‘The Cracks That Are Already There Are Going To Widen’: El Paso County Coroner Says We Can Learn From 2020’s Non-COVID Deaths

What can non-COVID deaths from 2020 teach us about how the pandemic affected people?

For El Paso County coroner Dr. Leon Kelly the answer became clear as he saw an increase in teen suicides, accidental overdose deaths, and domestic violence homicides last year.

Kelly, who runs the biggest medical examiner's office in the state, said that focusing on mental health is key as we emerge from the trauma of a global pandemic. 

“We’ve had these problems long before anybody ever heard of COVID-19,” Dr. Kelly notes. “But when you have this sort of global emotional, economic, interpersonal stress, the cracks that are already there are going to widen.”

Drug-related deaths show people are struggling to cope

Kelly’s office saw 186 drug overdose deaths in 2020 — up from 130 the previous year.

“While we were all watching suicide numbers and thinking that's what we needed to worry about,” Dr. Kelly said, “substance abuse kind of snuck in the back door and our drug deaths just massively exploded.” 

Use of fentanyl, a powerful opioid that Dr. Kelly said is 80 times more lethal and toxic than heroin and 100 times more lethal than morphine, increased across southern Colorado. El Paso County saw 47 fentanyl related deaths in 2020 — compared to 21 in 2019.

“Once you have fentanyl make its way into your community,” said Dr. Kelly, “your deaths are going to jump, because the drug itself is so dangerous, so potent that with it comes inevitable deaths.”

But it wasn’t just fentanyl that was killing people. Drug deaths tied to methamphetamines, cocaine, heroin and dangerous mixes are up across the board.

Dr. Kelly said a lack of access to medical care, addiction centers, and counseling during shutdowns and lockdowns led to unhealthy coping mechanisms. 

“Some of our safety nets sort of collapsed for a period of time,” he said.

Increase in suicides shows focus on mental health is key

Colorado and the Rocky Mountain region have had serious challenges with suicide. El Paso County in particular, had a spike in teen suicides from about 2015 to 2017 that put it on the national map for youth mental health concerns. 

“The community really came together” during those years, Dr. Kelly said“and every youth-facing organization, agency or group came to the table and said what are we going to do about it? We were able to cut those suicides in about half fairly quickly.” 

Sadly, when the pandemic hit, “everything kind of unraveled for many of us” he said and teen suicide numbers jumped back up. There were 15 in 2020 compared to 9 in 2019 in El Paso County. 

“The upside,” said Dr. Kelly, “is that we've been down this road before and we have our own community strength and resiliency from that.”  So far in 2021, his office has seen two youth suicides.

If you are in crisis or are looking for mental health services for you or someone you know, call the Colorado Crisis Services hotline. Call 1-844-493-8255 or text “TALK” to 38255 to speak with a trained counselor or professional. Counselors are also available at walk-in locations or online to chat between 4 p.m. and 12 a.m.

Adult suicides went down slightly in 2020 from 2019 — 178 compared to 180. 

But that’s not necessarily a victory because 2019 was one of the worst years for overall suicides in El Paso County, Dr. Kelly said. 

“When the coroner shows up, people tend to listen” about COVID-19

You can’t talk about death in 2020 without talking about COVID-19. While all deaths due to the virus are reported to the coroner’s office, Dr. Kelly doesn’t autopsy most of them because the individuals died in a hospital or in a long-term care facility under the care of physicians. He does investigate the cases of people who die at home from COVID-19 and who didn’t seek medical care. 

Dr. Kelly assumed the role of deputy medical director for El Paso County when the pandemic began, so he’s spent a lot of time trying to educate the community about the deadliness of the virus, the effectiveness of prevention measures, and when the time came, the importance of vaccines.

But El Paso is lagging behind some of the state's largest counties on vaccinations. About 49 percent of residents have received at least one dose as of June 11. Arapahoe County is almost at 62 percent; Denver is just over 70 percent; and Jefferson County is almost at 73 percent.

“When the coroner shows up,” he said, “people tend to listen. I've lived it, right? I've seen it, I've talked to families. I've done the autopsies myself. This is not something that you play around with.”

He believes people should make an informed choice about whether to get a COVID-19 vaccine. And he said the more people choose to get it, the closer we’ll be to the end of the pandemic. “We have the ultimate solution to this problem,” he said. “This thing is over as soon as you choose to get your vaccine.”

Domestic violence ranked No. 1 in last year's homicides

Domestic violence accounted for more than any other type of homicide. Of the 55 homicides last year, 19 were domestic or family violence. 16 were altercations -- arguments, sometimes between friends, that escalate rapidly and often involve firearms.

“In most cases,” said Dr. Kelly, “the root problem is just the inability for young males in particular to have the tools to navigate what many of us see as relatively normal stresses in life. Simple arguments, road rage incidents, arguments with partners that escalate to violence because they do not have the tools to deal with those stresses in a positive way. I think that's where the focus in many ways needs to be.”

Still, as difficult as the past year was, Dr. Kelly said it also shone a light on where society needs to do better. “The pandemic, yeah, it sucked,” he said. “There's no doubt about it. We saw the ugly parts, we saw where the cracks were, we saw where we needed to strengthen and bolster our efforts.”

Since taking office as El Paso County Coroner in 2008, Dr. Kelly has been passionate about suicide prevention and promoting mental health. 

For Dr. Kelly, it’s personal. He talks openly about how his own mother attempted suicide many times and eventually died that way. 

“Ten years ago,” he said, “not one elected official would be telling a personal story about how they or a relative faced suicide or substance abuse. Now, many elected officials including myself, are openly discussing that and bringing that to the front of our collective discussion, and putting real money behind it and real effort behind it.”

Mental health and mental wellness, he said, is the key to much of what ails us as a society. And he believes we are turning a corner to having those critical conversations. 

He sees his own office as an important part of them. “I'm the first conversation a family has after the worst imaginable tragedy,” he said. “But I provide answers, and in those answers comes that first step towards healing.”

Editor's note: This article has been updated with the most recent vaccination number provided by the state of Colorado.