Our Role in Preventing Suicide…

With the recent untimely death of Broncos WR Kenny McKinley and tragic loss of several college youth across the nation this question has been thrust into our community’s collective conscious. Sadly, suicide has become an all too common occurrence within our society, while at the same time remaining a rather taboo subject for our own interpersonal relationships. Despite our frequent reluctance to discuss this issue with those that we care about, there are vey few of us who have not had our lives directly touched by suicide, whether through a child, parent, sibling, relative, neighbor, coworker, or acquaintance. We’re often left with lingering existential questions that challenge our own sense of meaning in life... Why? How could someone with seemingly so much going for them take their own life? What could lead a person to believe that suicide was an option in their situation? What could I have done differently or how could I have known this was going to happen? Perhaps the most important question we can ask ourselves, as we seek to move forward and create meaning from such a seemingly senseless act, is what can we do to reach out to those still suffering in silence to help prevent suicide from taking another life? Through this brief post I hope to review current research to provide some context to the national suicide epidemic, dispel some myths about suicide, and empower you with some tools and resources to make a positive impact on the struggle against suicide.Colorado consistently has one of the highest suicide rates in the nation, with suicide representing the 7^th leading cause of death across all age groups and the 2^nd leading cause of death for young people ages 10-34. Just last year Colorado had its most deaths by suicide on record at 940. Nationally, death by suicide claimed the lives of 34,598 people in 2007. It is estimated that another 11 suicide attempts occur for every 1 death by suicide. These are staggering and heartbreaking statistics that highlight the all too prevalent nature of suicide within our nation and immediate community. For more information on some of the national suicide statistics you can visit the National Institute of Mental Health (NIMH) or see the Suicide in Colorado report for information specific to this State.

             Given the widespread nature of suicide within our communities, one might think that this issue would be a more frequent topic of conversation and routine preventative effort by nearly all people. Unfortunately, some of the myths and stigma surrounding suicide has prevented this from becoming the case and we all too rarely openly discuss or ask about suicide until the topic has been thrust before us by the loss of someone we love or a prominent public figure. By then it’s already too late. Our own fears, assumptions, and false beliefs about suicide often get in the way of reaching out to those in need around us.

• How can I possibly say anything that might be helpful to someone considering suicide? People contemplating suicide are just like you and me. We have all been through some difficulty in our own lives and share a common humanity which gives us the capacity to help someone who is depressed or thinking of taking their own life.
• If I say anything it might make the person upset or give them an idea that makes them more likely to hurt themselves. This is actually the opposite of what research has found to be true. Being direct with someone about suicide generally lowers their anxiety and sense of isolation that has been created by the stigma surrounding suicide. By opening a line of communication we can cue in to any warning signs and decrease the risk of an impulsive act. Additionally, if you’re worried that someone you know might be considering suicide, it’s nearly a guarantee that they’ve already at least thought about this themselves.
• People who consider suicide keep their plans to themselves. This is another common misperception that has been debunked by the literature. Psychological autopsies on those who have completed suicide found that approximately 95% of these individuals had in some way communicated their suicidal intent.
• People who talk or joke about suicide don’t actually do it. As previously highlighted, nearly all people who attempt suicide convey their intentions in some way. Increased talking about death or suicide is a frequently evident precursor in individuals who try to take their own life.
• Once people make up their mind to complete suicide there’s no way to stop them. Most people have conflicting feelings about suicide and are generally ambivalent about their decision to complete the act. Interviews with Golden Gate Bridge survivors indicated that one of the most common thoughts that entered their minds after jumping from the bridge was “I wish I hadn’t done it.” This is also why the vast majority of people convey their intentions in some form or another before performing a suicidal act. People generally want help but don’t know how to ask. Suicide is the most preventable cause of death and any positive action you take may save a life.

            I know how incredibly difficult it can be to break the circle of silence surrounding suicide. I live with my own painful reminder of how I was unable to do just that with an acquaintance during my sophomore year of college. However, as I’ve learned to break that silence and reach out to those in both my personal and professional lives (as both a crisis helpline worker and therapist) I’ve come to appreciate the incredible power of a simple question or gesture of support to someone contemplating suicide. Whether a person is actually considering suicide or not, the mere act of asking a question offers a tremendous opportunity to create a profoundly meaningful connection with another person that you may find not only has a significant impact on that person’s life but on yours as well.

            So what can we do to help? Everyone can play an important role in suicide prevention by being mindful of several simple things and being willing to reach out to others whenever warning signs arise. Moreover, we can all work together to help break the silence and lower the social stigma surrounding suicide.

• Be attuned to any suicide cues or warning signs in those around you. Listen for direct verbal cues (e.g. I wish I were dead, I’m going to kill myself, I’m going to end it all) and indirect verbal cues (e.g. I’m tired of life, You won’t have to worry about me much longer, You’d be better off without me anyway, I just want out of it all).
• Be on the lookout for behavioral cues (e.g. previous suicide attempts, giving away possessions, sudden disengagement, making arrangements for an absence, acquiring a weapon, storing large quantities of pills). Symptoms of depression and drug/alcohol abuse are present in approximately 90% of instances of suicide.
• Also, be mindful of times in which previously depressed individuals seem to be getting better or have an increased level of energy as they may now feel as though they have the resources to carry out the act they have been thinking about for so long. Moreover, as counterintuitive as it may sound, the hours preceding an attempt may involve an air of happiness or calm as the person has resigned themselves to death.
• Check-in with people following any major life changes that may represent a situational cue for suicide (e.g. loss of job, end of a significant relationship, death of a family member or friend, difficulties at school, serious medical condition).

            Whenever you have any concerns the most important thing you can do is simply ask if someone is considering suicide, or if you’re unable to then find someone who can. Ask the question and then listen. Listen without judging and then ask if you can help them get connected with resources to help. For additional information on suicide and how you can help people struggling with this issue checkout the National Suicide Prevention Lifeline and the Suicide Prevention Resource Center.

By Scott Nebel, Psy.D.

• Scott is a Psychologist on MHCD’s Intensive In-Home Treatment Team and collaborates with the MHCD Research Institute.

Books on Suicide and Depression:

Suicide: The Forever Decision by Paul Quinett

Darkness Visible by William Styron

Night Falls Fast by Kay Redfield Jamison