long, it’s that young people are dying in their twenties and thirties. Chronic illnesses, including diabetes, asthma, obesity, and severe autism, as well as higher rates of cancer among children and young adults, are all part of the trend towards lower life expectancy. More young people are dying from colorectal cancer than ever before. Incidents of multiple myeloma, uterine, gallbladder, kidney, and pancreatic cancer are all steeply on the rise in adults ages 25 to 49, according to research published in The Lancet.
But though the rising rates of illness accounts for some of the downward trend in life expectancy, researchers say that the upward trend in suicides and drug overdoses, especially among young people, is another key factor.
A leading cause of death among young people
Suicide is a topic that hits close to home: My cousin, a 31-year-old mom with her whole life ahead of her, died by suicide in Seattle nine years ago. My good friend’s 19-year-old son hanged himself in his Chicago dorm room last November. And my husband’s best friend was just 45 when he shot and killed himself in his home in Kensington, Maryland, three years ago, leaving behind an eight-year-old daughter, the same age as our youngest.
A new government report shows that suicide has become more common in every demographic, that suicide among youths has grown faster than in any other age group, and that suicide is now the second leading cause of death among teenagers and young adults, beaten only by accidents. In just ten years, from 2007 to 2017, the number of suicides among Americans ages 10 to 24 increased 56 percent. Young people in America are more likely to kill themselves than young people in Japan, Mexico, Israel, and most of Europe. Compared to other countries, young Americans (and young Oregonians), seem to be unhealthier, shorter-lived, and a lot less happy.
“We have a crisis in the schools,” says Cedric Hayden, the state representative for District 7, which comprises northern Lane County and parts of Douglas County. “Teen suicide is a huge concern,” Hayden, 51, who has made mental health issues in Oregon one of his top priorities, says.
Attempted suicide, thoughts of self-harm, and self-injurious behaviors (like cutting and punching things with the intention of hurting yourself) have also become more common.
When teenagers were asked about self-harm in one national survey, 19 percent reported having been bullied at school and over 7 percent reported having attempted suicide. Among lesbian, gay, and bisexual Latino teens the numbers are much higher: A full 40 percent say they have thought about suicide, 34 percent have even made a suicide plan, and 21 percent have tried to kill themselves.
Troy Willett, 44, a licensed professional counselor and trauma specialist practicing in Medford, Oregon, isn’t surprised.
He cites a poll that found that 30 percent of millennials ages 23 to 38 said they feel lonely and 22 percent said they have zero friends. Last year Willett’s 20-year-old stepson, who he had been close to as a child but had not seen in six years, died by suicide.
“I’ve noticed an increase in despair among millennials,” says Willett. “Some feel hopeless. They wonder, ‘What’s the point?’”
Plagued by social anxiety
Ann Sanborn, Gabriel’s mom, and her black lab greet me warmly at the door to their home. Ann and I have never met before but we both have tears in our eyes. She canceled our first scheduled interview at the last minute.
Gabe’s death just felt too raw. This time, Ann is eager to tell me about Gabe, his life, and to think out loud about what drove her son to suicide.
A chef and a single mom, she worked at resorts while raising her children. Gabe spent most of his childhood in West Virginia where Ann had a job with really long hours.
When Gabe was three years old they went through what she describes as a “horrible divorce.” Ann’s husband wasn’t Gabe’s biological father but she had met him when Gabe was a newborn. Gabe never knew his biological father, who urged Ann not to have the baby, tried to get out of paying any child support, and was uninterested in meeting, let alone raising, his son.
When he was six years old and his first grade class was doing a project about fathers, the other boys made fun of Gabe for not having one. Sobbing, he was so upset he peed his pants.
“He felt like he was a loser because his dad didn’t want him,” Ann, 50, says. “He always struggled with it.”
By the time Gabe got to ninth grade, he was plagued by social anxiety and begged his mom to homeschool him. Though they were very close when he was younger, Ann says, when he was about sixteen, Gabe became very hostile towards her. The family moved to Oregon where Ann got a job as a chef, and Gabe enrolled at Southern Oregon University. Once a week, on Sundays, she took her son to lunch. But their mother-son time didn’t always go very well. “He’d tell me I’m stupid, I’m ugly,” Ann confides. “One time he said, I should’ve kept my legs closed instead of being a whore and giving birth to him.” Though he was angry and aggressive towards his mom, he was always considerate with other people.
