Addressing Suicide

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r By Scott Daniels – MD, MHA, and Psychiatrist at Mountain View Hospital

Suicide is an unspeakable tragedy. Those affected by suicidal behavior experience a suffering that defies description. And yet suicide must be spoken of. Suicide is a wall that separates those who have gone ahead and those who are left behind from having the conversation that might have healed them both. It is critical that we not allow these heart-rending experiences to rip our communities apart. Instead, we can come together.

Suicide is estimated to end the lives of more than 45,000 people every year in the United States, and tragically, is on the rise. Each death is estimated to affect 115 living people, doubling their risk of significant depression, anxiety, and suicidal thoughts. We owe it to those who have struggled with this tragic challenge, and we owe it to ourselves, to try to understand what can be done to reduce the toll of pain, isolation, and suffering.

Every day, we can make efforts to reduce isolation, whether through community-building organizations or through direct personal outreach. We can acknowledge that most people have had suicidal thoughts at some time. Suicidal thoughts do not mark someone as evil, sinful, or destined to die in this tragic way. Recognizing that suicidal thoughts are a common experience can help to combat the kind of isolation that often exacerbates the condition.

We can talk about suicide. Medical evidence has demonstrated time and time again that we need not be afraid to ask someone whether they are having thoughts of suicide: reaching out helps prevent suicide. Once the conversation starts, aim to keep it going so that you can be confident that the full extent was shared. Remember to thank people for trusting you enough to talk about this difficult topic.

We should be cautious about discussing the particulars of how someone has killed themselves. Detailed descriptions of self-inflicted death can inadvertently act as suggestions for others who are struggling with suicidal thoughts.

Not knowing how to help someone with suicidal thoughts may have held us back in the past. People are often relieved to learn that there are simple ways to change these feelings and reduce the likelihood of suicidal action. Safety Plans help increase awareness of emotionally difficult experiences and list exercises that quickly decrease emotional distress. These exercises are usually strategically listed from least-disruptive (savoring a pleasant smell) to most-disruptive (going to an Emergency Room) and include a variety of options in between. One format that has evolved as it has been tried by thousands of patients, can be printed and shared at www.PracticeLearning.org. Safety Plans are also useful for addressing anxiety, impulsivity, anger, and substance use.

If you are concerned that someone is likely to take action to kill themselves in the next few days, or if they refuse to take steps to prevent suicidal action, professional assistance is strongly encouraged. The desire to die is typically fleeting: temporary containment provides an opportunity to recover. Police can be dispatched via 911 to call to check on someone, but the more participation from the person at risk, the better. Staff in the Emergency Room will assess whether further care is necessary.

We can help bring our communities together to address the tragedy of suicide. Community and personal outreach can decrease perceived isolation. While we may not be able to control what thoughts come into our minds, we can make plans for how to address overwhelming emotions before they become suicidal actions. Law enforcement and medical professionals can provide a structured response. We can make our communities better connected, more resilient, and more welcoming to the full breadth of human experience.

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