Suicide Prevention: Can We Talk?

JAN. 28, 2015

Consoling a Friend Of all the topics in mental health, one of the most difficult to consider is suicide. People contemplating it often do not speak directly of it. Families are surprised, stunned, mortified, angry, and devastated in the face of it. Non-mental health professionals may feel uncomfortable asking about anything related to it.  And mental health professionals feel helpless, as we are terrible at discretely predicting and preventing it. There are tragedies, and there is fear; suicide is at the crossroads when these two meet.

As I review scientific articles, and program after program, the despair continues. In spite of more folks talking about it, more people training to identify it, and more programs put in place to prevent it, suicide continues.

So what do we know? The Centers for Disease Control (CDC) says suicide is the 10th leading cause of death in the U.S., and the third leading cause of death for those aged 15-24. More than 800,000 around the globe die each year; many more attempt it. The figures boggle the mind, and challenge us all: how can we possibly intervene?

Many of us know to watch for warning signs—a history of loss (social support, job, resources, health), prior attempts, family history, recent violence; changing appearance or behavior like plummeting grades or productivity, tearfulness, negativism, social isolation, drugs and alcohol); we’re not so good at communicating our concern or finding help.

Programs like Typical or Troubled from the American Psychiatric Foundation and QPR (Question, Persuade, Refer) to name just two of the many that have been developed, frequently focus on training sentinels—folks in a position to observe people at risk—to heighten awareness of those with potential for suicide, and help find relief and support for the person in need. And yet, still we struggle.

On January 9, an article was published in Lancet looking at the results of 3 different kinds of suicide prevention training on over 11,000 students in Europe: QPR, where teachers act as sentinels; ProfScreen, where mental health professionals provide screening, and the Youth Aware of Mental Health Program, which trains the students themselves. This program used “lectures, role playing, and education about mental health and suicide risk” with students. At 12 months, there was a significant reduction of suicide attempts, and of severe suicidal ideation, compared to the other control groups. It has been suggested that perhaps this program was more effective because it offers interventions “before there are outward signs of risk, and doesn’t stigmatize individual students.” It's an interesting idea: going to the at-risk population itself, giving them the education, and empowering them to make different choices.

The CDC suggests the key to reducing suicides is to reduce risk and increase resilience. We cannot begin to reduce risk or abolish stigma or enhance resilience if we cannot even talk about the topic. We need a structured national conversation, an engaged public, an engaged media, engaged policy makers, and engaged legislators.

How about a president who starts by mentioning the “dignity and worth of every citizen… (including) Americans with mental illness” in his State of the Union speech? (He did, last week!) How about asking every pediatrician and every primary care doc and every pastor and preacher (heck, place signs in every bus stop, subway, and grocery store for that matter) to educate each family to store firearms locked and unloaded, with ammunition locked separately, if a household member is at high risk for suicide? How about widespread movements to have the public certified in suicide prevention like so many of us are certified in CPR? How about offering NAMI Ending the Silence to every 9th grader to let them know about the warning signs of a mental health condition and what they can do? The list is endless.

I know we all care. I’m ready to start talking, and doing; how about you?

Comments

Comments
FEB, 22, 2018 07:52:45 AM
Daniel
Suicide is one of the leading causes of death. Bracelets are effective in bringing about education and awareness in helping those who struggle with suicidal thoughts and who may be at risk. Resources such as the hotline and local services can help prevent suicide.

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AUG, 24, 2016 12:42:10 AM
James William
There may be many reasons for suicide, fight with the family or you lost your job or other significant situation. These make life rough and leads to loose interest in living. It affects many people joined with them. Aware people, prevention suicide and save lives.

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MAR, 01, 2015 09:03:00 PM
Roger Batchelder
http://commondreams.org/news/2015/02/27/great-recession-linked-rising-suicides-among-middle-aged-americans

MAR, 01, 2015 08:59:01 PM
Roger Batchelder
And consider the fact that many people on Social Security Disability: SSDI, and especially SSI, receive benefits BELOW MINIMUM WAGE!
Political action needed here.

MAR, 01, 2015 08:54:35 PM
Roger Batchelder
Prevention for a number of people: www.thepetitionsite.com/773/344/804/remember-fdr-wpaccc-jobs-now/

Rising Suicide Among Adults Aged 40–64 Years
The Role of Job and Financial Circumstances
Katherine A. Hempstead, PhDcorrespondenceemail
,
Julie A. Phillips, PhD
Published Online: February 26, 2015
Article has an altmetric score of 65
DOI: http://dx.doi.org/10.1016/j.amepre.2014.11.006
Publication stage: In Press Corrected Proof
showArticle Info

FEB, 28, 2015 05:51:58 PM
Roger
Can we talk? I guess not. You'd rather censor than answer?