Before he died, Gabriel Sanborn packed up all his clothes. He left his banking information and passwords in a file on his computer.
He covered himself with a blanket, a note neatly tucked into his shirt pocket. The note paints the picture of a thoughtful, intelligent, kind-hearted, desperate young man who was in terrible pain:
I will never be able to understand the level of pain my actions have caused you. All I can say to you is this is my only option. I have failed at everything I have tried to do in life. I cannot, and will never be, successful at anything. I truly hate to leave a world filled with so many amazing things that I love, including all of you. Everything from mountains to mushrooms, to music, I will miss dearly.
I wish I could be a good friend, a good musician, a good employee. Or good at anything, really. But I am only a failure and a burden. This is why I must leave. I don’t know if I have a mental illness causing this, maybe I’m bi-polar or autistic or some other fancy thing. It doesn’t matter though. I’ve never had a girlfriend. Never even kissed a woman. The experience of having a relationship is one thing I would like before I die. Oh well.
Please know I loved you all dearly and I’m doing this to end my own pain. Not to cause you more.
Does a difficult childhood affect suicide risk?
Representative Hayden, himself a dentist and a father of seven, believes improving mental health is an urgent need in our state. Hayden tells me that he thinks the high rate of suicide in Oregon is connected to failures in the foster care system, access to highly addictive opioid medications, and a lack of coordinated care for people at suicide risk.
Community support, Hayden says, is key. “I think if we provide a happy home and a happy community, many of these 825 suicides will never get to the crisis point in the first place, and never become one of the statistics.”
Hayden’s contention that to address the problem of suicide we need to start by helping children leaves me wondering: Does a difficult childhood actually affect suicide risk?
It turns out the answer is yes. Some suicide attempts are categorized as “impulsive,” a result of sudden inclination that may not be connected to anything beyond a present situation (a relationship break up, a public or private humiliation, a fight). But it turns out that there’s a growing body of scientific literature that suggests that adverse childhood experiences, which researchers call “ACEs,” have a lasting effect on overall health, including suicide risk.
What are ACEs? In 1998 a pioneering study spearheaded by the CDC and Kaiser Permanente was published. This study investigated the impact of bad (“adverse”) childhood experiences on the physical and mental health of over 17,000 adults. The study identified ten ACEs:
1 Psychological abuse
2 Physical abuse
3 Sexual abuse
4 Emotional neglect
5 Physical neglect
6 Witnessing violence against your mom or other adult woman
7 Substance abuse or overuse by a parent or other household member
8 Mental illness, suicide attempt, or suicide death of a parent or household member
9 Jailing of a parent or other household member
10 Parents’ separation or divorce
In that first study, researchers discovered a direct correlation between the number of ACEs a child experiences from birth to age eighteen and future health issues, findings which have been replicated several times since. In 2017 researchers at the University of Texas at Austin and the University of California at Berkeley found that adults who had experienced ACEs were more likely to have attempted suicide than those who had not. Yet another study, published in January 2019 in Child: Care, Health, and Development, sampled nearly 9,500 people and assessed their health over a 13-year span, concluding that the more adverse experiences you have as a child, the more likely you are to think seriously about suicide or try to kill yourself. “Compared with those with no ACEs,” the authors write, “the odds of seriously considering suicide or attempting suicide increased more than threefold among those with three or more ACEs.”
A survivor shares her story
Three or more ACEs certainly categorizes Sharon Ledbetter’s childhood. Forty-nine years old, Sharon tried to kill herself three times as a teenager.
Though her mother was engaged, loving, and attentive when she was little, Sharon’s father and grandfather were both alcoholics. Her grandfather was a “scary person,” she says. Her father did not physically abuse her but “the mental abuse was extensive.” Sharon’s father was never satisfied. He cheated on her mother, abandoned the family, and disappeared for several months. When he came back he told Sharon he wished he’d never had a daughter. “He was probably drunk at the time but that doesn’t excuse it,” Sharon says. She was 14 years old.
