32% Dip in State Suicides Found as U.S. Rate Rises : Research: Amid debate about causes, UCI study of 1970-1990 data finds O.C. among counties with lower rates than California.

As experts lament a steep rise in youth suicides nationwide, and as U.S. suicide rates outside California edge upward, the numbers for this state--painstakingly charted by a UC Irvine graduate student--tell a brighter but less known story.

From 1970 to 1990, while the U.S. suicide rate increased almost 19% outside California, this state’s suicide rate plunged, even among young people, according to the recently published research by Mike Males, a doctoral student in social ecology.

The 32% overall drop--even more dramatic in urban coastal counties such as Los Angeles and San Francisco--is a largely unheralded trend that Males believes cries out for attention.

Orange County’s decrease slightly exceeded the state’s, but Los Angeles County saw a drop of almost 45%. Statewide, among Californians ages 15 to 24, the rate tumbled almost 37%, Males found.

Examining extraordinary patterns like these “should be an exciting opportunity,” Males said. “Part of understanding why people commit suicide is understanding why they don’t.”

Yet suicide seems to draw interest, and funding for prevention, only when it’s on the way up, he said. When Males reviewed the literature on suicide for a paper published in March, he found a single reference to a decline in California.

While they are aware of the drop in California’s overall rate in the past decade or so, state and national officials acknowledge they have not analyzed the trend closely. The downturn since the early 1980s, though significant, eludes easy explanation, they say.

Suicide “is a very poorly understood phenomenon,” said Roger Trent, chief of injury surveillance at the state Department of Health Services. “We really don’t know much about it. There is a very strong cultural and social element. It varies sometimes and we don’t know why.”

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Suicide was the eighth leading cause of death in the country in 1991, ranking above AIDS and homicide. It was the ninth leading cause in California. Yet it “is not high on the public agenda as a public health issue,” said Lloyd Potter, team leader for suicide prevention at the Centers for Disease Control and Prevention in Atlanta. “We have fairly limited resources to do investigations.” But some in the nation’s small circle of suicide experts, who for years have pursued what they acknowledge is an obscure and often mysterious field, are intrigued by Males’ findings.

“On pretty close first scrutiny, (Males’) observations seem to hold water,” said psychologist David Clark, director of the Center for Suicide Research and Prevention in Chicago. “I think he has something meaningful here”--and it’s already sent some suicide trend-watchers “scurrying now to look at it in detail.”

California sits among a cluster of Western states such as Nevada, Montana, New Mexico and Idaho--which consistently post among the highest rates in the nation. The question, say Clark and others, is why this state bucks the trend.

According to the CDC, California had the nation’s 12th highest suicide rate in 1980, but dropped to 34th a decade later--the only one among the Western states to show such a drastic shift.

It’s not that the state’s suicide rate is comparatively low. Before 1970, California’s rate was more than double that of the rest of the country; by 1990 it was equal to the national average.

Even Males, who has made the issue his academic mission, says he can’t fully account for what he calls “the weird California effect.”

The bearded 44-year-old doctoral student, who describes himself as an “all-purpose skeptic”, began thinking about the issue of suicide while working as a newspaper reporter in Montana. He was disturbed, he said, by the “hype” that followed a teen-age girl’s suicide; no one bothered to mention that youngsters kill themselves far less often than adults do.

Later, when he took a close look at numbers published in a national statistical manual, he noticed the suicide figures among U.S. residents had gone up but California’s hadn’t. It seemed odd, he said, so he called about a dozen experts to find out why. All they could tell him was why suicide rates were rising. He went back to school, he said, to find out for himself.

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Much of California’s pattern remains a mystery, he said--but he has some theories.

Clearly, changes in the state’s population make-up explains some of the downturn, he and other experts say. California has been a mecca for minority groups in the past several decades. Males said in his March article in the journal Suicide and Life-Threatening Behavior that the state’s proportion of Latinos and nonwhites doubled to almost 44% between 1970 and 1990, twice the rate of the national increase.

For cultural reasons that are not well understood, these minority groups tend to commit suicide at a much lower rate than whites.