FEB, 25, 2015 09:23:41 PM
Roger Batchelder
For at least one very good article on suicide,
go to wsws.org and search "One Fifth of World's Suicides Linked to Unemployment".
Of course, this is only one cause of suicide, but
it is significant, at least to those affected by it,
directly or indirectly. Not just talking dozens or hundreds...
My roommate and I have petitions on thepetitionsite.com and moveon.org.
The petitions are to get the President and Congress to re-start FDR's jobs programs of the 1930's, the WPA and CCC.
You can see how important these sites consider this issue by the number of signers. (Sarcasm)
We have signed hundreds of petitions that get
sent out apparently to full lists across the country, but moveon only sent it out to 3,300 people.
And it looks like "Care2" (thepetitionsite.com) did less. Apparently, people rank below manatees. (Nothing against manatees- I like gentle animals.)
I sent the petition to my local Democratic Party.
No response. Sent it to my sister's local Democratic Party. No response.
I also sent it to the magazine of the American
Psychological Association. Unprinted. Zero response. Sent it to the AFL-CIO. No response.
Obama was asked about reviving those job
programs in 2010. His answer: "We just don't
have the money." But he had the money to bail
out Wall St., continue Bush's (bogus) wars, and start new ones.
I see posters saying "It's Up2Us." to stop suicide. I guess it is, when so many people who we would EXPECT to care- DON'T! SHAME!
If you DO care, you might also check out the Green Party. At least they call for a (Green)
"New Deal". Haven't heard that term lately, have you?
We need to recognize that economic necessities, like food, water, shelter, medicine,
education... are HUMAN RIGHTS.
People better start to care again- we're even on
the verge of losing our planet! (Search "Climate
Precipice" and "Climate Elephant".)
Do you care enough to take 2 minutes to sign?
www.thepetitionsite.com and search "Remember FDR?" Of course, this petition will just be shined
on by both political parties. But it can get people
thinking, and hopefully, building a NON-corporate party like the Greens, so we can institute some
humane policies. What will YOU do when the robots take all the jobs? What will everyone live on?

FEB, 07, 2015 11:56:51 AM
Scewbs
Mike, suicide is a wide-spread issue. One suicide could lead to endless grieving, unproductivity, and even suicide of THEMSELVES for family, friends, loved ones, and even acquaintances. I see you think its freedom of speech, but I disagree. If you want to do it, think it through, because you'd be another tally in the list of suicides, affecting yet another hundred (or hundreds) of people. Also, no offense, you capitalized too often, which is annoying to me.

FEB, 06, 2015 06:24:08 PM
Mike P
With all due Respect, this is MY Free Speech Message, Suicide is Freedom, Freedom from Lives of Unbearable Mental illness and other Unbearable Sufferings, Myself and Countless Others, support the RIGHT TO DIE, Legal Dr. Assisted Suicide for the Mentally ill, and all other Suffering People who just want to be Left Alone, Not Bother Anyone Else, and go to a Better Place, God is Love and allows Suicides into Heaven, God is Merciful and Forgiving
It's easy for some people to say "Suicide isn't the answer" but ever notice those People Never Knew Unbearable Mental illness or other Suffering, they are Ignorant about the Sufferings of People who want to die
There will always be Countless Mentally ill and other Suffering People who will always want their Lives to End, No matter how Much Treatment and Medications they Take, no matter how much help they get
What is so Terrible about Suicide ? What about the Rights of Suffering Mentally ill and other Suffering People Not to Live Against their Will, and their Right to have Legal Dr. Assisted Suicide,
If we allow the Suffering Mentally ill and other Suffering People the Legal Right and Freedom to End their Lives in a Doctor's Office, they could Notify their Families and Friends and Co-Workers in Advance of their Decision to Legally End their Lives, the Suffering People could Say Goodbye to their Friends, and have a Nice Last Meal with them, People should decide for themselves the time and Manner of their Deaths, People should have the Freedom to Choose for themselves if they want to live or Not, see the Article Suicide: A Civil Right by Lawrence Stevens,
Very Often in life, Sadly things do NOT get Better for the Suffering Mentally ill and other Suffering People, things just get Worst and Worst, Problems are Very Often Permanent and Chronic and Lifelong, NOT "temporary" often things Never Get Better, We should all Live and Die on our Own Terms.. We should all have Choices, and the Freedom to Choose for Ourselves, and live and die on our Own Terms, Actor Robin Williams who Killed himself by Hanging himself on Monday August 11, 2014, since God is Love, and Robin Williams went Directly to Heaven,
Robin Williams is saying to his Friends in Heaven, "I Killed myself and I'm Proud of it, I lived and died on my Own Terms, The Government and Laws, doesn't tell me what to do with my life and body" Studies have shown "Suicide Prevention" does NOT work, and only leads to More Suicides, if any Suffering Person, Mentally ill, or any other Suffering Person Truly wants to die, they should be Allowed to Legally End their Lives in a Doctor's Office...

FEB, 05, 2015 02:41:31 PM
June Thiemann
I love your emphasis on "before." As a suicide survivor and mental health proactivist who's been working on this issue for the last 2 decades, "before" is the best I can come up with, too. In fact, I believe if we all began treating our mental health more like our dental health, we'd get much better outcomes. Please see allintheasylum.com for more.

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