The Alabama Department of Public Health recorded 640 Alabamians who committed suicide in 2011, which is higher than the national average, and Alabama Department of Public Health Research Unit Director Debra Hodges said there is a practical explanation as to why.

“According to research one of the reasons is Alabama has a lot of rural areas and is sparsely populated in a lot of areas, and that’s where suicides are generally the highest, which is probably contrary to what most people believe,” Hodges said. “Things like social isolation, lack of economic opportunities and for young people a [lack of] things to do. Also, there is a lack of mental health facilities and good mental health care. There are several counties in Alabama that have no mental health care at all.”

Dallas County falls under what is known as a suppression rule.

“Any time you look at suicides in a single county, unless it contains a really large urban city, they fall below what is called the suppression rule,” Hodges explained. “That means if there are 20 or less [suicides reported] in an area such as a county then you’re not allowed to give out those numbers, because it’s entirely possible that people can figure out who they are.”

Dallas County reported less than 20 in 2011.

In 2006 the Alabama Department of Public Health reported suicide as the third leading cause of death among those aged 15 to 24, the 8th leading cause of death for men throughout their lifespan and the 11th leading cause of death overall. In 2010 those statistics continued to show the same. Alabama males were reported as having 535 suicides and females were reported at 141 suicides.

Males tend to have the highest suicide rate, Hodges said, especially white males.

“There are some very sound reasons behind that. For one thing, males have fewer help seeking behaviors than females. They’re less willing to go to the doctor or even talk — especially about personal stuff,” Hodges said. “Actually women do make more [suicide] attempts than males, but they don’t as often for instance use fire arms, where you really can’t change your mind or try and seek help at the last minute.”

Hodges said she has found in her research that suicide data is often under-reported because there has to be sufficient evidence that a death was in fact suicide to be counted as such.

Only 25 to 35 percent of people leave a note, Hodges said, adding that if there’s no evidence the coroner may call it a death of unknown intent, which means it could be suicide, homicide or accident.

Hodges said there are risk and protective factors for suicidal behaviors, and noted if friends and family members don’t pay attention, they might miss the warning signs.

“You have to really be paying attention to a person, particularly over time, but almost everyone who makes a suicide attempt tells someone they’re planning to do it. But people don’t always pay attention, and people don’t always take it seriously. The person may say it as a joke or something,” Hodges said. “If you know they’ve had problems with depression recently, or some kind of catastrophic situational event — loss of a spouse or a partner, lost their job, something like that — you need to really pay attention.”

Most researchers believe the economy has a lot to do with suicides, Hodges said, which is why right now the rates are going up nationwide. The whole nation has a pattern of suicide rates going up.

“The economic situation has so much to do with [the suicide rate], particularly for men. They lose their job, maybe they lose their home — it’s like losing their identity,” she said.

For more information on suicide prevention visit adph.org/suicideprevention or call toll free 1-800-SUICIDE or 1-800-273-TALK.