Alabama’s suicide rate above national average, how to recognize the signs

Published: Sep. 14, 2021 at 9:15 PM CDT|Updated: Sep. 15, 2021 at 10:52 AM CDT
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BIRMINGHAM, Ala. (WBRC) - Suicide is something no one wants to talk about, but mental health experts say it’s a critical conversation to start. The rate of suicide in Alabama is higher than the national average. It’s a problem so pervasive, the CDC says suicide is the second leading cause of death for people between 10 and 34 years old.

“There are twice as many suicides in this state, and really in every state in the United States, than there are homicides,” explained Richard Shelton, M.D., a psychiatrist, professor and researcher for UAB. “So you can think about every time you hear about someone getting killed, there are two people who died in that time, from suicide. It’s hidden in the community, because we really don’t talk about it enough.”

No one is immune from mental health challenges, especially over the last 18 months rife with isolation and uncertainty. Shelton says even those who’ve been stable long term are struggling.

“Other people we’ve treated in the past who’ve been actually doing pretty well, we found that just progressively over that period of time we’ve seen more and more people slip into either periods of depression or severe anxiety,” Dr. Shelton explained.

Shelton believes this is due in part to isolation.

“Isolation is probably the most deadly thing,” Shelton added. “I think for the situation it’s deadly for two reasons: it will certainly increase the likelihood that somebody is going to attempt suicide, but the decrease in social interaction means that other people are not going to recognize it, other people are not going to see what’s happening to you. That social isolation really cuts both ways.”

Based on Shelton’s training and clinical experience, he believes the lack of socialization is impacting teens the most.

“I’m convinced that we’re going to see a pretty significant increase in suicide rate, especially among adolescents,” he explained. “If you think about it, it’s almost a perfect storm. You have adolescence, which is tough enough as it is, then you have the stress of the pandemic, of family members being ill, losing family members.”

Shelton encourages safe social interaction for both teens and adults, while wearing masks and social distancing. He even encourages online meet ups with friends and family.

“One of the things that I’m encouraging patients to do is to form communities online and use Zoom or Skype or some service like that in order to connect with people on a regular basis,” he said. “You can have dinner with friends sitting at your own table, them sitting at their table and having a computer in front of you. I know of, actually a fairly large number of people who have game nights, online, so they just, they have that as a way of interacting with other people so that they just don’t feel so socially isolated.”


Experts say the best way to advocate for those who are hurting is to recognize the signs. Depression is a key driver of suicide.

“If a person starts to become withdrawn and starts to isolate themselves, that’s kind of a key indicator that they may be getting depressed,” Shelton acknowledged. “Number two is having sleep problems. Sleep problems associated with depression are an even more important factor that increases the likelihood of people committing suicide.”

If you’re concerned someone is considering self-harm, ask them directly.

“Research has shown very clearly that asking that question does not increase the risk for completed suicide, again people very often are honest about things,” Shelton assured. “Clearly talking about it reduces the likelihood of it happening.”

Help connect those who are struggling with professional help. If resources are not immediately available, Shelton encourages everyone to contact their primary care doctor or a hotline.

“The good news, treatment is usually effective and usually works to help people to get well and no longer have those thoughts,” he explained.

Shelton says the most critical aspect of suicide prevention is securing guns. In fact, owning a firearm increases the likelihood that someone in the home is going to use to use it for self-harm.

“That introduces the lag, the delay that people need in order to take a take a step back, take a moment, think, breathe and maybe ask for help. Reducing access to firearms is really probably the most important thing that we can do in our homes,” added Shelton.


The State of Alabama ranks last in the country in mental health service availability. UAB and other providers are working to expand services and enlisting in telehealth to reach rural communities where suicide is most prevalent. Hotlines and mental health organizations can offer counseling and connect callers with services in their area.

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