“Isolated,” “lonely,” “disconnected” — these are words that older adults in Richland County used in suicide letters to describe how they felt before taking their own lives.

Such suicide letters have become very common in Richland County, where suicides have increased dramatically over the past two years.

Richland Coroner Nadia Rutherford said many letter writers were elderly and struggled to maintain human connections or get mental health help.

“In the suicide notes they left, they expressed that they felt like a burden to their families,” Rutherford said. “One note, in particular, talked about how their families never come to visit.”

As of late August, Richland had already lost 49 lives to suicide this year, according to county records.

Those 49 deaths have already exceeded the 47 recorded in 2022 and are on track to exceed 72 in 2023.

It’s unclear if South Carolina’s other counties are seeing the same recent trend. State and national figures for 2023 and 2024 are not yet easily accessible to the public.

In Richland, the surprising jump to 72 last year was the start of what threatens to become a troubling epidemic.

“It was eye-opening,” Rutherford said. “Unfortunately we are on track to exceed that number this year.”

The coroner’s office does not provide a detailed breakdown of the ages of those who have died by suicide. But Rutherford said their ages ranged from 13 to 91, with a “shocking” number of older people.

He said some people expressed feelings of abandonment, especially if they couldn’t move as well as before.

“They felt abruptly forgotten as family members,” Rutherford said. “They weren’t invited to vacations or family gatherings. The only time families would go visit them is when they go to doctor’s appointments.”

Address barriers

A representative from the South Carolina coroner’s offices attends the sites of unusual, suspicious or violent deaths.

But coroners are also looking for safety trends and tips for county residents on how to prevent deaths whenever possible.

Part of the problem with the recent spate of suicides, Rutherford said, is a change in technology that has left behind some older people who are not as tech-savvy.

For example, many mental health services can be accessed online. But that can be difficult for some older people.

Chava Raymes, a therapist with South Carolina-based Blue Moon Senior Counseling, said the technological barrier could discourage some seniors from seeking help.

“I think it scares them,” Raymes said. “Older adults tend to be much more distrustful of technology in some ways, which is totally fine. But they don’t fully understand how to use these resources.”

Rutherford suggests that the older population is overlooked by mental health professionals, as most resources are directed toward younger people.

“I think that’s why we’re having this jump,” Rutherford said. “There’s just a huge disconnect between this generation and people who are aging.”

Rutherford also said there are fewer and fewer mental health services in general, especially counselors.

“There aren’t a lot of free, readily available resources,” Rutherford said. “There can be a six-month waiting list, and by the end you’re already deeply immersed in the crisis.”

The stigma surrounding mental health could also prevent some people from getting help.

“Especially among older men, there’s a stigma like, ‘Oh, you don’t need help.’ You’re not sad. You’re not depressed,’” said Jessica Barnes, program director for the South Carolina Department of Mental Health’s Office of Suicide Prevention.

Some don’t want to be a “burden on other people,” especially their families, Raymes said.

“They often find it embarrassing, especially if they spent their entire adulthood being independent. They forget how to ask for help,” Raymes said.

John Tjaarda, South Carolina area director of the American Foundation for Suicide Prevention, noted that suicide rates decreased nationally during the height of the COVID-19 pandemic in 2020.

It suggests the decline was because people were more focused and connected.

“They were playing commercials over and over saying, ‘It’s okay to not be okay,’” Tjaarda said. “They talked about reaching out to their loved ones who were isolated. And that decrease in suicide nationally demonstrated what works: having a deep sense of community and connection.”

Tjaarda said national suicide rates increased again in 2021 as COVID-19 began to subside.

“As the pandemic began to subside, so did the sense of connectivity,” Tjaarda said. “So, in my opinion, we saw what a country can do in a world focused on connection.”

Rutherford said reminding the people in our lives that we appreciate their presence can go a long way.

“We are literally losing members of our community and the numbers are going up,” Rutherford said. “We have to continue to show these people how much they matter. “We need to give them a life and a purpose other than sitting at home waiting patiently every day for someone to notice they are still there.”

Recognize signs, provide support.

Tjaarda said mental health and suicide are extremely complex and affect everyone differently, but they can come with subtle warning signs.

“If you notice someone suddenly withdrawing from something they love, like an older person who loves going to a bridge club, that may be an indicator that a time of crisis is approaching,” Tjaarda said.

Older people sometimes have difficulty accepting greater dependence on others, Barnes said. And loss of mobility can also lead to self-isolation.

Family and friends of older people can often help in ways they may not realize.

Tjaarda said directly asking people if they are thinking about suicide is an effective strategy for normalizing discussions about mental health issues.

“A lot of people think that that will bring that thought to mind, but our research has shown that that’s not true,” Tjaarda said. “What happens is you just took this super taboo topic that they thought they couldn’t talk about and allowed them to discuss it. “You have created a safe space for them to share their feelings, fears and pain, allowing them to be open about their struggles.”

Raymes said his therapy sessions with older adults focus primarily on acceptance and control.

“I think the loss of control creates a lot of anxiety and feelings of worthlessness,” Raymes said, noting that some are starting to wonder, “What’s the point anymore?”

The first step is to destigmatize mental health at all ages and ensure that older people have access to the resources they deserve, she said.

“Actually, I don’t think humans were meant to do it alone,” Raymes said. “In many ways, we need each other. And we need to learn to ask for help at all ages.”

Barnes said that, although it may be a cliché, suicide prevention takes a village.

“There have been many times where I felt like I was in the right place at the right time, but it really is a community effort,” Barnes said. “But I carry my hope with me and I keep hope for others, even if they feel like they don’t have it.”

This story was brought to you as part of an editorial partnership between South Carolina Public Radio and the University of South Carolina’s Carolina News and Reporter, which is responsible for its content. You can learn more about Carolina News and Reporter here.