Every day, Dr. Matt Larsen sees the devastating effects of suicide. In his five years working as a psychiatrist at the Behavioral Health Center (BHC) at Eastern Idaho Regional Medical Center, he treated patients every day who had attempted suicide. Now he does the same in his outpatient clinic, and his daily appointment schedule is consistently, sadly, full.

An Idaho native, Dr. Larsen returned to his home state after finishing medical school and earning his degree in psychiatry. In addition to entering professional practice, he started volunteering with Community Suicide Prevention, a nonprofit dedicated to reducing suicide in southeast Idaho.

After several years of hard work, advocacy and outreach, Dr. Larsen was discouraged that suicide rates in Idaho continued to surge upward. In 2022, 444 Idahoans died by suicide – a rate of 22.2 per 100,000 people. Even more alarming, the state’s suicide rate increased by 11.9% between 2021 and 2022 alone. Dr. Larsen decided to find out why.

A first-of-its-kind study

While extensive data exists about survivors of suicide attempts, very little is known about those who die by suicide. To address this gap, Dr. Larsen and his research team – Dr. Cassandra Sauther, Dr. Ryan Sauther, and Justin Solomon – developed a new study approach.

“Most suicide research focuses on survivors,” explains Dr. Larsen. “But we needed to understand more about those who didn’t survive. That meant talking to their families.”

The team created a comprehensive 77-question survey covering everything from demographics and employment to mental health, substance use, and access to lethal means. For three months, they gathered information from families who had lost loved ones to suicide in Southeast Idaho.

Some of their results were surprising. Read the medical journal here.

Challenging common assumptions

“Our study shows that nearly 80% of those who died (of suicide) never announced their intentions.”

“Everyone has a picture in their mind of who is typically at risk for suicide,” said Dr. Larsen. “You probably think of lonely, isolated teens with mental health or substance abuse issues. But in our study results, the group most likely to die by suicide was white middle-aged men.”

Specifically, the study revealed that those who died by suicide in Southeast Idaho were:

• Predominantly white (95%) and male (77%)
• Usually had no previous mental health hospitalization (76%)
• Had ready access to firearms (66%)
• Did not alert others or seek help (79%)
• Had previously attempted suicide (55%)
• Were experiencing relationship stress (55%) or legal issues (54%)

A new direction for prevention

“These findings suggest we need to shift our prevention strategy a bit,” Dr. Larsen notes. “While we must continue supporting those who express suicidal thoughts, we can’t focus exclusively on that group. Our study shows that nearly 80% of those who died never announced their intentions.”

Another significant finding concerns access to lethal means, particularly firearms. While securing firearms didn’t prevent all suicide attempts, it did lead 22% of people to choose less lethal methods. This is crucial because 82.5% of firearm attempts are fatal, compared to just 1.5% of overdose attempts.

“Therefore,” says Dr. Larsen, “if we can reduce the number of firearm attempts, we should be able to reduce the number of deaths, even if they still attempt suicide by other means.”

Practical applications

The key is recognizing risk factors and reaching out before crisis points. The research points to several practical steps for suicide prevention:

1. Increased awareness among lawyers, law enforcement, and medical professionals who interact with white males facing relationship or legal challenges.
2. Community education about recognizing risk factors, particularly during periods of personal crisis.
3. Focus on safe storage and reduced access to firearms during high-risk periods.
4. Enhanced support systems for individuals going through relationship changes or legal difficulties.

“We don’t really need a new law or new regulations. Instead, we need to get this information to lawyers, judges, law enforcement officers and doctors – the professionals most likely to interact with white men who are struggling with legal or relationship issues.”

Community awareness can help too.

“Be aware of the professional family man down the street who is going through a divorce or has other major legal or financial issues,” advises Dr. Larsen. “Guys, if you have a friend who is going through a rough patch, take him out, ask him how he’s doing.

“If he’s struggling, offer to hold on to his gun or ammo for a while. I know that can be an awkward conversation to have. But if you tell them that you are really worried for their safety and that it would help you sleep better if you knew their gun was safely locked away, then they’re more likely to say OK.”

Moving forward: a new study for the whole state

Because the suicide rate in Idaho as whole has increased by 43.2% over the past 20 years, Dr. Larsen is conducting a new, statewide study. Using lessons learned from the first study, his team has trimmed the questionnaire down from 77 to just 20 questions.

He hopes to get a larger study group and is looking for participants. If they feel comfortable doing so, friends and loved ones (18 years or older) of someone who died by suicide in the state of Idaho are invited to fill out the questionnaire.

If you or someone you know is struggling, resources are available: