Why Is Colorado's Suicide Rate Among the Highest in the USA?

September marks Suicide Awareness Month across the nation, but here in Colorado, this observance carries particular weight. Our state faces a mental health crisis that demands immediate attention and action from every community member, from Denver's urban corridors to the rural expanses of the Western Slope. 

Colorado's Alarming Suicide Statistics: What the Numbers Tell Us 

Colorado consistently ranks among the top 10 states for suicide rates nationwide, a troubling distinction we've held for over a decade. According to the Colorado Department of Public Health and Environment, our state saw 1,290 deaths by suicide in 2023, with a rate of 21.1 deaths per 100,000 people placing us 10th highest in the nation. 

The statistics paint a stark picture across our Colorado communities: 

• Mesa County leads with the highest rate at 34.7 per 100,000 residents 

• Denver County and surrounding metro areas range from 16.8-17.5 deaths per 100,000 

• Larimer County has shown promising improvement, dropping from 23 per 100,000 in 2019 to 16.5 in 2023—a 28% decrease 

Research from USAFacts shows that Colorado's suicide rate has increased by 30.2% over the past 20 years.

The crisis affects all demographics, but certain groups face heightened risk: 

• American Indian or Alaska Native populations experience the highest rates 

• Risk peaks between ages 45-49 

• Men die by suicide three times more often than women 

• Veterans in Colorado have a suicide rate of 43.0 per 100,000. Significantly higher than both national veteran and general population rates 

The Altitude-Mental Health Connection: Colorado's Unique Risk Factor 

Living in the Rocky Mountains comes with unexpected health considerations. Research from the University of Colorado School of Medicine reveals a complex relationship between high altitude and mental health that goes beyond simple correlation. 

At elevations above 6,500 feet which encompasses much of Colorado from Colorado Springs to Fort Collins several factors converge: 

Biological Impacts: 

• Reduced oxygen levels may affect brain chemistry and neurotransmitter function 

• Antidepressants and other mental health medications may be less effective at altitude 

• The body's stress response systems can be altered by chronic altitude exposure 

Social and Environmental Factors: 

• Rural isolation in mountain communities from Aspen to Durango 

• Limited access to mental health services in remote areas 

• "Cowboy up" culture that discourages seeking help 

• Harsh winters that can exacerbate seasonal depression 

Dr. Emmy Betz from CU's emergency medicine department notes: "There is an association but not a clear-cut link. It suggests that there are high-altitude victims not receiving care." 

Recognizing Warning Signs Before It's Too Late 

Understanding warning signs can mean the difference between life and death. According to the National Institute of Mental Health, immediate risk indicators include: 

Verbal Warning Signs: 

• Talking about wanting to die or kill themselves 

• Expressing feelings of being a burden 

• Saying they have no reason to live 

• Speaking about unbearable pain 

Behavioral Changes: 

• Withdrawing from family and friends 

• Giving away prized possessions 

• Visiting or calling people to say goodbye 

• Increasing use of alcohol or drugs 

• Searching online for suicide methods 

• Purchasing firearms or stockpiling medications 

Mood Indicators: 

• Depression, anxiety, or agitation 

• Loss of interest in activities 

• Extreme mood swings 

• Expressions of hopelessness 

• Sudden calmness after depression (potential sign of decision made) 

Colorado Youth in Crisis: Teen Suicide Trends and Prevention 

Young Coloradans face unique challenges that contribute to alarming suicide rates. The Colorado Health Institute reports that suicide is the leading cause of death for Colorado residents ages 10-24. 

Youth-Specific Risk Factors: 

• Social media pressure and cyberbullying 

• Academic stress in competitive Front Range schools 

• LGBTQ+ youth face significantly higher rates 

• Substance use, particularly marijuana (detected in 20.4% of suicide deaths) 

• Access to firearms in homes 

Safe2Tell Colorado has emerged as a vital resource, allowing students to anonymously report concerns about peers. In the 2022-2023 school year, the program received over 28,000+ reports, with suicide threats being one of the top categories. 

The 3-Day Rule: A Life-Saving Strategy from Suicide Survivors 

One of the most powerful prevention strategies comes directly from survivors and online support communities.  

How the 3-Day Rule Works: 

A survivor from Denver shared on Reddit: "I've been suicidal many times... But I've always given myself 3 days to change my mind, and so far, I have every time." This simple commitment creates a crucial buffer between suicidal ideation and action. 

Research published in the Journal of Clinical Psychiatry confirms that approximately half of suicide attempts occur within 10 minutes of the decision. By implementing a mandatory waiting period, individuals can: 

• Allow intense emotions to subside 

• Seek support from Colorado Crisis Services (1-844-493-8255) 

• Access mental health resources in their community 

• Remember that suicidal crises are temporary, even when pain feels permanent 

Local mental health providers from Axis Integrated Mental Health in Denver, Boulder, and Westminster, encourage clients to create personalized safety plans incorporating this principle. 

How to Have the Conversation That Saves a Life 

Many Coloradans worry about saying the wrong thing when someone they care about shows warning signs. Mental health professionals across the state, from UCHealth facilities to community mental health centers, emphasize that direct communication saves lives. 

