Ending it all: Can life insurers help stop suicide?

Again, there are imperfections here. Mesa, AZ has a suicide rate of 19.6, which has grown 31.2% since 1990, but it was excluded from this comparison because it was not included in the Brookings poverty study. Likewise, Las Vegas, NV, though ravaged by the economic downturn, has long had unusually high suicide rates; for starters, many of its people are transplants from elsewhere who may not have a close support structure to lean on in times of emotional or psychological distress.

The correlation holds up under anecdotal evidence as well. A call to the American Foundation for Suicide Prevention revealed that suicide prevention hotline calls have risen by some 50% since the beginning of the Great Recession. Likewise, county mental health officials serving Las Vegas, Colorado Springs and Portland all admitted that they had either seen upticks in suicide activity since the end of 2008, or suggested that it was possible, given the increase across the board for people’s financial stress. But the affect of the recession is not just limited to a few cities. A cold call to the Monmouth County Department of Human Services for Monmouth County, NJ revealed that even there, there was a noticeable increase in suicides since the end of 2008. “We had one precisely because of financial reasons,” said a representative before stopping short, unwilling to offer any further information.

A survey of the recession’s impact in Europe is simpler, but just as compelling. According to the Lancet’s article, “Effects of the 2008 recession on health: a first look at European data,” suicide rates in European Union countries had steadily declined before the 2008, but afterwards instantly reversed, rising as much as 7 % in some EU states. Generally speaking, any rise in unemployment greater than 3 % was also met with a corresponding rise in rate of suicide.

Aside from the clear mental health implications this level of suicide activity presents, there are also life insurance implications, especially among those who commit suicide because of a sudden reversal of financial fortunes. Those who are insured are most likely to receive a full payout on their policies, since typical life insurance policy wording includes a two-year contestability period during which self-inflicted mortality or mortality caused by factors knowingly hidden or obfuscated would give the carrier cause to contest payment. For many cases of middle-class financial suicide since 2008, the life insurance was already in place well before the financial turmoil that contributed to acts of suicide. What this means is that contrary to the commonly held notion that suicide always voids a life insurance policy, a good portion of the 30,000 or so suicides occurring each year in this country are also triggering a life payout.

Given the many billions of dollars the life industry otherwise pays out on all life claims, the costs incurred by suicide very well may not be of a magnitude that merits some kind of claims management in terms of reaching out to policyholders with suicide awareness materials or by making available access to counseling services if they are needed.

That is unfortunate, because the life industry is in a unique position to raise suicide awareness dramatically if it so chose.

USAA Steps Up

Calls to suicide prevention organizations in every city on the above mentioned “hot list” revealed that none of them had ever received any formal support from life insurance companies. The Insurance Industry Charitable Foundation, a group that coordinates the philanthropic efforts of life/health and property/casualty insurers confirmed that they neither supported suicide prevention efforts, nor were they aware of any member companies that did.

Calls to the American Council of Life Insurers likewise turned up nothing either on its own or among its members. Calls to a dozen other major life insurers also turned up nothing, which seems like a lost opportunity, since National Suicide Prevention Week (which this year runs from 9/7 to 9/15) dovetails with Life Insurance Awareness Month.

It would seem that not a single life insurer has in place any kind of suicide outreach program or even lends their support to raising suicide awareness. Except for one: USAA. USAA is an unusual company in that its focus is on its military members, and in many ways, as Joe Annotti, president of the American Fraternals Alliance notes, USAA behaves like the world’s largest for-profit fraternal society. It is the kind of life insurer that actually steps up how much life insurance it sells to soldiers as they are going off to war, because it knows the troops will probably need it.

USAA is the sole sponsor of the USAA Educational Foundation, a separate, but allied, organization that provides a wide variety of educational materials to USAA members and the general public. Each year, they keep in print more than 70 different booklets on topics ranging from cybersecurity to distracted driving to living a greener life, to financial planning. In 2010, as it was becoming clear that the U.S. military was suffering a suicide crisis of its own, USAA decided to print a booklet on suicide awareness.

To understand the depth of the suicide problem in the military right now, know that U.S. service members are committing suicide at an average rate of more than one a day, outpacing battlefield deaths. The situation is so bad that the Army recently approved a $3 million research grant to develop a nasal spray that would deliver a dose of thyrotropin-releasing hormone that will reduce suicidal urges. Previously, such hormones could only be administered by spinal tap, but the Army hopes that a simple nasal spray could be issued and that it could help prevent additional deaths.

Steve Finley, executive director of the The USAA Educational Foundation, says the military has been unable to pinpoint why it has such a large problem. Financial hardship definitely plays a role, he says, and soldiers are hardly immune from that. (Which is one reason why the Foundation also offers a 50-minute financial briefing to ROTC cadets and active duty called Basic Financial Management, which teaches basic financial responsibility, to stave off money problems before they start.) Relationship problems are also a contributing factor, especially for those stationed far from home.

The USAA Educational Foundation’s booklet, Suicide Prevention, describes common suicide risk factors, behaviors that tend to precede suicide, how to help someone in crisis, important steps for servicemembers and veterans, and what to expect when grieving a suicide loss. The piece is updated once a year, and is currently undergoing its 2012 update. It is also available to the public online.

