On Feb. 20, Calaveras County sheriff's deputies recovered a body along the Mokelumne River. The victim of a self-inflicted gun-shot wound, the man's death contributed to the high suicide statistics in the rural Gold Country area. Photo by: Bill Lavallie

It was a sunny Friday morning when the vehicle pulled into the parking lot of Amador Hills Cremation and Funeral Service in Pine Grove late last month.

Inside the mortuary, Linda Hill was helping a family make funeral arrangements for a loved one when she spotted the idling car.

"I didn't think too much about it, because people are always pulling up and parking there," Hill recalled. Hill realized she might have to briefly shift her attention to a new client, but the man never came in.

Instead, witnesses say, the 78-year-old man called his wife from a cell phone and reported some sort of emergency. He then walked to the side of the building by the driveway, sat on a bench facing a barber shop across the street and shot himself. Inside the mortuary, Hill and the family heard the muffled crack. "It sounded like something heavy fell," she said. "None of us recognized it as a gunshot. It didn't sound anything like it does on television."

The next thing Hill and those inside would hear would be the terrible, grief-stricken cry of a woman finding her husband dead. Inside the man's truck was a letter to his wife, one to the mortuary regarding arrangements and a copy of his will. In one letter, he explained he was suffering from prostate cancer and didn't want to drain the financial resources he and his wife had accumulated during their life together. He remarked what a shame it was to take his life in such a violent manner and expressed hope that his wife would carry on and even remarry at some point.

Despite his methodical planning, despite his intent, despite his belief that he was doing the right thing, the man's March 20 death caused lasting aftershocks in the lives of the barbershop employee who saw the slumped body from her window, a mortuary veteran familiar with grief and the fragility of life, a family already struggling with its own loss, and the man's devastated wife. Twenty-two days later, on April 11, using a similar model handgun, the man's 62-year-old widow would take her own life.

"I see horrible things all the time, but it's different when the scene is happening at your own office," Hill told the Ledger Dispatch a few weeks after the man's death. "He ended up bringing a lot more people into his situation."

Recent deaths close together

Since late March, there have been at least four area suicides, including the one outside the Pine Grove business.

On Feb. 20, two people fishing along the Mokelumne River discovered a body just off of Highway 49, about half a mile from the bridge at the county line separating Amador and Calaveras. According to Calaveras County sheriff's deputies, the deceased male was the victim of an apparent self-inflicted gunshot wound believed to be prompted, in part, by the recent loss of a job.

On Feb. 15, an upcountry teenager one month shy of his 18th birthday ended his life with a .22 caliber rifle. His death wasn't added to the county's suicide tally, however, because it occurred at a Roseville trauma center. Paul Nelson, a volunteer firefighter and employee of Daneri Mortuary in Jackson, said it can feel like such tragedies come in clusters. "It's bizarre," he said. "It seems like these things happen in pairs."

Rural statistics troubling

Amador County tallied eight suicides last year, a significant improvement from 2007, when a dozen of the 172 deaths reported to the Amador County Coroner's Office - nearly 7 percent - were ruled suicides. In 2004, suicide or self-inflicted harm ranked as the second cause of fatal injury in Amador County, behind unintentional poisonings, according to a United Way study. Attempted suicide was the third leading cause of non-fatal injury during that same time period.

In the region, Tuolumne County has experienced perhaps the most alarming statistics. In 2006, the community of nearly 56,000 lost 35 people to suicide, doubling the previous year's count. The following year dropped to below 25 (still astronomical for a tiny county), while there were about 16 between January and November of 2008.

There were 10 suicides in Calaveras County last year, a shade over the nine that community of 47,000 averages annually. The ranks included two elderly individuals who recently lost spouses and two from outside the county. Six were by gun, four by hanging. The oldest was 79 and the youngest 34. All were men.

"For us, any suicide is too many," Rita Downs, director of Calaveras County's Mental Health Program, said of reaching the double digit mark. "That's actually double the rate of the state average overall." California averages 9.3 suicide deaths per 100,000 people a year, which comes out to more than 3,000 annually.

