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When the state cut funding for suicide prevention, this Wyoming church stepped in

Star-Herald - 12/17/2017

On a Sunday in September, morning light drifted through stained glass as churchgoers in Rock Springs raised their eyes to God.

In Basin, a congregation joined voices to sing an opening hymn. In Thermopolis, they bowed their heads, opened their hearts and asked for mercy.

Then the prayers - recited in each of those Episcopalian churches - became specific.

"God of Mercy, hear our prayer for ourselves, our friends and families who hold painful memories of loss, grief and suicide," the priests read. "We ask for strength for today, courage for tomorrow and peace for the past."

"Amen," the congregations responded. Amen, they said, thinking of those they knew who died by suicide. Amen.

Not many Christian sects have a service specifically dedicated to suicide prevention. In many churches, suicide is taboo - something to be whispered about over after-service coffee but never mentioned from the pulpit. For some, suicide is a violation of the Fifth Commandment - thou shall not kill. For some, those who die by suicide are damned to hell.

But the Episcopal Diocese of Wyoming doesn't condemn those souls. Instead, the 49 parishes across the state are actively attempting to save them. They fight the stigma of suicide with efforts like the special liturgy and train their clergy and lay people to recognize the signs. Suicide prevention has been a priority for the Episcopal church in Wyoming for years. But after state lawmakers drastically cut funding for prevention earlier this year, the church's efforts further intensified.

It's an obligation, Bishop John Smylie said, especially in a state that consistently has one of the highest rates of suicide.

"It's become the moral priority for the diocese," he said.

In 2016, more than 130 people died by suicide in Wyoming. In 2015, the most recent year for which national data is available, the state had the highest rate of suicide in the nation - 28 deaths by suicide for every 100,000 residents. Wyoming consistently ranks in the top five states with the highest rates.

After lawmakers cut suicide prevention funding this year, the diocese pledged $100,000 for local churches to use toward that aim. Parishes across the state have held trainings and recruited speakers.

But Smylie wants one thing to be clear: This was a one-time gift. It's the job of the Legislature to fund suicide prevention and awareness, not the diocese's, he said.

"I don't understand the thinking of the legislators and how they can choose not to care about this profound crisis," he said. "This is their responsibility."

Allocating resources

During the 2017 legislative session, lawmakers voted to cut $2.1 million from the Wyoming Health Department's$5.7 million budget for suicide and substance abuse prevention. Legislators reduced state spending by hundreds of millions earlier this year as they faced a major revenue decline due to the downturn in the energy sector.

That cut has deeply affected the Prevention Management Organization of Wyoming, the nonprofit that the state contracts with to provide prevention services. The health department said in April that it would no longer contract out suicide prevention work and would instead manage the effort internally.

Because of those cuts, PMO had to eliminate 21 positions at both the local and statewide level, including the position that coordinated suicide prevention efforts in the state, CEO Keith Hotle said. The organization no longer has the money needed for informational campaigns, training materials or prevention efforts focused on specific at-risk communities and is only able to facilitate suicide intervention trainings with the help of the Episcopal diocese.

Local PMO staff partner with the Episcopal church in their area and request funding from the diocese's foundation. The nonprofit can provide the trainer, but money for materials and space now comes from the church.

"It's possible we would've been able to do intermittent training," Hotle said. "But eventually that would've dwindled away all together."

"It really was a saving grace. A blessing."

At Tuesday's meeting of the Joint Appropriations Committee, health department director Tom Forslund noted that suicide prevention funding took a "significant cut" last session. He explained that the health department changed how it pays for suicide and substance abuse prevention. Instead of a single contract to the PMO, the department broke the money into three smaller contracts.

Ultimately, Forslund said, the department chose to prioritize issues like smoking and substance abuse, which he said affect more people than suicide.

"I don't want to send the message that suicide prevention or the suicide issue isn't important or very devastating to the families or individuals who decide to end their lives," he said. "The thought was to focus on the areas that affect the greatest number of people."

