Deborah Root-Slaney, 74, has always been “the strong one,” a single woman with a tough exterior and a don’t-need-a-man attitude.
She found her happiness riding horses, nearly every day for 30 years. She moved from California to the mountains of Colorado to cross-country ski and float the rivers, to “disappear, laugh and kind of be on sabbatical from all of life’s traumas,” including fighting with her family and a past marriage to a “periodic drug addict.”
But when she got a rare infection in her spine that put her in the hospital, then followed that with a series of other health issues, including severe hip pain, a broken wrist and COVID, Root-Slaney grew depressed, even suicidal. It turned out that her mental well-being was deeply connected to her physical abilities, and those had declined seemingly overnight.
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“I used to be very strong and muscular and now I’m just this skinny, bony woman,” said Root-Slaney, who lives in Eagle. “I used to ride horses every day, then I could barely walk up the stairs. I couldn’t go outside much because I was afraid I would slip.
“I was literally feeling day and night, ‘Oh, you’re old now. If you think you can go walk outside when it’s snowing, you’re mistaken. I figured I was heading for the last roundup for sure.”
Physical decline is a common lead-up to depression among older Coloradans, especially for those who were active on the ski slopes, rivers and hiking trails. It’s also one of the reasons that the suicide rate among older people is higher in Colorado than the rest of the nation, with more than one-third of suicides in Colorado among people age 55 and over.
The suicide rate among older Coloradans has not budged in a decade, even as the teen suicide rate has dropped to its lowest in 18 years. It’s a growing concern because Colorado is getting older — by 2050, one-quarter of the population is projected to be over the age of 60.
Root-Slaney is sorting it out in therapy through Vail Health, where her therapist diagnosed her with post-traumatic stress disorder going back to a sexual assault and abusive relationships decades ago. She learned how to find joy in sitting and reading a book, or playing with her two cats.
Her physical health has improved enough that Root-Slaney was recently able to go on a two-hour horse ride. She’s also begun to mend some relationships that blew up in part, she realizes now, because she was always trying to protect herself.
“For the first year, I pretty much cried,” Root-Slaney said of the therapy. “I have wanted to commit suicide many times in my life. I haven’t had that feeling for quite a while now that I’ve been in therapy. I’m doing so much better, physically, mentally and everything.”
Suicide rate of oldest Coloradans is triple the teen rate
Coloradans 75 and older are three times as likely to die by suicide as teenagers ages 15-18. The state, local communities and nonprofits have poured money and resources into preventing suicide among young people for the past decade, and there is proof those awareness campaigns and school-based organizations are working.
In four years, the suicide rate among young people ages 10-18 has dropped to 5.85 per 100,000 people from about 12.9 four years ago. But the rate among Coloradans ages 65-74 has been about the same for at least a decade, now at 22.5 deaths per 100,000. And for those 75 and up, it’s 28.13.
In mountain towns, older Coloradans are struggling not only with losing physical abilities, but in how their communities are changing as new people move in and everything feels bigger and busier, said Kady Svitak, a licensed clinical social worker at Vail Health Behavioral Health.
“Not only is the community changing but they are changing,” she said. “It’s hard to accept. Who am I now that I am not this amazing skier or mountain biker or hiker?”
Older people, no matter where they live, are also often more isolated, which can lead to poor mental health, Svitak said. She sees many patients who moved to the mountains after their kids had grown, but then felt alone, too far from their families and without much community support or access to care.
Others, like Root-Slaney, moved to the mountains thinking they would escape past traumas. But that doesn’t work. The traumas reemerge when aging brings about physical decline, isolation and, for some, financial worry.
“They hope that being in the mountains can be a reprieve, but they still come with themselves,” said Svitak, who is helping several older people who are in therapy for the first time in their lives.
The most common reason older people seek mental health care is to deal with grief and loss — and not necessarily a death, but the grief and loss of losing who they once were. Svitak doesn’t offer advice about how to keep busy or explore new hobbies. Instead, “we explore what makes them who they are, try to shift the wisdom of their life and their experience.”
“It’s a touchy subject. We sit with the loss and the grief of what they used to be able to do. Is there another purpose that life can offer them?”
One of her oldest patients is 88 and, after initially resisting the idea, recently found joy going on excursions with the local senior center. The center has a crochet group, exercise classes and field trips to places including the Georgetown Loop Railroad and the peach orchards in Palisade.
