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Examining How Society Supports Suicide Prevention

Photo: Courtesy of Sasha Freemind

Experts and advocates in the field of suicide prevention discuss how we should approach suicide and suicide prevention as a country.

Dr. Mike Hogan

National Action Alliance on Suicide Prevention

Suicide rates have continued to increase over the past 15 years, leading to over 44,000 deaths a year in the United States. What do you think has contributed most to this increase?

Since decisions to complete suicide are personal and the causes are diverse, there’s no one reason. The data showing greatly increased rates among men — especially white, rural and lower income men — labeled “diseases of despair” (along with drug use and alcohol) are very troubling. The data also show that prevention efforts must be redoubled, but also that we need to address suicide care in health care systems, where many people participate in care but are not “seen” or treated effectively.

Research shows that suicide rates are higher for men than for women, and are more prevalent for middle-aged Americans.  With such patterns as this, can any conclusions be drawn as to what we need to emphasize as a society when it comes to suicide prevention?

Again, there is no single, simple answer. Clearly economic dislocation is a cause, but one that is very hard to fix. We clearly need to make suicide prevention a higher priority in health care. This is because most people who die by suicide had a recent contact with a health care or mental health provider, where their risk of suicide was not addressed.

Where specifically do we need to focus in the coming years to succeed in not only spreading awareness for suicide, but in providing resources for those struggling with their mental health and, ultimately, preventing suicide?

We need to spread messages of hope rather than tolerate depictions that glamorize suicide. We need to work on a society where everyone sees opportunity, rather than a future that is grim. But these are big and diffuse challenges. I hope we can focus specifically on making health care — from the doctor’s office to the emergency department to the mental health clinic — safe for people at risk of suicide.

What needs to change in American policy and healthcare to help in decreasing the rate of suicide in this country?

The policy is starting to change. A good example is leadership by The Joint Commission, which accredits hospitals and other healthcare organizations, to make detecting and treating suicide a priority for all hospitals and clinics. Now we need change in practice: asking patients who are at risk for thoughts of suicide, helping them immediately to manage these thoughts and feelings, staying in touch while their risk remains high, and making their environment safer. We also need to change the training of mental health professionals — psychiatrists, psychologists, social workers, nurses and therapists. Usually their training in how to work with suicidal patients is inadequate.

For anyone who is struggling with their mental health or for anyone who knows a loved one is struggling, what message do you ultimately want to share?

First, there is hope. We know from interviews with people who survived a suicide attempt that almost always they are very glad that they did not die and that life got better. Second, don’t be afraid to ask for help — or to ask someone you are concerned about if they are having thoughts of suicide. Usually, they will appreciate the support. Silence is our enemy.

Alison Malmon

Active Minds Founder & Executive Director

Suicide rates have continued to increase over the past 15 years, leading to over 44,000 deaths a year in the United States. What do you think has contributed most to this increase?

It is hard to pinpoint one thing that has contributed to this increase, but we cannot minimize the impact of the ongoing hesitancy that people have to talk about issues related to mental health. There continues to be an immense need in our society to change the conversation about mental health and suicide. Ninety-five percent of all people who die by suicide have an underlying mental health disorder. Until people of all ages are encouraged to talk openly about their health and well-being, especially mental health, we will continue to lose far too many individuals to suicide every year. We must encourage help-seeking and create a community of hope.

Research shows that suicide rates are higher for men than for women, and are more prevalent for middle-aged Americans.  With such patterns as this, can any conclusions be drawn as to what we need to emphasize as a society when it comes to suicide prevention?

Research is demonstrating that there is no singular group that is touched, nor just a single way to have an impact, when it comes to suicide prevention. One place to start is by teaching social and emotional awareness as soon as children start school. We need to be teaching our young kids about coping skills and resiliency early, connecting them with networks of support and infusing them with the message that seeking help is a sign of strength. We must teach the lesson that talking about one’s thoughts, feelings and emotions is welcomed for boys and girls; men and women of all ages; ethnicities; religions; and gender identities. As those young people get older, they will then become supported, networked Americans with a greater chance of living a long, healthy life in which they thrive.