But that decision meant less resources for the thousands of people affected by suicide every year in this state. Each death leaves behind loved ones - as many as 115 people per suicide death, one study found - to grapple with loss and bewilderment, anger and grief. During his inaugural suicide prevention symposium in 2016, Gov. Matt Mead estimated that half of all Wyomingites had been affected by suicide.

The Episcopal diocese first started working with the PMO on suicide prevention in 2014, but the relationship became more formal after lawmakers cut the budget. In July, the bishop sent a letter to legislators and the governor condemning the cuts.

"The Scripture says, 'For where your treasure is, there your heart will be also,'" he wrote. "Have you no heart for the individuals and families who suffer so greatly from suicide? Your budget would suggest this to be true."

In the letter, he explained that the diocese's foundation would set aside $100,000 for suicide prevention. However, he made it clear that the money was a one-time contribution. He didn't want lawmakers to think that the private sector would provide a long-term solution for the reduced funding.

"This omission of funding for suicide prevention is an embarrassment, one that I trust you will remedy at your next session," the letter ended.

In the meantime, the bishop and his diocese took matters into their own hands.

'Postvention'

Once a month, Rev. Tom Fiske gathers families grieving a loved one who died by suicide. They meet in a room in Gillette College's technical education center and discuss their loss, their bewilderment, their healing. Talking doesn't always ease the pain, but at least they know they're not alone.

Facilitating the support group is separate from his role as an Episcopalian priest, Fiske said. His work with people affected by suicide predates the church's decision to prioritize the issue. It's personal.

"With the survivors of suicide loss, I can wear that t-shirt," he said. "I know where they've been."

Fiske still grieves the death of his sister, Betsy. She killed herself nearly 50 years ago. His father also died by suicide, 12 years earlier.

Sorrow comes in waves: on Christmas, on New Year's, on Betsy's birthday. It gets better over time, he said, but the loss is too profound to ever truly dissipate.

"It still leaves a pit in my stomach," he said.

In his work, he has become especially interested in "postvention" - or the care of people whose loved ones died by suicide. How can someone support a family while they heal from such a loss? How can he guide his community to embrace those who are hurting?

In 2015, the church's foundation approved a $23,000 grant for suicide prevention work at Fiske's church. Most of that money was spent on a two-day training so that people in northeast Wyoming could better help those affected by suicide. After the training, the church had about $7,000 left over.

The parish put that money in a savings account. Later, it would be used to help families affected by suicide. Not just for counseling, but also for cleanup of the physical mess left behind.

"Since we live in Wyoming, most of the suicides that do occur are by a middle-aged man with a gun," Fiske said. "Often there's biohazard material to take care of."

The cleanup and repair can be expensive. Walls have to be mended. Carpets cleaned. The money can help pay for motel rooms for the family while their home is fixed.

So far, the fund has helped four families recover in the wake of a suicide, Fiske said. Donors have helped replenish the money as it is spent. As Fiske sees it, the church is obligated to care for those left behind.

"Whatever it takes," he said. "The church is called to affirm life."

On the other side of the Bighorn Mountains, Rev. Lin Davenport has held multiple QPR - Question, Persuade, Refer - trainings at Thermopolis' Holy Trinity Episcopal Church. The two-hour sessions teach participants to recognize the signs of a suicide crisis, persuade that person to seek help and to refer them to resources.

Davenport's own training has made her better able to recognize the symptoms of suicide. She's no longer afraid to ask the difficult questions, she said.

"I don't believe there is one member of my church who isn't aware of suicide prevention and the need for it," she said of her congregation of about 60 people.

Churches in other parts of the state are tailoring the funding to their own needs, said Rev. Bernadine Craft, a priest and a member of the diocese's Episcopal Suicide Prevention Connection. In Fremont County, churches are requesting money to train law enforcement to better respond to people in crisis. In Sweetwater County, the three churches are pooling their money to bring in a man who survived an attempt to jump off the Golden Gate Bridge and now tours the country to educate audiences about suicide.