Seeking answers

That gap between the state average and rural communities is both typical and distressing, say mental health experts. Tuolumne's troubling figures prompted local agencies and other entities to form a Suicide Prevention Task Force in 2007 to analyze risk factors and plot out a response. This January, the task force released a 35-page strategic plan it hopes will reduce its high numbers, and also "shed light on the reasons why suicide is so prevalent in rural communities."

Amador is gearing up to prepare one of its own plans, according to Lynn Thomas, the community services program manager for the county's Behavioral Health Department. She noted the challenge that comes with understanding a particular area's unique identity. "How you do intervention in Amador might look different than in San Francisco or Los Angeles or even San Joaquin," she said.

Tuolumne's study first identified risk factors that typically are present when someone considers suicide. They include some well-known hallmarks (depression, previous attempts, a family history of suicide) and other indicators, like barriers to accessing treatment, physical illness, easy access to lethal means and the unwillingness to seek help because of the stigma attached to treatment. But even studies of rural communities didn't always offer fully applicable data. Access to firearms correlated with suicide rates "weakly," according to the research the task force examined, but 85 percent of Tuolumne's suicides in 2006 involved guns. "It's generally an issue of access and isolation," Christa Thompson, Mental Health Services Act coordinator for Calaveras County, said of the prevalence of gun-related suicides in rural counties.

Soft figures

According to the state, there may actually be more acts of suicide than statistics suggest. According to the Office of Suicide Prevention, "Suicides may be 'hidden' behind tragic events" like lethal overdoses, car crashes in which the driver slammed into a fixed object or incidents in which someone engages in behavior that forces law enforcement to use deadly force, otherwise known as "death by cop."

Amador County is no stranger to such ambiguity. In May 2007, a Jackson man called 911 and told the dispatcher he planned to kill his family before hanging up. When sheriff's deputies arrived, they found the suspect atop Butte Mountain Road, waving a handgun and demanding that officers shoot him. He got his wish after firing off several rounds, none of which hit authorities, and ended up with a non-fatal bullet wound to the stomach.

It was a year ago April that the Jackson Police Department confirmed the death of a 23-year-old resident from a self-inflicted gunshot wound. Det. Chris Mynderup told the Ledger Dispatch then that he didn't know, and probably never would know, any further details. During his investigation, Mynderup was told by family members that the victim was not depressed.

By the numbers

At a suicide prevention training workshop in Calaveras a couple of months ago, a representative from the state Office of Suicide Prevention declared rural suicide numbers to be higher than the state average and more often due to self-inflicted gunshot wounds.

That's one of the reasons Calaveras County has embarked on a campaign to get its suicide prevention hotline out to the public. Funding from the Mental Health Services Act will help with the outreach effort. Calaveras' death review team met shortly before the Mokelumne River suicide to discuss a public relations campaign known as the Live On Initiative. Targeted toward the community's youth, one of its efforts involves disseminating wristbands with crisis hotline numbers imprinted on them to school children.

Thompson reasoned that local youth can either be at risk themselves or are associated with risk groups, like the elderly. Either way, the county is hoping to reverse the trend of first hearing the names of those who kill themselves from the local coroner. "What we think we're learning is that they're not, for the most part, people that are known (to Behavioral Health)," Downs said.

Going forward

Aside from Amador County's participation in funding a program at California State University, Sacramento intended to address rural counties' shortage of qualified mental health providers, it hasn't put together anything as ambitious as the strategic plan Tuolumne recently released or the task forces Tuolumne and Calaveras formed. "We don't have a real specific intervention plan at this point," Thomas acknowledged.

But that is expected to change soon.

Behavioral Health is in the midst of evaluating applications from prospective consultants. When the department completes its hiring process, tentatively expected to occur early this month, its consultant will be tasked with developing a comprehensive strategy comparable to Tuolumne's. At that point, Amador would begin putting together planning groups and distributing surveys to gauge the needs and gaps in service that exist.

Thomas said the department has already been looking at the plans of surrounding counties to see what approaches might work. "So we do not have to start from scratch," she said. "We're really ready to go."

Jerry Budrick and Bill Lavallie contributed to this report.