Since October 2010, 118,000 copies of Suicide Prevention have been distributed through police departments, fire departments, veterans support groups and other groups allied with The USAA Educational Foundation. Finley has received numerous thanks from groups disseminating the literature, and reports that so far, it has been very well received. Finley does not have an exact cost for development, but says that it was not much, considering how many other print products the Foundation develops. “It’s just a piece of what we do,” he says.

An Epic Loss

Few people in the insurance world understand the impact of suicide better than Michael McRaith, director of the Federal Insurance Office. In 1996, McRaith lost his partner, Eric, to suicide. Eric lost his job that Spring for being gay. “Looking back, he had probably symptoms preceding his firing that were bipolar. And when he lost his job, those events cascaded into more frequent and more volatile episodes that I couldn’t, at that point in my life, comprehend or understand,” McRaith explains.

That July, McRaith left for Colorado to run a race there. He originally meant to bring Eric along, but at that time, decided they needed some time apart. When McRaith came home, he had a phone call with Eric. It wasn’t an argument, but it was a conversation in which Eric was saying things to McRaith that McRaith had difficulty comprehending. “Unfortunately, I was the last person to speak with him, “McRaith recalls. “He was found a day and a half later.” Eric had hanged himself in his apartment.

As a survivor of suicide, McRaith first spent a year recovering himself. People often underestimate just how much work it takes to cope with the rawness of suicide. It is the kind of suffering for which time does not heal all wounds. The pain does not subside or recede; one learns to live with it and build around it.

Afterwards, McRaith joined the Chicago chapter of the American Foundation for Suicide Prevention and became an outspoken advocate for suicide awareness and prevention, eventually joining the AFSP’s Chicago board of directors. He helped organize the first National Survivors of Suicide Awareness Day in Chicago, an annual AFSP event held the Saturday before Thanksgiving to connect members of the suicide survivor community by satellite to show that one does not need to recover from suicide alone. “There is always this fear that we’re the only ones who can ever understand or suffer through this trauma,” McRaith says. “The value of awareness day is to show there is a community of people who have experiences similar epic, tragic loss, and who are working every day to recover from that loss.”

In 2001, he participated in the AFSP’s first Out of the Darkness suicide awareness walk in Washington, D.C., which was hosted by the AFSP. Today, Out of the Darkness walks are held in cities across the country, and have become a major national suicide awareness effort. As for McRaith, he remains active with the AFSP and engaged with the Chicago chapter.

A problem with raising awareness about suicide in particular and mental health in general, is that people simply to not wish to talk about it. Although mental health and suicide are limited to no demographic, stigmas about them persist. “Our first challenge as a country is removing the stigma that is often stuck on someone who identifies himself or herself as having a mental health issue,” McRaith says, noting that public policy conversations about mental health parity in coverage and access to mental health services are critically important. “We need as a community to acknowledge this and talk about it without creating a culture of shame.”

The next step, he says, is simply making more people aware of the scope of the problem and for people to listen to their friends, family and colleagues more closely so they might attune themselves to the signals that someone might be in need of professional help. That is where suicide education comes in. The AFSP has chapters across the country, and every community has some kind of volunteer opportunity for people who are interested in mental health issues or suicide prevention.

“Every employer should consider awareness programs, sensitivity and education for their employees to help them better understand what their colleagues might be experiencing,” McRaith says. “There are a variety of organizations that would benefit from the constructive participation of all aspects of our country’s biz comm. That’s not limited to financial services. Being open to the subject of mental health and supporting organizations that are directly involved in providing mental health services or suicide prevention programs provides businesses across the country with an opportunity to get involved in their local communities.”

For individuals or organizations interested in getting involved, but have concerns about being attached to such a sensitive topic, McRaith dismisses any possible downsides as fiction. “Every family, every community is affected by suicide to one degree or another, and in acknowledging it and supporting education, awareness efforts and suicide survivor programs, we are providing support for people in their most vulnerable moments. That is an indelible imprint an organization or a business leave on a community’s well-being.”

To underscore McRaith’s point, the city of San Francisco recently honored Bernard Mayes, the founder of San Francisco Suicide Prevention, which Mayes founded 50 years ago on his own, without any training. He simply placed cardboard ads on city buses with a hotline for desperate people to call, and he went home to wait by his phone. All he did was listen to what people had to say. Today, the SFSP handles 200 calls a day at (415) 781-0500, with 10 paid staff and 100 volunteers. The service has been repeated in 500 cities across the country, in every state. As for San Francisco, its suicide rate has dropped by 50% since Mayes first started taking phone calls. It doesn’t take much to make a big impact; the SFSP has proven that. Large national organizations like the American Foundation for Suicide Prevention and businesses such as USAA have led from the front against a problem that can never be truly eradicated. And as laudable as their efforts are, what is needed most is something else. The real difference may very well be made by the local efforts, the grass roots movements, the individuals. When it comes to saving a life from suicide, sometimes all it takes is just a single person and a willingness to get involved.

Need help? In the U.S., call 1-800-273-8255, the National Suicide Prevention Lifeline.