Greg Marley has lived on the coast of Maine for 35 years, and in that time the licensed clinical social worker has seen a lot of sad things, including the death by suicide of too many of his hard-working neighbors.
“This is a field I’ve worked in for a long time,” Marley, the clinical director of the National Alliance on Mental Illness Maine, said recently. “I know fishermen, I know foresters, I certainly know people in the construction industry who have died by suicide.”
That’s why a recent report from the U.S. Centers for Disease Control and Prevention on the suicide rates among people working in different occupations wasn’t surprising to the social worker, who’s part of the Maine Suicide Prevention Program. In the CDC’s weekly morbidity and mortality report on July 1, the agency found that persons working in the farming, fishing and forestry fields had the highest rate of suicide overall, with 84.5 deaths by suicide per 100,000 people. The second highest suicide rate was found among people who work in the field of construction and extraction, with 53.3 deaths by suicide per 100,000 people.
In sharp contrast, the lowest suicide rate was found in the education, training and library occupational group, with 7.5 deaths by suicide per 100,000 people — more than a tenfold difference from the farming, fishing and forestry group.
“The study is interesting, and it’s useful,” Marley said. “But for me, heavily steeped in this field, I found little of surprise. It does tell me that, hey, maybe we need to do better or more active outreach in those areas.”
The CDC’s suicide rate report used data provided by 17 states in 2012. Maine wasn’t one of those states because the state didn’t start participating in the CDC’s National Violent Death Reporting System until 2014. Still, Maine has some commonalities with some of the states that were included in the report, Marley said, especially Alaska, Oregon, Colorado, Wisconsin and North Carolina. Those are all places with a large rural population and where many farmers, fishermen or lumbermen work. According to the 2010 U.S. Census, Maine is the most rural state.
Suicide is an important topic in Maine, where the suicide rate of people ages 10 and older is higher than the overall rate in the nation — 17.7 suicide deaths per 100,000 people in Maine compared with 14.6 deaths per 100,000 nationwide. Suicide also is the second leading cause of death among Mainers ages 15 to 34, and the fourth leading cause of death among Mainers ages 35 to 54. Men in Maine are four times more likely to die by suicide than women, with firearms being the most common suicide method used by men.
For the Pine Tree State, which has a rich and storied tradition of people — mostly men — working on the farm, on fishing boats and in the forests, the new study may highlight some old problems.
“I think there are a number of factors operating here,” Emily Haigh, an assistant professor of psychology at the University of Maine, said. “Farmers, fishermen and foresters — they are largely male-dominated professions, and we know that males are more likely to complete suicide. Farmers, fishermen and foresters also probably have more access to firearms. And my other guess is that we’re dealing with factors related to isolation.”
Among those factors is the way many parts of rural Maine are underserved, with respect to mental health care, she said, and the stigma about seeking help that still exists in many places.
“Suicide is a very striking and disturbing occurrence,” Haigh said. “We still regard it as not common. But as researchers we want to be very aware of risk factors.”
According to Marley, additional factors that likely play a role in the higher suicide rate among farmers, fishermen and those in the forestry industry include substance abuse and higher accident risks in those fields.
Agriculture, for instance, is one of the nation’s most dangerous industries, with the injury rate in 2011 more than 40 percent higher than the rate for all workers, according to the U.S. Department of Labor. The fatality rate for agricultural workers was seven times higher than the fatality rate for all workers in private industry.
“The other piece is the culture and the mindset of the people involved in those industries,” Marley said of farmers, fishermen, foresters — and construction workers, too. “They are people accustomed to using their bodies, accustomed to doing things and fixing things themselves. They don’t easily reach out for help.”
The Maine Suicide Prevention Program seeks to increase awareness about risk and the availability of help to more Mainers, especially to high risk populations working in what he called the male-dominated fields. But Marley said that can be an uphill battle, pointing out that some of the traits that Mainers pride themselves can be very unhelpful when a person is having a crisis.
“What is the culture of northern New England?” Marley asked. “Yankee, stoic, private, pulling ourselves up by our bootstraps. This is a piece it’s hard to intervene on. It’s a value that’s closely held.”
Intervening, however hard, can be critically important, he said.
“If you’re worried about your spouse or your brother or your neighbor or your fellow Rotarian, do you reach out and say, ‘hey, I’m concerned,’” Marley asked. “Or do you say that’s their private business?”
For those who need help: call the Maine Suicide Prevention Program’s toll-free crisis hotline at 1-800-568-1112.