The Right Approach: 

1. Listen Without Judgment: Whether in a Denver coffee shop or on a Boulder hiking trail, create a safe space for honest conversation. 
2. Don't Leave Them Alone: If someone is in immediate danger, stay with them. Call 988 or drive them to the nearest emergency room. 
3. Remove Lethal Means: Colorado statistics show that 56.7% of male and 30.7% of female suicide deaths involve firearms. Temporarily removing guns, medications, or other means saves lives. 
4. Connect to Resources: Have Colorado-specific resources ready: 
5. Text "TALK" to 38255 for Colorado Crisis Services 
6. Call 988 for the National Suicide & Crisis Lifeline 

Colorado-Specific Resources and Support Systems 

Our state offers comprehensive suicide prevention resources tailored to Colorado communities: 

Statewide Services: 

• Colorado Crisis Services: 1-844-493-8255 (24/7 hotline) 

• Walk-in Crisis Centers: Located in Denver, Boulder, and Westminster

• Mobile Crisis Units: Available in most Colorado counties 

Regional Programs: 

Denver Metro Area: 

• Mental Health Center of Denver 

• Jefferson Center for Mental Health (Wheat Ridge, Lakewood) 

• Aurora Mental Health Center 

• Arapahoe/Douglas Mental Health Network 

Northern Colorado: 

• SummitStone Health Partners (Fort Collins, Loveland) 

• North Range Behavioral Health (Greeley, Weld County) 

• Alliance for Suicide Prevention of Larimer County 

Southern Colorado: 

• Diversus Health (Colorado Springs, El Paso County) 

• AspenPointe Health Services (Pueblo, Southern Colorado) 

• Spanish Peaks Behavioral Health (Las Animas, Huerfano counties) 

Western Slope: 

• Mind Springs Health (Eagle, Garfield, Mesa, Moffat, Pitkin, Rio Blanco, Routt counties) 

• Center for Mental Health (Delta, Gunnison, Hinsdale, Montrose, Ouray, San Miguel counties) 

Specialized Support: 

• Veterans: Colorado's veteran-specific programs through the VA Eastern Colorado Health Care System 

• LGBTQ+ Youth: One Colorado, The Trevor Project (1-866-488-7386) 

• Native Communities: Denver Indian Health and Family Services 

Breaking the Western Stigma: Overcoming Self-Reliance Culture 

The rugged individualism that defines much of Colorado's identity—from ranchers on the Eastern Plains to ski town residents in Summit County—can become a barrier to seeking help. 

The Colorado Sun reports that rural Colorado's "cowboy up" culture significantly contributes to our high suicide rates. This is particularly evident in: 

• Agricultural communities were asking for help is seen as weakness 

• Mountain towns where seasonal work creates economic instability 

• Construction industry, which has the highest suicide rate by occupation in Colorado 

Breaking Down Barriers: 

Communities from Durango to Sterling are working to normalize mental health conversations through: 

• Man Therapy: Colorado-created campaign using humor to reach men 

• Agricultural Wellness Programs: Supporting farmers and ranchers through Colorado State University Extension 

• Workplace Mental Health Initiatives: Construction companies partnering with suicide prevention organizations 

• Faith-Based Support: Churches across denominations offering mental health ministries 

The Alliance for Suicide Prevention of Larimer County has pioneered outreach to construction workers, veterans, and LGBTQ+ youth, demonstrating that targeted, culturally sensitive approaches work. Their efforts contributed to Larimer County's 28% reduction in suicide rates over five years. 

Remember: Suicide is preventable. Whether you're in bustling Denver or rural Moffat County, help is available. Save these numbers in your phone: 988 (National Suicide & Crisis Lifeline) and 1-844-493-8255 (Colorado Crisis Services). 

Frequently Asked Questions 

Q1: My friend suddenly seems happy after being depressed for months - should I be worried? 

Yes, this could be a serious warning sign. When someone who's been struggling suddenly becomes calm or cheerful, they may have decided on a suicide plan and feel relieved. This "improvement" is actually one of the most dangerous periods. Reach out immediately, express your concern directly, and don't leave them alone if you suspect immediate danger. Contact Colorado Crisis Services at 1-844-493-8255 for guidance. 

Q2: How quickly can someone go from thinking about suicide to attempting it? 

Research and survivor accounts show that many suicide attempts happen within 10 minutes of the decision. This impulsivity is why limiting access to lethal means (firearms, medications) is crucial. Creating time barriers, like the "3-day rule" where you wait 72 hours before acting on suicidal thoughts, can save lives. In Colorado, where 56.7% of male suicide deaths involve firearms, secure storage is particularly important. 

Q3: What should I actually say if I think someone is considering suicide? 

Be direct - ask "Are you thinking about killing yourself?" This won't plant the idea; it shows you care and opens the door for help. Say things like "I'm worried about you," "You matter to me," and "Let's get help together." Avoid saying "Think about how others would feel" or minimizing their pain. Have Colorado resources ready: 988, Colorado Crisis Services (1-844-493-8255), or your nearest walk-in crisis center. 

Q4: Does living at high altitude in Colorado really increase suicide risk?

Studies show correlation between altitude and suicide rates, possibly due to reduced oxygen affecting brain chemistry and antidepressant effectiveness. However, it's not just altitude - factors like rural isolation, limited mental health access in mountain communities like Leadville or Silverton, and cultural attitudes about self-reliance in Western Slope communities also contribute significantly. Communities above 6,500 feet should be particularly aware of these compounded risk factors. 

Q5: If someone posts concerning things on social media, what should I do? 

Take it seriously. On most platforms, you can report posts for self-harm concerns, which triggers outreach from crisis counselors. Also reach out personally - keep the conversation public if possible, express genuine concern, and provide specific resources like texting "CHAT" to 741741 for Crisis Text Line, calling 988, or contacting Colorado Crisis Services at 1-844-493-8255. For youth, remind them about Safe2Tell Colorado (1-877-542-7233).