Sharon had her first panic attack when she was eight. During the blizzard of ’78 in Chicago, which is where they lived, she started packing a suitcase so she could run away from home. She was sobbing so hard she was almost vomiting. Her father just laughed.
A few years later, Sharon’s family moved from Illinois to Tennessee. Like Gabriel Sanborn, she had a hard time fitting in. “The first girl I spoke to in sixth grade was an African-American,” Sharon remembers, “Because I befriended her, I was shunned…by the white kids. I was bullied to the extreme.”
In gym class someone stole her shirt and tried to flush it down the toilet. Sharon had to wear her jacket all buttoned up for the rest of the day. That week each student was asked to share their proudest moment. When the girl who stole it, whose name was Kim, said, “My proudest moment is when I flushed Sharon’s shirt down the toilet,” the whole class erupted in laughter. The teacher said and did nothing.
By the time her mom moved Sharon and her brother back to Illinois, Sharon was depressed and borderline anorexic. By freshman year of high school she was 5 feet 4 inches and weighed barely 100 pounds. She stopped menstruating, and was eventually diagnosed with polycystic ovarian syndrome. As if that weren’t enough, she also got a staph infection on her chin that was so bad she had to be hospitalized. She believes her poor health, malnourishment, stress, and low self-esteem all played a part in why she tried to kill herself. But it wasn’t until after she lost her grandmother, had two more staph infections on her face, and was put on extremely high doses of antibiotics (she was told to bathe in them daily), that she made her first attempt.
“I had no thoughts of suicide prior to these mass doses of antibiotics,” Sharon says. “Obviously I had things to be upset about. My dad was horrible to me and my mom, and both my grandparents had died. But my physiology was horrible, my nutrition was horrible. I had no fats in my diet and I had to stay out of the sun because of medication I was taking. That was all also part of it.”
In May of her first year of high school, Sharon took every prescription medication she could find in the house, including almost an entire bottle of Inderal (a blood pressure drug her mom was using for migraine), and washed the pills down with a bottle of apricot brandy.
She still remembers how she felt trying to die: “I was completely detached at that moment. I was in a dissociative state. The reality was I was going to go to sleep but not wake up, I was going to die. But I wasn’t thinking about that. I was just thinking, ‘I can’t do this anymore, this is too much.’ I couldn’t see that it was going to be better. I just gave up.”
A chiropractor based in Ashland, Kacie Flegal, 43, and I spoke at the same health conference last year. But I had no idea that Kacie’s father killed himself when she was 15. He was 45 years old.
Like Sharon Ledbetter’s father, Kacie’s dad had a drinking problem. Her mother was also an alcoholic and lost custody of Kacie and her older brother when they were two and five years old. She got sober soon afterwards and spent years fighting to get her children back.
Kacie’s father, Kenneth Richard Flegal, repeatedly told her and her brother that their mom was crazy and didn’t love them.
But Kacie says she didn’t believe it. “That’s my mommy and she loves me to death,” Kacie remembers telling herself as a child. Kacie says her father also told her that women were “worthless cunts,” and he hit her so hard once that he knocked her teeth out.
When Kacie was in sixth grade her father remarried. An airline pilot, he traveled for work and was gone for long periods. His new wife was also abusive. “She locked us in the basement, we’d go to the bathroom in a bucket. She didn’t feed us. We told my dad when he came home but he didn’t believe us.”
One time her father’s wife burned her with a curling iron. Another time she hit her with a vacuum cleaner. It was after that that Kacie and her brother got up the courage to tell their father they wanted to live with their mom. Kacie was in seventh grade. Her father didn’t take it well.
“He flipped out,” Kacie remembers. Her father screamed at them, calling them ungrateful pieces of shit, telling them he didn’t want them anymore, shoving them in the car and driving them to their mother’s house without their clothes or other things. He pounded on the door, pushed the two teens inside. Kacie tells me her father said to her mother, “Here are your fucking kids,” and left.