Craft, a psychotherapist and a former state senator, said the diocese chose to focus on suicide prevention out of a number of potential social priorities because it seemed to be the most underfunded.

"We said, 'This is a void,'" she said. "This is something where we as a faith community can step in."

Partnering with a church and its clergy has a number of benefits, said Hotle, the PMO chief executive. Priests and deacons are often the first person to whom someone might admit depression or suicidal thoughts. Making sure the clergy are educated about suicide and equipped to handle those conversations is crucial, he said.

That is even more true in small, rural communities where there aren't formal mental health practitioners, he added. Clergy often act as counselors when professionals are not available - there is nobody to refer the person in crisis to.

"Those priests think, 'I'm it,'" Craft said. "That can scare them to death."

The bishop himself is trained in QPR and ASIST, which is described as "suicide first aid" by the Suicide Prevention Resource Center. Most of the diocese's 94 clergy have also been certified in one of the courses, Smylie said. Both QPR and ASIST trainings are mandatory in the diocese's training for prospective priests and deacons.

"We can't say we're Christians and then turn our back on issues that our impacting our population," Craft said.

A consistent message

Clergy, like others who work in suicide prevention, constantly battle damaging cultural myths about suicide and mental illness. Depression is not a weakness, they have to repeat, it's a health condition. Discussing suicide with someone will not cause that person to kill themselves, they teach.

But within the Christian community, clergy and churchgoers have to combat a deeper theological issue. Among the faithful, there is often a belief that those who die by suicide are condemned to hell, the bishop said. The act of suicide is compared to homicide - the active taking of a life. For many years, some Christian churches would not allow a person who died by suicide to be buried in their cemeteries.

Smylie, along with the larger Episcopalian church, rejects that interpretation. Smylie believes that God's love extends to everyone who is repentant.

"There needs to be a consistent message" that suicide does not equate damnation, he said. "We want folks to know that they're going to be heard, loved, listened to."

At the Episcopal Church's national convention in 2000, church leaders adopted a formal resolution on suicide prevention. In that decision, church members committed to educating themselves on suicide prevention methods and how to best minister to those who have suicidal ideation and to those who lost a loved one to suicide.

In the resolution, the church cited a Bible verse from Romans: "Nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord."

Fiske, the priest in Gillette, was more blunt.

"We don't condemn to hell the person who has died of cancer, or in a car wreck, or in a car wreck while they were talking on the telephone," he said. "Nor should we condemn the person who has long suffered from depression."

Craft, with the help of others, wrote a prayer for suicide prevention to help battle that belief. Later, others expanded on that prayer and created the Liturgy for Suicide Prevention - the church service that was performed across the state in September. She hoped that the liturgy would help church members know that they would not be judged for their struggles with suicide.

"We are called to be the face and hands of God in the world," Craft said. "God, as we see him, is loving and giving and compassionate."

Three years ago, a coalition of Sweetwater County organizations and the diocese commissioned a Rock Springs writer to create a one-act play about suicide. His work, "Chimes," is a stark portrayal of suicide, Craft said, and has been performed in Rock Springs for the past three years. The play follows a character who is contemplating killing himself. It's not easy to watch, Craft said, but ultimately carries a message of hope.

This year, the play was performed for the first time in a church. The actors recited their lines in front of a large mural of a blazing light, their words rising to the vaulted ceiling like incense.

After the performance, a stranger approached Craft in the dim light. With tears in her eyes, the woman told the priest that her dad died by suicide more than 20 years ago. For all that time, the woman believed that her father was barred from heaven because of the way he died. For all that time, she bore two burdens: that of loss and that of torment.

But that night, for the first time, the woman was able to believe her father wasn't in hell.

Finally, she said, she could believe her dad had found peace.