Where specifically do we need to focus in the coming years to succeed in not only spreading awareness for suicide, but in providing resources for those struggling with their mental health and, ultimately, preventing suicide?

It is critical that in the coming years we focus on empowering and mobilizing teens and young adults to transform the way mental health is talked about, cared for, and valued. Mental health is the social justice issue of the next generation. By arming these young people with the trainings, tools and resources to educate themselves and reach out to their peers when concerned, and to clinical resources when needed, we will most succeed in not only spreading awareness for suicide but providing resources for those struggling with their mental health.

What needs to change in American policy and healthcare to help in decreasing the rate of suicide in this country?

Social cues often come from national policies. Until mental health services are equally offered and covered in all American healthcare, they will continue to be viewed as less important and under-utilized. We need national policy and corporate America to step up and take on mental health as the most critical health issue facing America that it is.

For anyone who is struggling with their mental health or for anyone who knows a loved one is struggling, what message do you ultimately want to share?

For anyone who is struggling or is touched by these issues, I want you to know you are not alone. I want you to know that people care, that help is available and that treatment works. Please, reach out to the National Suicide Prevention Lifeline (1-800-273-TALK) or Crisis Text Line (BRAVE to 741-741) if you need to talk. Call 911 if you or someone you know are in imminent danger. Reach out to a loved one if you need connection. Contact a friend if you’re worried about them. As we continue to research and change policy, the real impact will come from human connection. You matter. The world needs you here.

Rick Kellar

President, Margaret Clark Morgan Foundation

Joe Pyle

President, Thomas Scattergood Behavioral Health Foundation

Suicide rates have continued to increase over the past 15 years, leading to over 44,000 deaths a year in the United States. What do you think has contributed most to this increase?

One contributing factor has to be an increase in the levels of anxiety experienced by all members of society. The advent of social media and overall acceleration of information, both wanted and unwanted, contributes to a higher level of anxiety for all of us. It is especially difficult for our youth, who are not emotionally equipped to manage and handle this information, particularly the unwanted variety.

Research shows that suicide rates are higher for men than for women and are more prevalent for middle-aged Americans. With such patterns as this, can any conclusions be drawn as to what we need to emphasize as a society when it comes to suicide prevention?

It is important to remember that while some research indicates certain higher risk populations, there are always a loved one, family friend, coworker or neighbor that is also impacted by the loss due to a completed suicide. Education regarding risk factors is one key step. The Campaign to Change Direction is one of a number of efforts to change the culture of mental health in America so that all of those in need receive the care and support they deserve. The Campaign encourages all Americans to pay attention to their emotional well-being, and it reminds us that our emotional health is just as important as our physical health.

Where specifically do we need to focus in the coming years to succeed in not only spreading awareness for suicide, but also in providing resources for those struggling with their mental health and, ultimately, preventing suicide?

End the silence. Too often stigma prevents a family, school, coworker, a loved one or a friend from reaching out to help someone, or for someone to seek support. This starts in our closest relationships, but must include others with whom we come in contact with — if even for a moment. A person riding alone on a bus, crying and despondent, should not have to wait for someone they know to care enough to ask, “Are you alright?” As Vivek Murthy, the 19th Surgeon General of the United States said, “Empathy is a powerful drug, and we all have the ability to prescribe it.”

What needs to change in American policy and healthcare to help in decreasing the rate of suicide in this country?

Behavioral health care is essential to good health, and should be discussed, treated, and funded as any other primary care ailment. We do not speak in “hushed tones” about heart disease, nor should we when discussing depression or other brain disorders.

For anyone who is struggling with their mental health or for anyone who knows a loved one is struggling, what message do you ultimately want to share? I concur with Alison Malmon of Active Minds in her response — she lists some excellent resources, and most of those help lines are often equipped to connect those in need with local resources. And most important in her response is the essential element of human connection: “You matter. The world needs you here.”

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