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MANY
SUICIDES ARE PREVENTABLE: Suicide
is a serious public health problem. In the United States,
it is the eighth leading cause of death overall and the
third leading cause of death for young people aged 15-24.
More than 30,000 people take their own lives every year,
about twice as many as those who die from HIV/AIDS. For
every death by suicide, there are about 20 suicide attempts.
Nearly everyone sometime in his or her life thinks about
suicide. Most people decide to live because they eventually
come to realize the crisis is temporary and death isn’t.
It is not unusual, however, for someone in a crisis to
perceive “no way out” of his or her dilemma
and feel an utter loss of control. When one can’t
cope and can’t see how things are ever going to
get any better, desperation grows.
Suicidal
thoughts and behavior can be successfully treated and
often can be avoided if help is obtained soon enough.
Recognizing when someone might be suicidal and getting
the person help are what’s crucial. Read on for
everything you’ve always wanted to know about preventing
suicide.
WHO
COULD BE IN DANGER (RISK FACTORS): There is no
typical suicide victim. It happens to young and old, rich
and poor. There are some common “risk factors,”
however. While many people experience one or more of these
risk factors and do not contemplate suicide, they are
useful in identifying someone who might become suicidal.
Some
people believe that “People who commit suicide are
people who were unwilling to seek help." This is
not true. For example, studies of suicide victims have
shown that more than half had sought medical help within
six months before their deaths. That is why the Surgeon
General’s Office recommends training physicians
in suicide risk assessment, and also teachers and school
personnel, clergy, police officers, correctional personnel
and emergency health care personnel as well. The opportunities
are there to spot and prevent potential suicides before
they reach the crisis stage, if one knows what to look
for:
A diagnosable mental health problem or alcohol or drug
problem:
Suicidal thoughts and behavior can be symptoms of a mental
illness or substance abuse disorder. Most often they are
symptoms of moderate to severe depression. Depression
is a medical condition that is often accompanied by a
loss of appetite; sleep disturbances, general bodily complaints,
social isolation/withdrawal and a lack of interest in
or enjoyment of everyday living as well as feelings of
loneliness, worthlessness, guilt and sadness. Depression
can also be a consequence of a person’s struggle
to overcome a serious mental health or substance abuse
problem and the stigma of having such problems. Dealing
with any debilitating illness can be depressing, but having
a “socially unacceptable” illness creates
added pressures. Accidental suicides are sometimes caused
by delusions and often by drug overdoses. People who have
undergone drug rehab and go back to using often overdose
because they think their bodies can still tolerate the
amount of drugs they used to take. Many times, people
have both mental health and substance abuse problems that
“feed” each other. Both need to be treated
at the same time for the person to get better.
Adverse
life events, especially significant losses:
The significance of the loss is always subjective. It
could be anything from the loss of a best friend to failure
to get an “A” on an exam. It is whether the
person is able to cope with the loss that is important.
Impulsivity: Even the most severely
depressed person has mixed feelings about death, wavering
until the very last moment between wanting to live and
wanting to die. Most suicidal people do not want to die;
they want the pain to stop. While the decision to kill
oneself may be reached over a long period of time, actually
going through with it often requires “seizing the
moment.” Impulsive people, or people rendered impulsive
by alcohol or drugs, are most likely to find themselves
“taking the plunge.”
Previous
suicide attempt: To be determined to kill
oneself takes a lot of “psychic energy” which
can be sustained for only a limited period of time, usually
no more than two to three days. However, many suicides
occur within about three months following the beginning
of “improvement” after a suicidal crisis,
when the person has regained the energy to try again.
A
firearm in the home: Firearms are the most
commonly used method, accounting for about 60 percent
of all suicides in the U.S. There are more suicides than
homicides in the U.S.
Other
Risk Factors:
-Family violence, including physical or sexual abuse
-Feelings of rage
-Family history of suicide
-Family history of mental health or substance abuse problem
-Incarceration
-Exposure to the suicidal behavior of others, including
family, peers or through the media.
WHAT
ARE THE WARNING SIGNS? These indicators help
one to recognize the threat of suicide in others. While
it is possible to misinterpret any one of these signs,
putting them together with other indicators, such as the
risk factors above, should show that action must be taken.
When the signs are there, it is time to act. The danger
of embarrassment through overreaction is not nearly as
great as the danger of death through failure to act.
A
suicide threat or other statement indicating a desire
or intention to die. Some people
believe that “people who talk about suicide won’t
really do it.” This is not true. Almost everyone
who commits suicide has given some clue or warning. Do
not ignore suicide threats. Statements like "You'll
be sorry when I'm dead," or "I can't see any
way out" -- no matter how casually or jokingly said
-- may indicate serious suicidal feelings.
Change
in personality or behavior: The changes
generally are sudden and quite noticeable. The person
who has been reserved or conservative suddenly becomes
loud and conspicuous. The person who was outgoing and
friendly becomes aloof and wants to be alone. The one
who is usually happy is sad; he sees his options slipping
away. The one who is usually depressed can be much happier;
he sees a “light at the end of the tunnel.”
Unusually aggressive, destructive or defiant behavior;
a lack of concentration on school, work or routine tasks;
a change in sleep patterns, eating habits, and a loss
of interest in activities the person previously enjoyed
are all “red flags” that something might be
very wrong.