But even after Males adjusted state statistics to account for ethnic composition, he found the population changes accounted for only about a third of California’s suicide decline.

While the drop in suicides was most dramatic among Latinos and nonwhites between 1970 and 1988, Males said that rates among white males, who of all groups are the most likely to kill themselves, dropped 12% in the same period. Among white females the rate dropped more than 58%.

Males explored another possibility: The trends may be skewed by reporting differences between California and other states.

He notes that California, by the 1970s a center for world suicide research, was much better than other states at distinguishing suicides from accidents at that time. As early as the 1960s, the state had suicide specialists advising coroner’s offices on suspicious cases. Only recently have other states begun to correct a longstanding reluctance to certify deaths--particularly youth deaths--as suicides, Males contends. So perhaps California and other states were closer in suicides than the numbers showed in the 1970s.

But misclassification by other states still falls short of explaining the dive in California’s suicide rate. It seems certain that California saw a substantial “real” decrease in suicides, Males said--particularly among women, nonwhites, the young and urban dwellers.

And the numbers suggest the drop-off had something to do with changes in behavior among people ambivalent about killing themselves in the first place.

The most dramatic dip in suicides occurred among people who chose so-called “soft methods,” such as drug overdose, poisoning and drowning, which leave open the possibility of being saved. To Males, that suggests that “people who are ambivalent about dying are choosing to live.” The question is why.

Males and others very cautiously suggest that California’s pioneering efforts at suicide prevention, begun in the 1950s, gradually might have paid off. Those efforts, such as hot lines and counseling, perhaps have been most effective among people least certain about whether they want to die.

Some of the most dramatic suicide declines are seen in such areas as Los Angeles and San Francisco, where suicide prevention efforts were early and vigorous.

Several suicide experts remain unconvinced. “We dont have any body of evidence proving that crisis centers and hot lines lower the death by suicide,” Chicago psychologist Clark said. “It doesn’t mean they don’t work. It’s just very hard to measure. We don’t know if they’re working. Maybe the effects are small and subtle and cumulative.”

Kim Smith, a New Mexico suicidologist, said prevention centers probably have not worked--with the exception of concentrated community efforts that occur immediately after suicide clusters, such as those among teen-agers. But Males, he said, has posed a provocative question--one that merits greater scientific inquiry.

Others caution that a drop in suicide rates is no reason for California to relax its prevention efforts or to dismiss the suicide problems as resolved. Certain subgroups, they say, remain at high risk--especially the state’s growing elderly population.

Michael Peck, a West Los Angeles psychologist who has written a book on youth suicide, said it is important to remember that California’s rate, while lower than it used to be, still is close to the U.S. average. “We’re not talking about it being very low.”

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At least some of California’s dip could be due to random variation, one expert familiar with Males’ data said. With a relatively rare event such as suicide, wide swings are not unexpected, said Richard McCleary, a professor of environmental analysis at UCI.

“I think he (Males) has got a real effect here,” McCleary said, but its significance should not be “overinterpreted.”

For at least one woman who lost a family member to suicide, news of Males’ findings evoked mixed feelings. Cathi Jones of Newport Beach, whose 23-year-old son hanged himself in 1992, said it would be “marvelous” if the state’s rate were going down.

“If suicide prevention actually does something, I think that surely should be something that is looked into,” she said. But Jones, who runs a peer support group for families affected by suicide, said she worries about the issue being minimized. “I’m concerned people will say it’s not a problem anymore . . . and (about) family members being put in the position of thinking that there is something wrong with them . . . that it is a shameful thing, that they are unusual.”

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California’s Suicide Rate Declining

While the U.S. suicide rate outside California edged up 19% between 1970 and 1990, the rate among California residents declined roughly 32%. Los Angeles County saw a 45% drop and Orange County’s rate slightly more than the state’s during the same period.

Rates per 100,000 residents:

Los Angeles Orange U.S. outside County County California 1990 11.39 10.09 12.55 12.25

Sources: Center for Health Statistics, California Department of Health Services; National Center for Health Statistics, U.S. Public Health Service; U.S. Bureau of the Census

Researched by JULIE MARQUIS / Los Angeles Times