Total Iowa suicides decreased in 2023, but teen suicides are up

Micki and Kevin Salge and Joe and Jennifer Skelley have been family friends for a few years, but not because they are neighbors or had mutual friends or hobbies. The two couples came together because of a shared tragic experience: both have lost a teenage son to suicide.

Dylan Salge was a 16-year-old sophomore at Iowa City West High School when he died on March 13, 2021. He had been struggling with mental health for a while, and had previously spent time as an inpatient at a mental health center, with his parents’ support.

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“We knew he was struggling, but after he got out of inpatient and started to get through the different processes with therapy and medications and things, we thought we were on the other side, at least a little bit,” Kevin Salge said.

The Salges moved to Iowa City about six months before COVID-19 put everything in lock down, which made it difficult to get community support, both before and after Dylan died. They were limited in the number of people they could invite to Dylan’s funeral, but more people were able to attend his visitation by coming through a few at a time.

Among those who attended the visitation were the Skelleys. One of their sons, Boyd Skelley, attended Liberty High School and competed with Dylan on the swim team that West High and Liberty High shared.

“Joe [Skelley] was there when we talked to the swim team, and he told me afterward he was sitting there thinking he couldn’t imagine that, and then a year later he found himself in that same situation,” Kevin said.

Joe and Jennifer’s other son, Owen Skelley, died by suicide on March 3, 2022, almost a year after Dylan’s death. Unlike Dylan, Owen, who was 15, didn’t show any outward signs that he was struggling with his mental health or contemplating suicide, according to his parents.

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“He suffered in silence, which was really unfortunate. So, our biggest goal is to tell the youth, the teens, the young adults in this community, their families, that it’s OK to talk about mental health and it’s OK to ask for help,” Jennifer Skelley said.

Dylan and Owen are two of the dozens of young people who have died by suicide in Iowa in recent years, and the teen fatality count keeps climbing.

Teen suicides rose slightly last year

In 2023, the total number of Iowans who died by suicide dropped from 581 to 496 — a success that researchers are trying to determine how to replicate. However, the portion of those suicide victims who were teenagers increased from 3.1 percent to 5.2 percent, or around 18 teen suicides in 2022, to 26 in 2023, according to data from the Iowa Department of Health and Human Services.

“It’s important to put it in context. The rates are based on relatively small numbers compared to other age groups. When the groups or the numbers are smaller, a change can look like a greater relative increase, year over year,” said Jonathan Platt, an assistant professor at University of Iowa, who specializes in research surrounding mental health and suicide.

“That’s important context, but still any increase is concerning and it’s important to think about what is driving those increases.”

The last time Iowa recorded fewer than 500 suicide deaths in a year was 2018, when there were 472. That number jumped 11 percent to 522 in 2019, and was at its highest in 2022, at 581.

As researchers try to understand why those numbers dropped so much in 2023, and why teen suicides continued to rise, Platt said “we have more hypotheses, more questions, than answers to that.”

Why did overall suicides decrease in 2023?

Platt said many factors may have played a role in the overall decrease in suicides in 2023. It could simply be normal fluctuation, or it could be a return to lower numbers as COVID-19 restrictions loosened, although suicides did not increase as much during the pandemic as researchers initially expected.

“We saw increases in anxiety and mental health related symptoms related to suicide, but we didn't see those big spikes that we all expected. People are still trying to figure that out, but I think people spending more time at home and having fewer opportunities to access the means that they would need to complete a suicide act may have had something to do with that,” Platt said.

“Part of what we’re seeing right now is the long-term ramifications of the disruption and the change in habits and social routines that might be related to suicide.”

Another potential factor in the decrease is a change, in 2022, to the national suicide lifeline. The phone line switched to an easy-to-remember three-digit number, 988, making it easier for people in crisis to remember and access.

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Platt said it’s difficult to determine the effect the 988 number had on suicides because researchers can’t isolate it from other factors, but he believes it could have had a benefit.

“It certainly was a positive resource for people to have, and much easier to remember than the long 800 number that they used to have,” Platt said.

Why did suicides among Iowa teens increase?

Platt said suicide rate increases have been highest among teenagers in the U.S. for around two decades, so the continued rise in youth suicides could simply be an extension of that trend.

