WAILUKU — Suicide is the leading cause of injury-related deaths in the state and getting help ahead of time is very limited for Neighbor Island people contemplating taking their life, experts said.

Part of the challenge in Hawaii is that many in the community don’t realize the scope of suicide.

“It has an impact on a much larger scale than most people probably think,” said Dr. Dan Galanis, state epidemiologist who works in the injury prevention branch of the state Department of Health. “It’s correct media policy to not publicize individual events or incidents for fear of copycat incidents. That’s a good policy. As a result, people don’t realize the scale of the issue.”

State officials are trying to turn the tide with recent measures in the state Legislature and work year-round to prevent suicides and to draw awareness to the issue, especially among high-risk youth.

On average, 190 Hawaii residents per year die from suicide, according to state data from 2013 to 2017. (2017 had the highest number with 217.)

The average annual number of fatal suicides in Maui County during the same time frame was 28. There were 108 for Oahu, 37 for Big Island and 15 for Kauai.

Suicide deaths exceed other injury-related fatalities in the state, such as falls, motor-vehicle crashes, drownings and homicides.

Citing Center for Disease Control prevention data for Hawaii, a state study showed nearly 70 percent of suicide victims in 2015-16 had at least one indicator of mental health illness. However, only 31 percent of people with a current mental health problem were in treatment and the total was only 8 percent for Neighbor Islanders.

The data underscore that “most people had been struggling up to the time of the incident,” Galanis said.

Suicide deaths and attempts were particularly high among among teens and young adults.

In 2015, 8.7 per 100,000 15- to 19-year-olds and 19.9 per 100,000 20- to 24-year-olds died by suicide. These rates were even higher on Maui, according to Kristin Mills, public health educator with the state Department of Health’s Maui District Health Office.

“A lot happens between these ages: Adolescence, high school, first loves, broken hearts, going to college or the military, new job, and becoming completely independent,” she said in her column No Kai Oi Health in The Maui News on Aug. 31. “It’s a lot.”

Hawaii data broken down by gender and age group from 10 to 85 and older show females in the 15- to 19-year-old group with the highest number of nonfatal suicide attempts at 335 per 100,000; males in the same age range had the highest attempts at 152 per 100,000. The data is from 2013-17.

During the years of 2005-09, Hawaii high schoolers had the highest proportions among 43 states for self-reported suicide risk factors that included considering, planning or attempting suicide, a state report said.

The state Legislature in May approved a measure that would mandate youth suicide awareness and prevention protocol for all state Department of Education teachers, teacher assistants, administrators and counselors. Signed into law by Gov. David Ige, Act 270 took effect July 1 for implementation in the current 2019-2020 school year.

DOE spokesman Derek Inoshita said the new rule builds on mental health training already offered to staff.

The DOE “has provided Youth Mental Health First Aid training for the past four years,” he said, adding that more than 4,000 teachers, counselors and school staff already have been trained. “Act 270 makes the program mandatory, establishes annual reporting requirements for complex areas and defines the extent of legal liability allowed.”

Youth Mental Health First Aid USA is a public education program that teaches participants how to assess a mental health crisis; select interventions and provide initial help; and connect young people to professional, peer, social and self-help care.

Inoshita added that the DOE is collaborating with DOH and Prevent Suicide Hawaii Task Force programs such as Safetalk, ASSIST and Youth Suicide and Bullying and Prevention to support staff and students in suicide prevention.

The DOE “is working diligently to implement and make available an array of services and suicide awareness and prevention training programs available to schools and complex areas,” he said. “Suicide prevention is a very important subject. September is National Suicide Prevention Month, and it’s important that we all are aware of ways to help others, especially our youth.”

Suicide rates have been rising in nearly every state, including Hawaii where it increased 6 to 18 percent from 1999 to 2016, according to a national CDC report in 2018. Rarely triggered by a single factor, suicide is the 10th leading cause of death and is one of three leading causes of death on the rise.

A state report said that nonfatal suicide attempts and self-inflicted injuries during 2013-17 resulted in 345 hospitalizations a year; 565 emergency department visits a year; and 865 calls to the Hawaii Poison Hotline.

State Health Director Bruce Anderson said suicide is a serious, complex and preventable public health issue that requires a multifaceted approach involving outreach, collaboration, relationships and resources.

“We hope that through these efforts, we’ll be able to identify effective strategies to reduce the risk for suicide,” he said.

As Suicide Prevention Month continues, officials said hope and resources are available.

“One of the positive aspects of this campaign is to raise the awareness,” Galanis said.

* Kehaulani Cerizo can be reached at kcerizo@mauinews.com.

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Suicide Prevention Events and Resources

September is Suicide Prevention Month and activities are planned throughout the month. Maui County Mayor Michael Victorino is proclaiming Suicide Prevention Week in Maui County next week. The events include:

• Mayor’s proclamation for Suicide Prevention Week, 10 to 10:30 a.m. Monday, ninth floor, Kalana O Maui building, Wailuku.

• Youth sign waving for suicide prevention and awareness, 4 to 6 p.m. Monday, across from Baldwin High School, near Wailuku

• Maui County Council Suicide Prevention Month proclamation, 9 to 9:30 a.m. Sept. 20, eighth floor, Kalana O Maui.

• American Foundation for Suicide Prevention “Out of the Darkness Walk,” 8 a.m. to 1 p.m. Sept. 28, Keopuolani Park, Kahului. (For information contact Tiare and Roger Agdeppa at 276-4203 or email tiaremariephotography@gmail.com.)

Resources for those contemplating suicide or loved ones dealing with a loss (from the Mental Health America of Hawaii, Maui office):

• Those considering or planning suicide may call Crisis Line of Hawaii at (800) 753-6879, National Suicide Prevention Lifeline at (800) 273-TALK (8255), or text “aloha” to 741-741. For LGBTQ+ youth, call the Trevor Helpline at (866) 488-7386.

• Those who need support after a suicide loss may call Leslie Hiraga, Survivors of Suicide Loss Bereavement Support Group, at (808) 205-8087.