Making
arrangements as though for a final departure:
Preparations before suicide vary with the person’s
personality or circumstances. They often consist of what
is generally referred to as “getting one’s
affairs in order.” To the head of the household
this might mean preparing a will or reviewing insurance
papers. To a housewife it might mean writing long overdue
letters or patching up bad feelings with relatives or
neighbors. To a teenager, it might mean giving away personal
possessions with sentimental value – jewelry, skis,
CDs. Final preparations may be made very quickly, with
the suicide following abruptly. Prevention often relies
on detection of the earlier signs, such as comments about
death, depression and marked personality changes.
Hopelessness:
A critical warning sign is when a person’s thinking
gets so constricted, he only sees things as “black
or white” and his life as all black with no patches
of gray. “This is the way it is,” he thinks.
“It will never get better.”
Other
warning signs:
-Increased drug or alcohol use.
-Taking unnecessary risks/careless behavior/accidents.
-Feelings of overwhelming guilt, shame or self-hatred.
-Fear of losing control, “going crazy,” harming
self or others.
-Worry about money or illness (real or imaginary).
-Preoccupation with death and dying.
-Loss of interest in personal appearance
WHAT
TO DO WHEN YOU SUSPECT SOMEONE IS SUICIDAL: Some
people believe, “If people are determined to kill
themselves, nothing is going to stop them." This
is not true. Again, most suicidal people don’t want
to die; they want to stop the pain. The impulse to end
it all, however overpowering, does not last forever. And
proper treatment can eliminate suicidal symptoms. If you
suspect someone is suicidal, the first and most important
step is to engage that person, to connect with that person.
He may have already “signed off” from the
world. Your job is to reestablish communications. Talking
helps ease the pain. Try to gage the gravity of the situation.
Some people believe that, “talking about suicide
may give someone the idea." This is not true. You
don't give a suicidal person morbid ideas by talking about
suicide. Bringing up the subject and discussing it openly
can give the person a great sense of relief. He doesn’t
have to keep it a secret any longer, and this allows him
to open up about the underlying issues. Treat all feelings,
gestures and language seriously. Be non-judgmental. Accept
the person’s feelings and don’t try to talk
him out of them.
-Don’t
debate whether suicide is right or wrong, or feelings
are good or bad.
-Don’t lecture on the value of life.
-Don’t give advice by making decisions for the person
or telling him to behave differently.
-Don’t dare him to do it. Share your feelings of
concern for the person. Offer hope that alternatives are
available but do not offer glib reassurances or try to
make light of the situation. It only proves you don’t
understand. Offer empathy, not sympathy.
-Do not make a promise of secrecy. Saving a life takes
precedence over confidentiality and loyalty. Ask who else
knows.
-Do not ask if the person wants help but tell him you
will help.
-Do not allow a rejection of help. Once you have connected
with the person, do not leave him. You are his bridge
back to life. Make it clear you will stick with him until
he is connected with someone who can really help him.
Encourage an anti-suicide pact.
-Get a commitment not to attempt suicide, even if it’s
short term.
Take
action. Remove means. Get help from persons or
agencies specializing in crisis prevention and suicide
prevention. Get immediate help for the person if he is
really at risk of hurting himself by calling 911. Finally,
get help for yourself. Taking care of someone who is hurting
and it can take its toll on you. Consider talking to a
professional about the experience after it is over.
HOW
TO GET HELP: There is a wide range of treatment
available for suicidal behavior, including medications
and “talk” therapies. The key is to get the
person professional help as soon as possible. It is better
to recognize a potential danger and have it addressed
at an outpatient clinic than to wait until the only option
is the Emergency Room.
If
you know someone who has some of the risk factors above,
a first step would be to find out whether the person has
a “safety net” -- a caseworker or a school
psychologist, for example. Many times, there are professionals
who are already involved with the person. If not, then
it is a matter of finding the right professionals and
getting them involved. Your local NAMI affiliate can help.
Call us at 1-800-950-3228 for your affiliate’s phone
number and address.
The
next step would be to contact these professionals and
share your concerns. When speaking to professionals, remember
that they might be limited by confidentiality rules in
what they can tell you about the person, but they can
and should listen to everything that you have to tell
them. If you notice some warning signs, it is imperative
to get the word out to as many people who can help as
possible: not only to a mental health professional, but
to anyone who can help: family, friends, teacher, doctor,
clergy. Find the people the person will respond to and
sound the alarm. Figure out the best way to intervene
to get the person professional help and then do it. If
you are dealing with someone who is in crisis, call your
local
crisis line. If there is immediate danger, call 911.
NATIONAL
HOTLINES: National Hope Line: 1-800-SUICIDE (784-2433)
The Help Line USA: 1-800-785-8111
Girls and Boys Town: 1-800-448-3000
Covenant House: 1-800-999-9999
The Trevor Project: 1-800-850-8078 (for gay or questioning
youth)
Finally,
in spite of your best efforts someone may go on to complete
suicide. His pain and the wish to escape it may be too
overwhelming. He is responsible for his death, not you.
Seek support and counseling.
LINKS:
please click here
For
more in-depth information on mental health crisis or getting
help; please choose below:
Mental Health Crisis | Where
to Call
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