Phillip M. Bailey, The (Louisville, Ky.) Courier-Journal 9:48 p.m. EDT September 18, 2015

Dr. Kevin Chapman, a clinical psychologist, sits in his office.(Photo: David R. Lutman, The (Louisville, Ky.) Courier-Journal)

LOUISVILLE, Ky. — When a national study listed Louisville as the third unhappiest city in the country, psychologist Kevin Chapman was reminded of why he opened a full-time private practice last year.

The study covered feelings of respondents upset over everything from rent hikes to cold weather. But Chapman, a former University of Louisville professor, said the survey's findings overall were about stress levels that more of his patients say they are experiencing.

And the effects can be deadly.

Louisville Metro Police have recorded 77 suicides this year, a 30% jump compared with this time a year ago and one more than the city totaled all of last year. The suicide total also far exceeds the city's homicide total this year, which stood at 53 as of Thursday.

Officials at the state and city level, however, admit Louisville's suicide count could be higher given that the police do not investigate all deaths that turn out to be ruled suicides.

"Suicide has increased steadily over the last decade in general, and Louisville specifically," Chapman said. "That's why I wanted to roll up my sleeves. I still do the research as a scientist, but the real work is out in the trenches with people who are hurting."

In his clinical practice, Chapman's patients confide they are experiencing perpetual hopelessness based on an array of problems, whether they're mental-health related, such as chronic depression, or disease and traumatic injury.

"These are things that we as a city struggle wrapping our head around to begin with," he said. "And if we can't understand the mental-health implications of those conditions, then it's going to be even more difficult to deal with suicide."

WHAT’S BEHIND INCREASE?

September is Suicide Prevention Month, and city officials admit they are struggling to understand reasons behind the increase as they look for ways to better penetrate populations more susceptible to self-inflicted violence.

"We're still trying to figure out and learn more about suicides, and why they're happening," said Anthony Smith, director of the city's Safe & Healthy Neighborhoods Department.

One of the stated goals of Smith's office is to develop and promote a citywide strategy for suicide prevention, and his office is partnering with other community organizations to get a better handle on the problem.

A 25-member work group helped formulate the One Love Louisville plan, released this year, that addressed reducing suicides.

The work group tasked Smith's office with half a dozen initiatives to reach that goal, such as securing resources to improve the suicide hotline for partnering agencies such as Seven Counties Services; improving the dissemination of prevention strategies among Jefferson County Public School employees and volunteers; helping faith-based groups provide training for religious leaders to recognize and counsel those with mental health issues; and assisting Louisville companies in creating protocols for employees with issues of suicide.

Smith said it has been difficult to get a conversation started about suicide. While murder is seen as a public safety concern — and a potential political problem for mayors — for neighborhoods or an entire community, "suicide is a little bit more private," he said.

"We're trying to figure how to get people out of those pipelines, and out of those systems," Smith said. "Part of it is how do you create awareness around them and getting people to pay attention to both homicides and suicides equally? It's difficult."

TARGETING THE PROBLEM

In all of Kentucky, suicides outpace homicides by nearly 4 to 1. It is the second-leading cause of death for Kentuckians ages 15 to 24.

In Louisville, a report released by the city's Center for Health Equity last fall showed that over a four-year period ending in 2010, the local suicide rate was 13 incidents per 100,000 residents, slightly above the U.S. rate. It also was higher than Louisville's homicide rate of nine per 100,000 during that same time frame.

The city is trying to aim its services, resources and initiatives at the demographic most vulnerable, which data show tend to be white men over age 25 who live across the southwestern and southeastern swaths of Jefferson County.

"I don't have a theory about the rise, but it's an issue we're working to reverse," said Dr. Sarah Moyer, interim director of the Metro Department of Public Health and Wellness. "It's a concern."

Moyer's department is a founding member of the Bounce Coalition — made up of leaders from 16 collaborating organizations — that is focusing on childhood trauma such as abuse, neglect and dysfunction. She said it is no coincidence that the first Bounce site was an elementary school in southern Louisville.

"It's working to build resilience toward toxic stress in elementary kids to prevent suicide and then also other chronic diseases as they get older," she said. "We're really moving backward to get to the root of the cause of why this is happening."

Moyer pointed out the health board gathered a wide-ranging group of stakeholders to coordinate enrollment in the Affordable Care Act that expanded mental health access.

City officials are also heartened that the Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities recently received a five-year, $3.6 million federal grant for a youth suicide prevention program called Zero Suicide. State agencies are using that funding to sponsor clinical training for assessing and managing suicide risk and piloting those efforts, which could trickle down to the city level.

Chapman said those are good signs, but added many clinicians are now overworked and that the city needs to expedite getting the newly insured to the right provider.

"One thing that's not unique to Louisville that's consistent with other cities is the risk factor of not having easier access to clinical intervention, which can take the form of being on a wait list, not having the right insurance and not being able to see specific providers of your choice," he said. "My colleagues have substantial case loads and can't devote attention to every client the way they need. We need more funding put into mental health to make this treatment available to more people."

Read or Share this story: http://usat.ly/1KlWYNj