suicide prevention

today is the last day of suicide prevention week. to honour those who have attempted suicide and survived, those who have lost loved ones, and the lives of people who have chosen this sad way out, i’ve collected a few worthwhile links on the topic. if we put them all together, here are some ways to further the work of suicide prevention:

  • stop focusing in the individual, switch to a population approach, one that is working so well with smoking and cardiovascular disease. the refinement of individual assessment has passed the point of diminishing returns.
  • address the social ills connected with suicide
  • pay attention to high risk individuals, e.g. LGBTQ youth
  • create a corporate culture where workers feel comfortable seeking help from their company’s EAP or other resources
  • learn and teach positive life skills to the whole family
  • create a buddy system to prevent the profound sense of loneliness, alienation and isolation that often precedes suicide
  • help people with chronic health problems such as depression, ptsd, seniors and people with chronic pain tunderstand that they are not a burden
  • accessible counseling
  • use the expressive arts to help prevent suicide
  • pay attention to the feeling of powerlessness that often precipitates suicide attempts in girls
  • listen and talk to your loved ones!
  • trust your gut
  • take seriously any sudden and troubling behaviour changes you see in your loved ones

and here are the links, with excerpts from the articles:

suicide prevention: stop focusing in the individual, switch to a population approach

firstly, identifying and treating high-risk individuals is unlikely to result in lower suicide rates. the refinement of individual assessment has passed the point of diminishing returns, and the obsessive study of suicidal individuals will not uncover the holy grail of perfect prediction …

secondly, pessimism about suicide may not be justified, despite the rising rates. the turnaround in the rising road toll and in cardiovascular disease teaches what can be done. the lesson is that measures which reduce overall risk in the whole population will reduce the number of people above the fatal threshold, and we do not need to identify the high-risk people individually.

consequently, we may have to abandon the frontal assault on suicide. we cannot justify prevention campaigns driven by the suicidal risk of individuals, despite the intuitive and political appeal of such measures. indeed, to the degree that they drive resources into ineffective strategies, current approaches to “suicide prevention” may impede suicide prevention. instead, we must “bite the bullet” in restricting access to means of suicide, the most proximate factor. beyond that, we need the diligent, unspectacular work in the population which mitigates those factors which lead, among other things, to suicide. for medicine, it is to treat the ill, whether or not they are suicidal, and, from a public health pulpit, to address the social ills which produce morbidity, whether or not they lead to suicide.

suicide and anti-gay bullying – a preventable epidemic

when two 11-year-old boys died by suicide in april of this year after enduring relentless anti-gay bullying at their separate schools, shocked citizens across the country were forced to come to terms with an uncomfortable but blatant epidemic. the hallways of schools, homes, churches and other places where all young people should be able to safely learn and grow are plagued with its tragic prevalence. youth who identify as or are perceived to be lesbian, gay, bisexual, transgender or questioning (LGBTQ) struggle with depression and thoughts of suicide at a disproportionately high rate as a result of the increased risk factors sexual minorities face.

workplace suicides

there was a 28 percent increase in the number of suicides committed in the workplace last year—251—compared with the prior year, according to a census by the US department of labor released in august.

and that number does not include the much greater number who kill themselves elsewhere, experts say.

employers are expressing increasing worry about employee suicide, say employee assistance plan providers.

there have been a greater number of calls recently from employers about how to handle potential suicides, said dr. doug nemecek, eden prairie, minnesota-based senior medical director for cigna corp.’s health solutions organization, which includes its behavioral health and EAP business.

in some cases, employees are informing managers about co-workers who have expressed suicidal thoughts on their facebook pages, he said.

but creating a corporate culture where workers feel comfortable seeking help from their company’s EAP or other resources can help, experts say.

suicides in the army

the army wants soldiers and their families to know help is available to those struggling with issues that sometimes bring about suicide.

“this year’s strategy focuses on three key points – training the army family in positive life skills, buddy care and counseling through a variety of ways,” said army chief of chaplains chaplain (maj. gen.) douglas l. carver. “i think educating our leaders, soldiers and families on what to look for in suicidal behaviors has made our people more sensitive and aware.”

soldiers who commit suicide usually do so because they can’t see another way out of a painful situation chaplain carver said. frequent and longer deployments add yet more burden, especially on relationships, he said.

using the arts to prevent suicide

a while ago, a friend of mine started a nonprofit. she’s a bit mad herself, splitting her time between denver and DC, working, writing a book and taking classes in addition to her passion: the nonprofit. mad to live is “a suicide prevention and awareness foundation, which aligns with and supports the arts as a way to augment mental health services.”