“Those that have a connection in community seem to do much better,” Svitak said. “If I’m the only point of contact and they see me once a week, that’s pretty limiting and it doesn’t translate to life.”
About 70% of suicides among older people, usually men, are by firearm
Targeting suicide risk among older adults takes a different approach than dealing with young people.
“Connectedness” is a major factor for people of all ages, but the strategies for tackling this are different depending on the age group, said Dr. Lena Heilmann, director of the Colorado Office of Suicide Prevention at the state health department. For older people, it’s often the death of a spouse, a move to a new home, health conditions and loneliness that contribute to poor mental health, she said.
Older men are far more likely to die by suicide than older woman. And the most common method, by far, is by firearm, at about 70%.
Of the 246 people age 65 and older who died by suicide in Colorado last year, 190 were men. And 151 of those men used a gun, according to the Colorado Department of Public Health and Environment.
Those are important statistics to know when trying to prevent suicide among older Coloradans because they show that community programs should make special attempts to reach men and should include firearm safety, Heilmann said.
The high suicide rate among older adults, she said, is likely due to the fact that funding for services is not keeping up with the growth of the older population.
And one big factor affecting older adults’ mental health is the most vulnerable of all topics — confronting death and dying, Heilmann said. “It’s the fear of the unknowns and how much life they have left to live.”
She recommends death doulas, especially for those who have a cancer return or are faced with a terminal illness.
Senior centers add mental health programs
Senior centers across Colorado have long been a place to connect and avoid loneliness, but in recent years they have put more direct emphasis on mental health. Many partner with local mental health and suicide prevention groups to create activities and programs.
In Pueblo, the local behavioral health center is asking older adults to crochet the tiny hearts that go inside their “We Care” totebags given to families who have lost someone to suicide. The point, besides collecting dozens of little crocheted hearts, is to get seniors talking about what they are crocheting. The center also plans to connect older people with student pen pals and puts on art sessions for older residents.
“We had a gentleman who was so upset at everything and we asked him to paint,” said Nanci Gonzalez, one of the suicide prevention coordinators at the nonprofit Health Solutions, which serves Pueblo, Las Animas and Huerfano counties. “He said, ‘No, I’m not going to do that.’ Then he eventually picked up a paintbrush. He ended up opening up the most. You could really tell that this guy was alone and really needed that connection.”
The man even ended up going out for dinner that night with a group from the senior center, Gonzalez said.
At WellPower, the community mental health center for Denver residents, clinicians are taking mental health care into nursing homes. The center has assigned behavioral health workers to seven skilled nursing facilities in the county.
For some nursing home residents, it was the move to the facility that made them depressed.
“There are a lot of changes with individuals that happen as we age and we have a lot of loss and a lot of grief in our life,” said JoAnn Toney, WellPower’s director of housing and residential clinical services. “A lot of our lived experience can be triggered or made a little worse when we have to leave an environment where we know we were safe and where we were comfortable.”
People even grieve the loss of their belongings, she said. “You can’t bring everything you own when you go into a facility.”
The safety net mental health center, which serves mostly people with Medicaid, also reaches older people through its Resource Center in Denver’s Lincoln Park neighborhood. The center has a food pantry and a clothing store, where people can pick out free items. There are daily lunches and coffee hours, and once a month, a popular raffle party in which people can win prizes.
Debbie Blair, 71, and Tracey Tuss, 62, who met in a grief and loss support group offered by the mental health center, are friends who ride together to shop for clothes and win raffle prizes.
They come for the community, the women said as they browsed the racks of used clothing. “There are so many activities here that I can participate in,” said Tuss, who lost her son to suicide. “My therapist is my lifeline, too. Without her, I don’t know where I’d be.”
Sherry Byrd, 62, spent about five years living on the streets and in shelters before she started coming to the mental health center. Through therapy, she’s unpacking years of trauma, much of it from what she went through while she was homeless as a single woman.
She lives alone now in an apartment and came to the raffle to be around other people, she said as she waited for a taxi to drive her home, several bags of food from the Resource Center’s pantry hanging off her arms.
“I’m lonely,” she said. “I talk to myself. I talk to the wall. I come here to mingle with people. I feel like other elderly women know what I’m going through.”