“When you want to know about the health of the county, go and talk to the medical examiner,” says state Sen. Patty Schachtner (D-Somerset). She knows. As the St. Croix medical examiner she is on the frontlines as the one who signs death certificates. Increasingly, the deaths she encounters are suicides.
During September, which is National Suicide Prevention Month, many elected officials look for ways to draw attention to preventing suicides, which are increasing nationwide and in this state. Three decades ago, Schachtner became an EMT. She became a death investigator in 2003 and the chief investigator in 2011. In these capacities she has worked for years on suicide prevention and fighting to increase access to mental health services in her predominately rural senate district that includes Burnett, Polk, Pierce and St. Croix counties in western Wisconsin.
Wisconsin’s suicide rate is higher than the national rate. It is also four times higher than the state homicide rate and has increased by 40% over the past two decades. In Wisconsin, more than 700 people die by suicide every year. And, she adds, each of those lives cut short is a story.
“The final chapter of your life’s book is done at the medical examiner’s office,” says Schachtner. “And when you think about your book, your birth certificate is chapter one, your death certificate is the final chapter and what goes on in between there is the history of the death certificate.”
Whether Schachtner is dealing with suicide, overdose or other types of fallout from unmet mental health needs, she is often the one survivors and family open up to when they are most raw and vulnerable.
“It’s when people are the most open and drawn to share the journey of how they got from there to here,” she notes. “There are very few people that actually get to see the real frontlines. As the medical examiner, you create a relationship with survivors that is a different relationship. And I think once you get that, you then see where the holes are.”
Even before tackling the services that were lacking, one of the first obstacles she felt needed to be bridged was the separation of mental health from physical health, often stemming from the stigma that surrounded the former. She notes that it wasn’t that long ago that many churches would not allow caskets of people who died by suicide inside. “If that was your religious belief, of course, stigma is going to be a hard thing to overcome,” she says.
Key to changing opinions on mental health has been finding holes and cracks in the system. Schachtner often asks survivors what support they needed that they did not get.. She also saw the need to stop shipping people across the state to a hospital rather than offering mental-health care in their own communities.
“Survivors and community members have created coalitions to fill the gaps through prevention and awareness,” she says. “So you can go to any community, and you will probably find the suicide prevention, drug awareness or mental health coalitions. It’s had to happen, because there haven’t been policies to help.”
Schachtner and a social worker co-founded the Suicide Prevention Task Force of St. Croix County and trained 7,000 people over 18 months on preventing suicide through QPR (Question, Persuade, Refer), an evidence-based method.
Schachtner also realized that even in her line of work, she would not know where to go if she felt suicidal. “Who would I call? What questions would I ask about insurance? Where would I go? If I am seen for mental health will it keep me out of the military or college due to stigma?”
In response to this reflection, she helped create a resource management guide on mental health and addiction in 2015. The medical examiner’s office collaborated to make 50,000 copies, distributing it to every high school and mailing it to 25,000 homes.
Her next step as medical examiner was getting trained in mental health first aid, and through another partnership, she helped train 30 other adults as instructors, and sent them back to their home counties to train others.
More is being done for the people on the medical front lines, too. Schachtner experienced personal tragedy when her law-enforcement partner, who rode with her on her ambulance, took his own life. She says it used to be that people in her line of work were urged to keep it all inside. “At the beginning of my career in the medical services we called it ‘the closet.’ Just put all that in there and close the door,” recounts Schachtner. “Now we talk about taking care of ourselves, too.”
Suicide and gun safety
Schachtner grew up hunting with her family. She has long been a gun owner. Recently, for their 40th anniversary, her husband gave her a small pistol and she took a concealed-carry class.
“As a gun owner, I believe personal responsibility is key, and that’s why my guns are on lock down,” attests Schachtner. “As a mother of six children and a grandmother of 12, I have a responsibility to maintain safety. That, to me, is the key issue.”
Many Democrats hesitate to connect the issues of guns and mental health not wanting to wrongly link mass shootings and mental illness. Republicans, on the other hand, often forward mental health legislation in place of addressing gun safety measures.
For Schachtner, it’s about safety, including limiting easy access for someone contemplating suicide. Hunting is a part of Wisconsin culture, as is being responsible with her guns to protect the safety of her family and others, she says. Growing up, she never knew where her dad kept the bullets. “When we would go hunting, they would come out…just miraculously appeared.”
When she taught QRP classes, they handed out free gun locks. And she’s currently sponsoring a bipartisan bill to give a tax credit for the purchase of a gun safe.
In 2017, the most recent statistics available, 60% of U.S. gun deaths were suicides. Nearly half of all suicides completed were with guns, arguably in part because bullets are lethal and death is often instantaneous.
“We are constantly, constantly trying to get the word out there on access and prevention. Talking about personal responsibility is a huge first step to the conversation. But if we can’t even agree there…” Schachtner lets the sentence trail off.
Running for office
Schachtner views suicide statistics as devastating stories of lives that were cut short. In her line of work, making resources available and accessible were huge first steps to preventing suicide. “It’s the hardest for that person who is struggling with emotional bankruptcy, you know, they feel hopeless, helpless and worthless.”
The overarching story is one of a lack of access to mental-health resources, but that is not where it stops.
Schachtner says she sees a link in numerous policy areas to preventing suicide. Asked about things that can be done she cites accepting Medicaid expansion money so more people have insurance and there is more money for mental health as a priority. She also sees transportation, especially in her rural district, as a barrier that keeps people from getting to a doctor or therapist who may be far away.
She wants to see not only better roads and transportation, but telemedicine (two-way, real time interactive communication between the patient and the physician or practitioner at what may be a distant site.)
Of course, that requires reliable broadband service. Schachtner says all this added up to her decision to run for office in a special election in 2018. That said, she has some advice anyone can follow to help.
“With the suicide piece, people say it’s one thing, but it’s not, it’s a whole bunch of things that come together. And when you are emotionally bankrupt, at that moment, you want that pain to go away. That’s what is probably the hardest for people to understand.
“So, the best prevention sometimes is just letting people know you are there. And once you do that, it is up to the legislature to work on prevention and strategies to have legislation to meet the next step. So that’s why I ran. And that’s what I will continue to fight for.”
The National Suicide Prevention Lifeline is available 24/7 with free and confidential support for people in distress and crisis resources for you or your loved ones at 800-273-TALK (8255)