the organization leverages creative expression and the arts as part of therapeutic healing. over the weekend, mad to live teamed with the kristin brooks hope center to raise awareness about the center’s Vet2Vet crisis line. the event revolving around the arlington arts center exhibit, picturing politics 2008, included the work of two veterans’ organizations, featuring photographs depicting life in iraq and afghanistan.

a new theory of why people commit suicide

dr. joiner has proposed a new theory of why people suicide which he believes is more accurate than previous formulations offered by writers like edwin schneidman, ph.d. and aaron beck, md. according to schneidman’s model, the key motivator which drives people to suicide is psychological pain. in beck’s understanding, the key motivator is the development of a pervasive sense of hopelessness. dr. joiner suggests that these are correct understandings but are also too vague to be useful for predictive purposes and not capable of offering a complete motivational picture.

joiner proposes that there are three key motivational aspects which contribute to suicide. these are: 1) a sense of being a burden to others, 2) a profound sense of loneliness, alienation and isolation, and 3) a sense of fearlessness. all three of these motivations or preconditions must be in place before someone will attempt suicide. psychological pain and a sense of hopelessness correspond roughly to joiner’s concepts of burdensomeness and alienation, and contribute to the content of much suicidal ideation. these are necessary but not sufficient preconditions for a suicide act, however. so long as a person remains fearful of death and the actions and consequences of the activities that will create death, the actual act of suicide is unlikely.

girls and suicide

girls are four times more likely to attempt suicide than boys. the risk factors leading to suicide among teens — family disruption, substance/sexual abuse, gay/lesbian sexual orientation — lead to feelings of powerlessness in our society. girls, i believe, have less avenues to excise these feelings and are therefore more likely to act out on their own bodies (e.g., cutting, anorexia, bulimia, and suicide) than boys.

listen to your kids!

a parent shares tips on helping children to overcome the desire to end their lives:

talk to your kid.
really talk to them with no outside distractions and try and get to the bottom of what is going on. if you do not feel like you can do that, do not be afraid to enlist the help of a professional. that is what they are there for. that is their job. they have been there and done that and they can be a world of help.

look for marked behavior changes.
has your bright and cheery twelve year old suddenly become this child who you do not recognize? is he/she doing things that you never would have dreamed that they would do like drinking, smoking or skipping school? while that kind of behavior can sometimes be a “teenager thing”, you know your child. you know what is normal and what is not.

trust your gut.
one of the most important things to remember is that a kid who is seriously considering suicide is most likely not going to broadcast it. i have never heard of a person saying, “i’m going to kill myself tomorrow. someone stop me.”. if they mean to die, they are secretive and this is when knowing your child’s friends and habits becomes so important.

5 thoughts on “suicide prevention

  1. Pingback: Tweets that mention suicide prevention -- Topsy.com

  2. Annie

    Isabella,
    You provided a well organized and helpful post on suicide. As a former therapist I think that providing this kind of information is essential if we are to see progress in suicide prevention. I appreciate your effort!
    Peace,
    Annie
    (A Psychotherapist with Bipolar)

  3. nancy (aka moneycoach)

    Our suicide rates up here, esp. among aboriginal males, is multiple times the national average. It all fits with the observations in your post – a sense of being a burden (the comments on cbc etc lead me to believe most cdns see First Nations people as a burden, rather than as the extraordinary people they are), the isolation (please, CTRC ensure superb internet service up here) and fearlessness – it all fits.
    .-= nancy (aka moneycoach)´s last blog ..9-5 and Worklife Balance – are they relevant or obsolete concepts? =-.

  4. Sandra

    Excellent ideas, thank you for the list. I especially like population approaches, anti-bullying, and some wonderful initiatives in the arts. They include media training and contests, like the just-announced Honouring Life aboriginal youth video contest:
    http://www.honouringlife.ca/en/youthCorner/videoContest

    I just wrote about @unsuicide, using social media for suicide prevention, including the video PSA from MentalHealthCamp: http://bit.ly/29n3J

    Thank you again (and Raul) for that great event!

    If Dr. Joiner’s theory is correct and hopelessness is the key issue to address, media – which includes social media – is useful to combat it.

    What do you think?

  5. isabella mori (@moritherapy)

    @nancy thanks for bringing attention to suicides among first nations people. definitely something i should write about here.

    @sandra thank you for those two great links! your thoughts on suicide and blogging are important – please, everyone who reads this, visit the second link.

    what dr. joiner calls hopelessness seems similar to what people educated in the satir process refer to as coping methods. in both situations the emotional pain (and sometimes, as in chronic or cancer pain, also physical pain) is overwhelming and the person cannot think of another way out. “there’s nothing else i can do”. in that situation, hearing others’ voices in a social media context can be very helpful, i think.
    .-= isabella mori (@moritherapy)´s last blog ..soul music from a piano’s underbelly =-.

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