One potential contributing factor to that trend in Iowa could be the percentage of the state that is rural. People living in rural areas — teens especially — tend to be at greater risk of suicide. The risk is increased because of things like social isolation, greater access to firearms, and limited access to mental health resources, Platt said.

The Salges said despite living in a more populated area, they believe Dylan’s mental health struggles that led to his suicide may have been exacerbated by feelings of isolation because of the COVID-19 pandemic. They said they wish he’d had more resources through his school and community.

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Both the Skelleys and the Slages now work to spread awareness about mental health.

The Skelleys founded a nonprofit organization called The Big O Foundation. They host events and speak in schools to help raise awareness about mental health resources. They also work to raise money to donate to local mental health organizations so that people who can’t afford to see a therapist or counselor can have their counseling sessions paid for.

The Salges are board members for the I’m Glad You Stayed Project, a nonprofit that provides mental health resources to schools and organizations around the country and offers free suicide prevention training. The I’m Glad You Stayed Project was organized by Abbley Schley, a friend of Dylan’s who he texted before he died.

The Skelleys said when they speak at schools, one of the things they often hear from teens is how much stress they feel in their everyday lives, socially and academically.

“There is a lot of pressures on people these days with social media, the internet, what they see on TV, and setting their expectations too high for life, and their threshold of achievement and defeat. Trying to meet that is an obligation and burden,” Joe Skelley said.

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While Owen didn’t talk to his parents about his mental health struggles before he died, Joe and Jennifer said they think he may have been too worried about being a burden or not meeting expectations to ask for the help he needed.

“He was mature for his age. He just didn't want anybody else's lives to be disrupted by him telling anybody about his own problems,” Joe said. “Maybe those pressures added to Owen's struggles, we'll never know.”

How do we keep suicide rates from rising?

There are two main areas of focus when it comes to understanding and preventing suicide on a large scale, according to Platt. First, researchers are constantly trying to determine what factors put people most at risk. This means studying where suicides and suicide attempts happen and among what groups of people.

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“One particular focus of my research is looking at if there are geographical or social variation between communities and across place, policies and other indicators at the community level that might be, not predictive of individual risk, but predictive of group risk,” Platt said. “If we can identify those kinds of indicators, we can at least know where our efforts for primary prevention … might be most beneficial.”

Second, is studying what types of intervention are the most effective, and when those interventions can best reach people. That can look different depending on which communities are being addressed, but in general, measures that create stronger social connections, better economic opportunities and less stigma around discussion of mental health, as well as increasing access to health care in general, are a good place to start, according to Platt.

“Thinking about young people, giving them the skills and tools to deal with stress and adversity in healthy ways and have adaptive coping, has been shown to have benefits. Other social skills around being able to cope with stress … are really helpful,” Platt said.

There are also more structural types of interventions that are beneficial, like promoting safe storage of firearms. Increasing firearms restrictions can be helpful in reducing the fatality rates of suicide attempts, since suicide attempts that involve guns are the most likely to be fatal, and people who survive a suicide attempt or make it through a serious crisis often don’t go on to attempt suicide again, Platt said.

The Skelleys said they’d like to see mental health and suicide prevention become a required subject in schools, so that people can learn early what to do if they or someone they know is experiencing a crisis.

“I think the more people are convinced and realize that having depressing feelings or … feeling a sense of anxiety, the more people feel that that’s normal, and that it’s OK to talk about, the better,” Joe Skelley said.

How to seek support

If you’re in need of someone to talk to about your mental health, there are resources available 24 hours a day, 7 days a week:

National Suicide Prevention Lifeline: Call or text 988

Crisis Text Line: Text 741741 for crisis help

Your Life Iowa: Call 1- (855) 581-8111 or text 1- (855) 895-8398 any time for crisis support in the state of Iowa; it is available 24/7

The Trevor Project: Call 1- (866) 488-7386 for the LGBTQ Crisis and Suicide Hotline

Veterans Crisis Line: Dial 988 and press 1, or text 838255

Find more local resources at:

For Linn County residents: www.linncountyiowa.gov/1458/Mental-Health-Resources

For Johnson County residents: www.johnsoncountyiowa.gov/service-directory/health-services/counseling-mental-health

Comments: (319) 398-8328; emily.andersen@thegazette.com