Complicated. That’s how Jeanette Mack describes her daughter’s short life.
As a young child, Angela suffered from night terrors. She was in and out of counseling for anxiety and depression most of her life. Once, her parents took her to the hospital for mental health treatment.
But Mack said she never really thought her daughter was suicidal until Angela took her own life on July 11, 2015, just weeks after her 16th birthday.
“Angela could be really closed off. She just didn’t let us in her world,” Mack said. “So we didn’t know everything that was happening until it was too late.”
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The Mack family is among a growing number in Thurston County grieving a loved one who has died by suicide in recent years.
In 2015, 48 Thurston County residents took their own lives.
Fifty residents had died by suicide in 2016, as of Dec. 1.
Coroner Gary Warnock said that’s the highest number of suicides in county history, and it’s likely the number will grow by the end of the year.
“Just the other day, we went out for another suicide,” Warnock said.
“My first thought was, ‘Not again.’ It’s sad.”
The suicide rate countywide has climbed steadily from 11 deaths per 100,000 people in 2005 to 16.9 deaths per 100,000 people in 2015, according to Thurston County data.
Thurston County’s suicide rate is higher than the state’s, which is 15 deaths per 100,000 people. And according to the state Suicide Prevention Plan, Washington has a suicide rate 11 percent higher than the national average.
Suicide is now the eighth leading cause of death in Thurston County, and it’s a major health concern, said Mary Ann O’Garro, an epidemiologist for the county.
“Suicide is complex and there are many factors that increase the risk for suicide,” O’Garro said. “There is no single answer to why the increase is occurring.”
Locally, rates vary by age and gender. Between 2010 and 2015, an average of 32 men took their own lives each year. An average of nine women per year died by suicide during the same period.
People like Angela — youths under the age of 17 — are less likely to take their own lives compared with other age groups. An average of one youth per year takes his or her own life in Thurston County.
An average of 32 adults between the ages of 18 and 64 die by suicide each year, and an average of 9 adults over the age of 65, according to county data.
After the birth of her first child, Jeannette Mack’s lupus symptoms flared up. So she and her husband, Curtis Mack, decided to adopt a second child.
Angela came into their life in 1999, about two months after she was born.
“Her birth mother preferred meth and who knows what other drugs,” Jeannette Mack said. “And we never knew much about her birth father.”
The Macks had some concerns about Angela from the beginning. She cried a lot and was bothered by certain sounds and textures. But doctors assured them that Angela was OK, that she would grow out of it.
As the child grew older, she developed irrational fears and anxiety, Jeannette Mack said.
“She had what I think now were night terrors,” Jeannette Mack said. “She would wake up screaming, then get up, come tell me. And so neither one of us really got a whole lot of sleep.
“And she was afraid a lot. She was afraid in situations that were completely safe.”
To combat these anxieties, Jeannette Mack took Angela to counseling.
The situation became more difficult in 2014, the summer before Angela’s sophomore year at Tumwater High School. Jeannette Mack and her husband learned that Angela had been sneaking out and going to parties.
The trend continued the following summer.
Angela first threatened suicide in the summer of 2015, Jeannette Mack said. One night she learned her daughter was at a party, so Jeannette Mack and her husband picked up the teen and brought her home.
“Angela was very angry at us and threatened suicide,” Jeannette Mack said. “So we took her to (Providence St. Peter Hospital) and checked her in, did the whole process. My husband and I felt like she wasn’t really serious, she was angry. But we don’t know that for sure."
The couple again found Angela at a party on July 11 and drove to pick her up. Angela was intoxicated, and Jeannette Mack said she told her daughter to go to bed and that they would talk in the morning.
Jeannette Mack and her husband sat down to watch a movie in the living room, and Angela came out wanting to talk. The couple again told her to go to bed.
“I told her to go to bed because you can’t really talk with someone who is intoxicated,” Jeannette Mack said. “It’s not going to go anywhere, it’s going to go round and round and round.”
On her way to bed, Jeannette Mack stopped at Angela’s room to check on her. The light was on — but that wasn’t unusual. Angela often fell asleep with the light on, and her mother went in to turn it off.
“But Angela wasn’t in her bed — I noticed that right away,” Jeannette Mack said. “As I stepped into the room, I looked around and I saw her hanging in the closet. I pretty much knew she was dead.”
Jeannette Mack said she still doesn’t really know why her daughter took her own life.
Angela often worried that if she got into too much trouble, her parents wouldn’t love her anymore, Jeannette Mack said. She wonders if that’s why Angela came out of her room to talk, and if that contributed to her decision to kill herself, she said.
It wasn’t until after Angela’s death that the Macks learned the full extent of their daughter’s troubles. Angela’s friends later said that the teen had tried to cut herself, and that she drank to the point of sickness at some parties, Jeannette Mack said.
“She struggled with anxiety and depression — we knew that,” Jeannette Mack said. “But kids are really good at hiding this stuff. I don't think you realize how good until you start hearing a little bit of this, a little bit of that.”
She said that the experience has taught her that most parents need to be more concerned with their children’s emotional well-being. She encourages parents to talk to teens when they come home from school, ask how their days went, ask how they’re feeling.
And she urges them to remember that teens are adept at hiding things.
That’s why it’s important for friends to come forward when they’re worried, Jeannette Mack said.