Kacie and her brother didn’t see their father again for a year. She found out later that he started drinking heavily, moved to Hawaii, and spent most of that year homeless. He sobered up again but it didn’t last long. He shot himself in the basement of his home when Kacie was a high school freshman.
“I went through a lot of guilt,” Kacie says. “I thought he killed himself because we left.” When a parent dies by suicide, “you go through a lifetime of trying to figure out why.”
A highly motivated student in high school, in college Kacie started using drugs and alcohol. She also thought a lot about killing herself. As she imagined doing it, she realized that suicide is really hard—you have to be highly motivated, and willing to overcome the fear.
Though suicides tend to run in families, Kacie does not feel she is at risk. She has worked hard, in a process that has taken twenty years, to overcome the abuse and trauma of her childhood, and come to terms with her father’s death. Things that have helped her include exercise (which has been a lifesaver, she says), meditation, and EMDR, a psychotherapy treatment that uses rapid eye movement to help trauma survivors and other patients reformulate negative beliefs. Being with a loving, supportive partner, one who models for Kacie what good fathering looks like, has also made a tremendous difference.
She realizes now that her father’s suicide wasn’t her fault. “He was really sick. He was in so much pain.”
Shining a light
When my husband’s best friend, who had been a prominent tech journalist at the Washington Post, committed suicide, there was no mention of it, no media coverage about it, and no word of suicide in his obituary. The silence, to us, felt deafening. It also felt like a lie. The truth was that Mike Musgrove had been struggling with depression, was devastated to lose his job as a journalist, and wasn’t able to stave off the despair he felt. At the same time, it’s hard not to worry that writing about suicide might encourage copycats. As a journalist covering difficult topics, the last thing you want to do is make things worse. But everyone I interviewed told me that it’s important to write and talk openly about suicide. Being honest about suicide is a way to improve mental health, help people recognize they’re not alone, encourage people to ask for help, and ultimately help them heal.
“I really wanted people to ask me about my dad,” Kacie Flegal confides. “For years I didn’t talk about it. But I always wanted to.”
As hard as it is, we need more openness about suicide. Shining a light on suicide won’t encourage it to happen more. In fact, being open about suicide may actually be a way to prevent it.
If You’re Feeling Suicidal…
NowMattersNow.org: is a suicide prevention website and YouTube channel for anyone who is having thoughts of self-harm. It also has resources for people whose loved ones are feeling suicidal.
Call 211: If you need immediate help, dial 211, an emergency telephone number that links people in crisis with local help organizations. You can also dial 911 to get help from the local police if you or a loved one is in crisis.
Jackson County Mental Health: has a 24-hour crisis hotline number: (541) 774-8201 and walk-in mental health services are also available at 140 S. Holly Street, Medford (Monday – Friday, 8:00 am to 5 pm).
Winter Spring (541-552-0620): A Medford-based nonprofit to help children, teens, and adults who are experiencing loss. They host grief support groups for suicide loss survivors and bereaved parents. They also provide peer-to-peer support with trained volunteers.
Ashland Death Café: While not slated towards suicide, this is a movement started in Europe to foster a safe space to talk about all aspects of death. This volunteer-run “café” meets four times a year to provide the community a place to come together to discuss death, grief, and loss.
Options for Southern Oregon: A non-profit that provides an array of mental health programs to people in Josephine and Jackson Counties and also runs training programs for people who want to learn applied suicide intervention skills.
National Suicide Prevention Lifeline: 1-800-273-8255, a toll-free, confidential support line for people in distress.
This article is dedicated to Lea Kleitman and Guai Guai.
A regular contributor to the Jefferson Journal, Jennifer Margulis, Ph.D., is a science journalist, Fulbright grantee, and speaker. Her articles have been published in the New York Times, the Washington Post, and on the cover of Smithsonian Magazine. She is the author of Your Baby, Your Way: Taking Charge of Your Pregnancy, Childbirth, and Parenting Decisions for a Happier, Healthier Family and, with Paul Thomas, M.D., The Addiction Spectrum: A Compassionate, Holistic Approach to Recovery. She graduated from Cornell University, earned a Master’s from the University of California at Berkeley, and a Ph.D. from Emory.