Suicide Prevention

2016 September 8
by Dr. Steve Sarche

The week of September 5th through 11th is Suicide Prevention week.  Suicide is a growing problem in the United States, making this week with a focus on awareness and prevention more and more important. The National Center for Health Statistics reports that, between 1999 and 2014, the suicide rate for all Americans under age 75 increased by approximately 24%. Epidemiologic studies report the number of suicides in the United States anywhere from 37,000 to 42,000 per year. Men complete suicide at a clip about 3.5 times more than women. Firearms are the most frequently used method in suicide, implicated in approximately 50% of all suicides.   Suicide outpaces murder as a cause of death in the United States by about 2 to 1. Major Depressive Disorder is implicated as the top risk factor for suicide.

There are three crucial areas to focus on in suicide prevention:

  1. Understanding risk factors for suicide and protective factors against it.
  2. Knowing what warning signs to watch for.
  3. Steps to take to help a person at risk.

For the first area, you can use your common sense or instinct. I will present a list of common risk factors and you will see that if you think about it, you probably would have come up with many of them. This list is not comprehensive:

  • Past suicide attempt.
  • Mental Health disorders, especially severe depression.
  • Recent exposure to a suicide/family history of suicide.
  • Substance abuse or addiction.
  • Impulsive/aggressive tendencies.
  • History of trauma or abuse.
  • Chronic illness/pain.
  • Job or financial loss.
  • Loss of a relationship.
  • Easy access to lethal means, especially firearms.
  • Loneliness/lack of social supports.
  • Victim of bullying.
  • Internal conflict about sexual identity.

The protective factors are basically the opposite of the risk factors.

The warning signs for a person attempting suicide include:

  • Verbal threats of wanting to die.
  • Expressing helplessness or hopelessness.
  • Daring or risk-taking behavior.
  • Personality changes.
  • Clear depression (always sad, with loss of any joy or interest).
  • Giving away possessions, especially important ones.
  • Lack of interest in future plans.
  • Isolation.
  • Viewing ways to commit suicide online.

Suicide is a permanent solution to a temporary problem.   The consequences of suicide often leave the survivors with permanent struggles in trying to recover from the loss and move on. Survivors tend to blame themselves; think they should have stopped it. It is possible they will never recover from the sadness and guilt.

Suicidal feelings tend to be intrusive and very powerful.   Those feelings force terminal negativity into a person’s mind and can convince a person that there is no way out and that others would be better off without them.   This translates to thoughts that ending life is the best solution to end the intrusive feelings.

So what are the steps to help prevent suicide? First and foremost, in serious and dangerous scenarios, you call 911 and ask for a wellness check if you are not sure a person is safe.   Alternatively, if the person is willing, you can accompany him or her to an Emergency Department for an acute evaluation.

It is imperative that firearm access be eliminated in any situation where a person may be suicidal.

Additionally, there is the suicide prevention lifeline at 1-800-273-TALK.   It is always open and provides immediate live support. I do have patients who have used this number and received excellent support.

I suggest developing a safety plan. A good example of a safety plan can be found at http://www.sprc.org/sites/default/files/Brown_StanleySafetyPlanTemplate.pdf.  It is always good to be as prepared as possible.

If it is not an emergency situation, begin in earnest to find a mental health provider. Mental health providers are trained to build a person’s protective factors, focusing on strengths. The focus is also on mitigating or managing the risk factors while listening and demonstrating understanding of the person’s feelings. Empathy can go a long way in easing suffering.

Treating the underlying illness is the cornerstone of the treatment.   The good news is there are many kinds of treatments that do work for mental health problems. There are interventions that stop the intrusiveness. Suicidal thoughts or feelings are not the normal default thoughts or feelings of a human nervous system. Therapy, medications, and other modalities will stimulate and restore the default setting of the nervous system to hope and optimism.

Finding a provider can be challenging, but you can always start with a primary care provider such as your general practitioner. They often have resources of where to look for psychiatric help. To broaden the search, the Colorado Psychiatric Society (CPS) provides a list of providers that are members, and they are sorted by location.   The CPS number is 303-692-8783.

There are also several psychiatric centers to try in each county. Those numbers are easy to find with a google search. Additionally, there is the University Of Colorado Depression Center (303-724-3300). The Outpatient Behavioral Health Services (OBHS) at the University of Colorado can also be searched for by location at https://www.uchealth.org/pages/services/behavioral-health/outpatient-psychiatric-services.aspx.   You can try Denver Health Outpatient Behavioral Health at 303 602 4840.

For other resources for therapy, there is the Colorado Psychological Association. The number is 303 692 9303. For sliding scale therapy, try Maria Droste Counseling Center at 303 756 9052. Jewish Family Services also provides affordable mental health services. They can be reached at 303 597 5000.

Here is the Suicide Prevention Ribbon:

ribbon-1-sm

There are so many prevention ribbon colors for so many things. I ask that you take the two striking colors of this ribbon to heart; they are different; the purple and teal are not most popular colors. They may seem neglected compared to other colors. The different colors should make us feel interested and not isolated. There is hope, there is help and it works.

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