"What’s really dangerous with this age group is that the friends know way more than the parents, and they want to keep their friends’ secrets,” Jeannette Mack said. “And when you know your friend is drinking more, having more risky behavior, you need to tell an adult. I can see where it would be hard for a teenager to come to an adult and tell them that.”
In hindsight, Jeannette Mack said she wishes she had told Angela more about her own mistakes. Maybe Angela would have been more willing to come to her parents with her problems.
“I think parents maybe have a tendency to not tell their kids about the stupid stuff that they did because they don't want their kids to do the same things,” Jeannette Mack said. “But I think it can also be a good learning experience. I don’t think it’s necessarily giving them permission, I think it helps them see you more as human if they do know you’ve made mistakes.”
How does a community combat a rising suicide rate — especially when there are so many risk factors? O’Garro said one of the keys is increasing awareness so that people know what to look for.
“It’s important for people to recognize the signs and symptoms earlier,” O’Garro said.
To help people learn those signs, local agencies are working to arrange adult mental health first aid training for sometime next year.
The Thurston-Mason Behavioral Health Organization is working to provide more mental health care locally with a mental health triage facility, which opened in September, and a mobile crisis unit that should be up-and-running early next year, said Mark Freedman, the agency’s director.
The new resource is designed to divert people from local jails into treatment, he said. If police officers respond to or encounter people who seem confused, are in crisis or need assistance, they can contact the unit. The program also will help people who have committed only minor crimes or haven’t committed crimes.
“We want them engaging with the individual and moving them farther into treatment,” Freedman said.
The unit will provide intensive case management for about 90 days and will link people to further outpatient care, he said.
Non-governmental organizations, such as Gun Sense Thurston, also have taken on the challenge of lowering the county’s suicide rate by promoting gun safety.
Thurston County records show that between 2010 and 2015, 55 percent of suicides involved firearms.
The group has handed out gun locks, provided by the Thurston County Sheriff’s Office, at local events, including Capital Lakefair. And Gun Sense promoted Initiative 1491, otherwise known as the extreme risk protection order initiative, which was approved by Washington voters in November. The measure will allow family members and law enforcement officers to petition judges to prohibit people deemed a danger to themselves or others from owning guns.
State officials hope to decrease the suicide rate statewide, and in 2013 lawmakers passed a bill requiring the Department of Health to create a state suicide prevention plan for people of all ages.
The all-ages plan was published in early 2016. However, the Legislature didn’t allocate money to execute the plan for adults, said Sigrid Reinert, a Department of Health suicide prevention specialist. She said she hopes lawmakers will allocate money in the 2017 session.
The agency has, however, received grant funding — $736,000 per year for five years — from the federal Substance Abuse and Mental Health Services Administration for work in Grays Harbor, Pacific and Clallam counties, Reinert said. Those counties have suicide rates much higher than Thurston County’s. From 2010 to 2014, there was an average of 20 suicides per 100,000 people each year in Grays Harbor County, 23 in Pacific County and 22 in Clallam County.
The funding covers education at schools and agencies that work with youths, for EMTs and for religious communities. The Department of Health also is working with medical and behavioral health providers, and with substance abuse treatment providers. In Pacific County, both Willapa Bay Hospital and Pacific County Hospital perform suicide screening for all patients, Reinert said.
With the proper funding, this work would be extended to other areas of the state, she said.
For the survivors
Jeannette Mack spends a lot of time in the room where Angela died. She uses the room to craft and work, and two pet sugar gliders live in a cage in the corner.
A set of shelves holds photos of Angela and artwork made by her friends and classmates. They also hold a medal given to the family after Angela’s skin and corneas were donated.
It helps to talk about Angela, Jeannette Mack said.
“Angela was looking forward to being on the varsity dance team,” Jeannette Mack said. “And she’d be a senior this year, and doing all the things that her friends are doing now. So that’s really hard to see sometimes.”
She remembers Angela as a strong, athletic girl who loved to dance. She also loved to bake cookies, brownies and cakes and take them to friends at school.
Mack shared her experiences in September at Olympia’s Out of the Darkness Walk for suicide prevention.
This year’s event raised $31,600 and included more than 400 participants, said organizer Eileen Bochsler. Proceeds go to the American Foundation for Suicide Prevention. The walk also serves as a place for people to come out and share their stories, she said.
“I think suicide often isn’t talked about,” Bochsler said. “People don’t know what to say — it’s a tough subject. (The walk) is a safe place to talk about what you’re feeling or going through.”
People often come to the event in teams, wearing shirts with victims’ names on them. There’s a memorial garden, and organizations are on hand to support people who are dealing with loss, or people who are struggling.
“It’s a really sad subject, but we try to create this feeling of connection so that people feel less alone,” Bochsler said.
Amelia Dickson: 360-754-5445
If you or someone you know may be suicidal, these community groups can help.
In an emergency:
Call 911 or go to the nearest hospital emergency room.
In a mental health crisis:
Call Crisis Resolution Services at 800-270-0041 or 360-754-1338, or call the Suicide Prevention Lifeline at 800-273-8255.
For 24-hour crisis support:
Call the Crisis Clinic of Thurston and Mason Counties at 360-586-2800.
For substance use and mental health services:
Call the Recovery Help Line at 866-789-1511.
Thurston-Mason Behavioral Health Organization
Call 360-867-2602 or 800-658-4105.