The suicide rate in Idaho has gone from bad to worse in 2011, and law enforcement agencies report that Medicaid cuts have exacerbated the problem.
Area police already have responded to more suicide calls this year than they did in 2010.
Bonneville County Sheriff's Office Capt. Sam Hulse said there definitely has been an increase in the number of suicide calls.
""We know we are in a spike right now,"" Hulse said. ""I think several things factor into that, but it's tough to measure one reason.""
Hulse said for the past six weeks or so, Bonneville County sheriff's deputies have responded to at least one, and sometimes two, completed suicides each week.
""This is a problem I think everybody needs to be aware of,"" Hulse said. ""The ramifications of (such a rate) are huge.""
In 2009, Idaho's suicide rate rose to 19.9 percent per 100,000 people - a 20 to 22 percent increase from the previous year, according to the Suicide Prevention Action Network of Idaho.
The 2009 rate was the state's highest in the past 15 years of data.
In 2010, however, the number dropped to 18.5 percent.
The Idaho Falls region reported 45 suicide deaths in 2010 - a rate of 21.7 percent per 100,000 people, according to SPAN statistics. That was the second-highest area rate in the state.
This year, the Legislature cut $34 million in state Medicaid expenses. Those cuts took effect July 1.
The cuts to mental health may be having an effect on the number of suicide reports officers are receiving, Hulse said.
""Mental health has undergone some serious cuts. The state of Idaho has a design that is to treat and put them back out on the streets,"" Hulse said. ""If that person doesn't have the resources to obtain mental health, the likelihood they will fall back into the same pattern increases. Then (law enforcement) sees them again (in criminal activity).""
The state's Medicaid cuts included a reduction from five to four in the number of psycho-social rehabilitation hours for adults. Psycho-social rehabilitation is a form of counseling therapy that Medicaid-eligible mental health patients receive.
SPAN Idaho executive director Kim Kane said Idaho consistently ranks in the top 10 states with the most suicides per capita per year.
Idaho and surrounding states, Kane said, have a culture of the ""rugged individual"" that does not lend to help-seeking. She said she thinks there is a link between that mentality and the Legislature's approach to mental health funding.
""If you're serious about any issue, you have to put funding toward it,"" she said. ""Our mental health system here is broken. But it's challenging because many of our legislators believe you pick yourself up by your bootstraps, but what if you don't have bootstraps (the tools to do that)? Every human needs help. Humans rely on other humans.""
Kane said mental health funding cuts have exacerbated the problem.
""I personally believe it's (the) cuts to mental health (that play a role in the high numbers),"" Kane said.
Dave Strong, assessment referral coordinator at Eastern Idaho Regional Medical Center, doesn't believe individuals with chronic mental illness have been as severely affected by the Medicaid cuts. But those who are more mildly depressed, he said, may have ""slipped out of services"" with the cuts.
""I would imagine there has got to be an increase (in mental health needs),"" Strong said. ""If you're cutting services, then there's got to be an increase.""
Some Idaho Falls Police Department officers and Bonneville County sheriff's deputies have taken crisis intervention training as a way to better understand the complexities of mental illness. Crisis intervention training is a key for first responders, said Strong, who helped organize several training academies.
Hulse said 19 police officers, 15 sheriff's deputies, six Bonneville County Jail officers and five dispatchers have completed the training. Police officers and firefighters who take the training learn to recognize people with mental health conditions and find different ways of dealing with them.
""Because, let's face it, police tend to have a direction as far as containing a scene that is going to tend to be very command-based,"" Strong said. ""They give instruction and they want compliance. (And) with someone who may be having a mental health crisis, that may not be the best direction to go.""
The training is an advantage for law enforcement officers faced with defusing a potential crisis.
An important factor in reducing the suicide rate is encouraging others not to be ashamed to seek help.
""We need to get the word out about asking for help and that it's OK to ask for help,"" Kane said.