Families of suicide victims are left to cope with guilt, grief, doubt
Bill Hores' heart sank when the radio scanner crackled with a dispatcher's report that a North Hills teenager died from a self-inflicted wound.
The Allegheny County deputy sheriff knew another family would endure nightmares like his. Three years ago this month, his oldest son killed himself.
"Those poor people," Hores thought. "They have to go through this."
People don't want to talk about suicide, survivors and advocates say. Yet, aside from natural causes, it is the second-leading cause of death in Allegheny County, behind accidents and ahead of homicide.
Suicides in Allegheny County claimed more than 800 lives from 2006 through September 2011, according to the latest available data from the county Medical Examiner's Office. Those who died ranged in age from 14 to 95 and included blacks, whites, Asians and Hispanics.
"No group is immune," said Robert Gebbia, executive director of New York City-based American Foundation for Suicide Prevention.
Glenn Hores, 23, shot himself early Feb. 7, 2009, at his family's Ross home.
"I still break down," Bill Hores said. "I'll drive down the road and break down. It never goes away."
Experts conservatively estimate that each person who commits suicide leaves six to 10 family members to grieve — or, about 5,000 survivors in Allegheny County since 2006.
No one the Tribune-Review talked to expected to be included in such a group.
'Never say never'
Glenn Hores battled bad days and dark places, his family said. He refused medication for depression because he thought it stifled his creativity.
His family didn't suspect he would take his life.
"We felt insulated," said Bill Hores, 56. "Now, I never say never. We feel very vulnerable now."
A lifetime of mental illness and suicide attempts often are not enough to prepare some families.
"I never in a million years ..." said Melissa Sasso, 48, of Beechview, her emotions stopping her thought. "I was completely and utterly shocked."
Her identical twin, Melinda Sasso, took her life in 2009 at age 46 after decades of therapy and psychiatric medications. She attempted suicide many times since her 20s, her sister said.
Her family held out hope after Melinda fought to survive a nearly fatal respiratory illness. But on Aug. 7, 2009, she died from a cocktail of prescription and over-the-counter drugs.
"She used to (attempt) it all the time," said Melissa Sasso, a nurse practitioner with Pittsburgh Public Schools. "... You think something is over."
Illness over choice
No single reason — such as losing a job, ending a relationship or suffering from depression — leads someone to take his or her life, said Alan "Lanny" Berman, executive director of the American Association of Suicidology in Washington.
"That's too simplistic of an explanation," Berman said.
Few of the 20 million depressed Americans kill themselves, he said. "Every case is unique, even though there are a lot of common factors."
Research shows a genetic component to suicide exists and that 90 percent of people who commit suicide suffered from a mental disorder, such as depression or anxiety, often undiagnosed or untreated.
Suicide is a topic wrought with misinformation, bias and discrimination, Gebbia said.
"I think we as a society still don't know how to deal with this," he said. "But unless you are personally touched by it, you don't really think about suicide."
Gregg and Sue Fiorina knew their son, Benjamin, 25, was upset about not getting a pay raise and under stress about starting a new job, but they didn't think he was suicidal before he fatally shot himself in September inside the Shadyside apartment he shared with his wife of two years.
They later learned his wife worried about his depression and urged him to see a therapist. Ben Fiorina scheduled but canceled an appointment.
"That's what hurts so much," Sue Fiorina said. "To know he was in that pain, and we didn't know it."
For more than 20 years, thousands of families have sought Sue Wesner's help to deal with grief associated with suicide. They include Melissa Sasso, the Hores family and the Fiorinas.
A clinical nurse specialist, Wesner runs Survivors of Suicide, or SOS, a support group at Western Psychiatric Institute and Clinic.
Similar to those who die from heart attacks, she said, people who kill themselves "have a brain attack. It turns completely against the basic function it is there for: to keep us alive."
The SOS program started in the 1980s and helps 30 to 50 families a year throughout the region. In eight-week sessions, they learn about suicide and how to process grief.
Their grief is compounded by feelings of blame and guilt, Wesner said.
"The wouldas, couldas, shouldas are just devastating. Did they love me• Did I not do enough• Did I know them at all• These are questions survivors often ask themselves."
Dana Kuskie had such thoughts after her sister, Jaime Kuzyck, fatally shot herself in January 2010. Shocked and numbed by what happened, she wondered why she didn't see it coming. She and her mother joined one of Wesner's groups, and Kuzyck's husband attended some sessions.
"I was shocked at how many people were there," said Kuskie, 35, of Whitehall.
Jaime Kuzyck, 32, of Crafton Heights, a medical assistant for a dermatologist, wasn't diagnosed with a mental disorder and never consulted a therapist, Kuskie said. The sisters, born 11 months apart, spoke daily. Kuskie had no indication of anything out of the ordinary.
"But from the time that phone rang, my life changed forever," Kuskie said.
Kuskie took her daughter to Highmark Caring Place, a free peer-support program located Downtown that helps families deal with death.
"The best way to support grieving children is to strengthen their families," program manager Andrea Lurier said.
Life goes on
Burying her son was the most difficult thing Helen Hores ever did, but she went into "survival mode" for younger sons Matt, now 22, and Harry, 19.
"I just decided I wasn't going to let this family fall apart," said Helen Hores, 54.
Bill Hores turned to his Christian faith and counseling.
"Life goes on," he said. "That's the moral."
The family completed Wesner's program and attends group therapy every other month. Harry Hores visits a counselor three times a week.
"I have no idea how somebody would get through this without help," said his mother, who wishes more people would talk to survivors about loved ones they lost to suicide.
"When people think of Glenn, they think of suicide," she said. "It's a chapter, but it's only one chapter. Over time, other things move forward, and suicide moves back."
Inside the numbers
A Tribune-Review analysis of records found that among 800 people who took their lives in Allegheny County from 2006 through September 2011:
• 9 in 10 were white
• 8 in 10 were men
• Nearly half used a firearm
Those trends match national data from the Centers for Disease Control and Prevention. CDC and state Department of Health data* show that from 2006 to 2009:
• Nationally, the suicide rate rose from 11.1 per 100,000 people to 12.
• Combined suicide rates for Armstrong, Beaver, Butler, Fayette, Washington and Westmoreland counties increased from 11.94 to 13.56.
• Pennsylvania's suicide rate increased from 11.03 to 12.70.
• Allegheny County's rate fell from 11.44 to 11.24, with a low of 10.5 in 2008. The county's records, which include all suicides regardless of a deceased person's county of residence, show a sharper decline. "I have no real idea why the numbers are going down," Medical Examiner Karl Williams said.
* The state Health Department's record-keeping attributes causes of death to counties where the deceased resided, not where deaths occur. Total suicides for the six counties rose from 137 to 154 during those years.
Tribune-Review researchAdditional Information:
Melinda Sasso: After decades of therapy and psychiatric medications, she died at age 46 on Aug. 7, 2009, from a cocktail of prescription and over-the-counter drugs.
Ben Fiorina: He fatally shot himself at age 25 in September inside the Shadyside apartment he shared with his wife of two years. At her urging, he had scheduled but canceled an appointment to see a therapist.
Jaime Lynn Kuskie Kuzyck: The 32-year-old medical assistant fatally shot herself in January 2010.
Glenn Hores: The 23-year-old refused medication for depression because he thought it stifled his creativity; he fatally shot himself early Feb. 7, 2009, at his family's home in Ross.