RICHMOND-Williamsburg once again has the unhappy distinction of having the highest suicide rate of any city or county in Virginia, according to data from the state medical examiner.

The Office of the Chief Medical Examiner investigates about 6,000 deaths a year in 132 Virginia localities and issues an annual report about how many people died because of suicide, homicide, injuries and other causes.

In 2005, Williamsburg had the highest suicide rate in Virginia n 59.6 suicides per 100,000 residents.

In 2006, Williamsburg’s suicide rate rose to 84.8 suicides per 100,000 people. Again, that was the highest among all localities, according to an analysis of data from the most recent annual issued by the state medical examiner.

Williamsburg’s rate was significantly higher than the state and national averages. Overall, Virginia recorded 11.2 suicides per 100,000 residents in 2006, the state medical examiner reported. The national rate was 11.05 suicides per 100,000 Americans in 2005, the latest statistic available from the federal Centers for Disease Control and Prevention.

While it is difficult to make generalizations about suicide, Williamsburg may have a high suicide rate because it has a large population of college students. The College of William and Mary is located there. Williamsburg has about 12,000 residents; William and Mary has about 8,000 students (although not all of them live in the city). According to the 2000 census, the most recent count available, about 6,000 Williamsburg residents were between ages 15 and 24.

“Suicide is currently the second leading cause of death among college-aged students; car accidents is the No. 1 cause of death,” said Dr. Joy Bressler of Virginia Commonwealth University’s University Counseling Services.

Older Americans and young people attempt suicide more often than other age groups, according to Dr. Julie Linker, an assistant professor of psychiatry at VCU. She primarily studies suicide among 15- to 24-year-olds. She said suicide is on the rise for that age group.

“I’m not going to speak to the issue for older adults, but teens are highly influenced by the media and what their peers do. For example, when Kurt Cobain committed suicide, there were a lot of attempts among teens who liked his music,” Linker said.

She also said that if there is one suicide attempt in a school, others often follow, a phenomenon known as the contagion effect. Linker added that it is often difficult to identify the signs of mental illness in teenagers, so they might not be steered into treatment by their parents. Since teens aren’t really in a position to get treatment themselves, they don’t get treatment at all.

Many of the cities or counties with the highest suicide rates are located in rural areas. For example, in 2006, Emporia, a city of about 5,700 residents in Southside Virginia, had the state’s second-highest suicide rate n 53.3 suicides per 100,000 population.

Other localities with high suicide rates included Covington, Fredericksburg, Lunenburg County, Bland County, King & Queen County, Pulaski County, Page County and Grayson County.

The rural location could be a contributing factor, Linker said.

“Usually rural areas have economic stressors that you don’t find in other areas. There are not as many resources. So if someone has depression, there is less opportunity to get treatment for that,” she said. “Also, in a rural town everyone knows everyone, and there can be a stigma that prevents people from seeking treatment.”

Linker added that rural areas also tend to have higher rates of substance abuse, which can contribute to suicide.

However, Linker stressed that while life issues such as economic stress can contribute to suicide, those alone rarely causes someone to attempt suicide.

“Usually, when people attempt suicide or complete suicide, it is due to a long-standing mental health problem,” she said.

When a stressful or otherwise difficult life event n such as being fired from a job, economic difficulties or a death in the family n is combined with mental illness, this can cause what the American Foundation for Suicide Prevention calls a suicide crisis. This is a “time-limited occurrence signaling immediate danger of suicide.”

The most common mental illness associated with suicide is depression. According to the foundation, “at least 90 percent of people who kill themselves have a diagnosable and treatable psychiatric illness n such as major depression, bipolar depression or some other depressive illness.”

Accidents were the leading cause of unnatural deaths in Virginia in 2006. Statewide, the accident death rate was 27.7 deaths per 100,000 residents. Then came suicides at 11.2 deaths per 100,000 population, followed by homicides with a rate of 5.4 deaths per 100,000, the medical examiner reported.

Males accounted for more than three-fourths of Virginia’s suicides. “Whites committed suicide at almost two and a half times the rate of blacks, three times the rate of Asians, and over four and a half times the rate of Hispanics,” the report said. “White males were 17.3 times more likely to commit suicide than black females.”

Linker said that one of the most important things that can be done to prevent suicide is for people to get treatment for mental illness. She said that people need to know where to get treatment and be able to afford it. She also said that removing the stigma surrounding mental illness would help to prevent suicide.

“You are not a flawed person if you are depressed,” Linker said. “It is OK to take medication for depression; it is not a character flaw.”

Meredith Kight is a Virginia Commonwealth University student and a reporter for Capital News Service.