Recession adds to depression woes on Cape

Recession adds to depression woes on Cape
(April 2009 Issue)

By Jennifer Chase Esposito

As if the yearly deluge of summer tourists and lack of jobs once they leave didn't already impact Cape Cod's economy, the nation's recession is hitting New England's quintessential vacation spot, driving depression and suicide rates among its yearlong residents to record heights in Massachusetts.

"This is really a beautiful place and those of us who have lived here feel very fortunate," says Tim Lineaweaver, LMHC, director of behavioral health at the Community Health Center of Cape Cod (CHC). "But a higher rate of uninsured [residents] and being hard to find housing and steady work all add up to a disparity," he says, which leads the Cape to battle a higher-than-average rate of alcohol and drug abuse and a suicide rate among youth ages 10-24 that's highest in the state.

Lineaweaver was a project manager for a survey conducted by the CHC, which found that from 16,000 patients polled at four Cape health centers from 2004-08, 43 percent showed some sign of clinical depression.

"I've been in this business for 15, 16 years, and the economy has never been more central in sessions," says Lineaweaver, whose daily work ranges from counseling families who have fallen behind nearly three months in their mortgages, to a patient who lost his job, home and relationship at the same time. CHC treated 30,000 patients in 2008 and will likely see 5,000 more than that by the end of this year.

In a statement in a news release announcing Massachusetts Suicide Prevention Week '08, Mass. Department of Public Health Commissioner John Auerbach said that more than one person a day commits suicide in Massachusetts. But for Cape Cod residents, "there are six suicides to every homicide on Barnstable County," says Maura Wilson, executive director of The Samaritans on Cape Cod and the Islands. Those numbers, says Wilson, represent only the suicides that are reported.

"Any time stress is prevalent, whether it's economically induced or otherwise, there is always the risk of people hurting themselves or others," says Wilson.

Rocky beaches, reliably good ice cream and genuine New England beauty are just a few things that draw thousands of tourists to Cape Cod every summer. But in their wake each Labor Day are summer resort closures, downsizing in staffs and a general drop in activity that, coupled with long winters, affect the mental health of the people who live there year round.

"We have a lot of young families who are leaving. It's been a real hardship," says Wilson, whose trained volunteers field between 15,000-20,000 calls each year from people on the brink of suicide. But Wilson also notes that the Cape's isolation, especially on the lower Cape, keeps people in their homes and amid their thoughts. With a senior population of 25 percent and growing and with the country's highest suicide rate being white males in their late 70s, in 2007, the Samaritans began a senior outreach program that makes outgoing calls to seniors referred by councils on aging across the Cape.

But regardless of age, "lack" is hitting everyone's wallet.

"The economy has impacted the calls we're getting, so sometimes the topics are changing. People feel depressed because they're experiencing the loss of a job or home foreclosure; food, for example, is costing so much more, [and] the cost of gas."

"I think [the economy] exacerbates whatever depression tendencies are in people," says Lineaweaver, who at the end of counseling sessions has often walked clients to case managers who help patients research unemployment insurance, get free samples of medication, or learn what resources are available for paying their utilities if they are unable. "A house represents a dream, security and hope. When you lose that, it can be seen as the end of a lifelong dream. It's really painful."

To combat the 20-25 patients per month that Lineaweaver and his staff see at CHC who present with suicidal ideation, there are several collaborations between Cape service providers and the Mass. Department of Mental Health including the Massachusetts Suicide Prevention Program and the Suicide Prevention Coalition. The 8th annual Massachusetts Suicide Prevention Conference will take place May 19-20 in Sturbridge, Mass., to further address issues.