Kill the Silence: Can We Reduce Suicide?

I never knew much about suicide. Never really talked about it. Never considered it as an opt-out to whatever life threw at me. It never touched me personally, because I didn’t know anyone who had committed suicide or even attempted it. That all changed on June 9, 2012.

It was a perfect summer day, mid 80s, not a cloud in the sky. I couldn’t wait to hit the court for my favorite new hobby – outdoor racquetball at Belle Isle.

I was cruising down the Lodge and my phone rang. My ex-wife. The ink wasn’t quite dry on the divorce decree yet, so I almost didn’t answer. But she rarely ever called, so I thought it might be important. Maybe it was about our daughters – 22 and 17 at the time. So, I answered it.

She told me our oldest daughter just received a text from her best friend, Nicole. It read “I’m sorry, I didn’t know who else to ask and I can’t let my family find me nor have them look for me. Thank you for being there for me these last few weeks, it meant a lot. Call 911 and tell them I’m at the park. Tell my Mom there’s a box under my dresser on the right side for my family.”

I pulled over and tried to let that sink in. Did it actually happen? Was she already dead? Or was it a cry for help? I probably sat there for five minutes in a state of shock, trying to figure out what to do next. I pulled myself together, drove home and met my oldest daughter there.

Suicide, through my daughter’s eyes

“Just a few hours earlier, we were together at another friend’s funeral who had committed suicide. Nicole said she was going to have work done on her car, and insisted on being left alone just as she had done for the weeks leading up to that day. I was driving when I got the text. Luckily my boyfriend at the time was following me, and I called him as soon as I received the text. I was so distraught he thought I had been in an accident. I pulled into a parking lot and just began walking…anywhere, everywhere. Almost like I was trying escape reality. I called Nicole’s phone repeatedly, although deep down I knew what a proud, strong person she was.”

“This wasn’t a cry for help. It was too late.”

“I called my mom. I remember how upbeat she sounded. It made me mad. I couldn’t understand how the sun was still shining and the world was carrying on as usual while I had to figure out how to tell Nicole’s family the most devastating news they’d ever receive. I called 911 like she asked me. Then I met my family at home and called some of our closest friends, who met us there. I went through what seemed like YEARS waiting for first responders to get there.”

“My mom told Nicole’s family, because I was too distraught. I paced up and down the entire block and physically pulled at my clothes, literally trying to escape my own body. How could this be happening? This is something that you hear about from other people, not something that happens to my beautiful, vibrant, best friend.”

“That night we went to her family's home and read through pages and pages of suicide letters…so scattered that some of them were just single thoughts on sticky notes. All written over a period of months.”

“How was she suffering this intensely and I didn't even realize it? I knew she was dealing with a struggle and heartbreak that I could never even fathom, but I never in a million years imagined she was actually going to end her life. It kills me to say that.”

“I loved her the best I could in her last weeks on this earth, but to this day I still carry extreme guilt for not taking the threat of suicide more seriously. I wish I would've just shown up at her door and sat there - whether she'd let me in or not. I didn't go there, out of fear she would push me away for not respecting her wishes of being alone. She was in such a fragile state, I didn't want to further upset her. Nearly five years later I can't think of that choice without an immeasurable amount of guilt. I was blessed enough to have no idea of the harsh reality of failing mental health and its blatant lack of concern for its victim. I was so ignorant.”

“From the outside looking in, she had it all. An AMAZING family who couldn't love her more, a career she loved, breathtaking beauty, a great sense of humor and the ability to win you over (despite her sass). Depression doesn't care about any of that. It is a blind disease that truly can affect anyone at any time, attacking like a cancer. Leaving you feeling lost, lonely and ashamed…like a burden.”

“There's no shame in this disease, or there shouldn't be. For years I couldn't speak about Nicole without being overcome by emotion, but I feel it's my duty to not let her die in vain. If sharing her story can save even ONE life it is more than worth it. If you're depressed and considering suicide, please reach out for help. I know it sounds cliché’, but there is help out there and there is a way out. Things can and will get better.”

“If you know someone who’s thinking about suicide, take it seriously - more seriously than you feel you should. Because if you don't, I can promise the choice may haunt you forever. I'd give anything to go back to that day 4 years ago and refuse to leave Nicole’s side.”

A big problem, getting bigger. 

Since 2000, five of the top 10 causes of death have been declining. In fact, cancer and diabetes deaths have dropped 38% each, according to the World Health Organization. The medical field has made great strides in the diagnosis and treatment of these well-known and highly publicized diseases. But another top 10 cause of death is going up: suicide. Its rates have increased every year since 2000, a total of 24%, according to the Centers for Disease Control and Prevention.

To change this, we need to: 

  1. Separate fact from fiction
  2. Know the issues and warning signs.
  3. Be willing to listen.
  4. Offer resources and care before it’s too late.

10 facts about suicide you may not know

  • The U.S. suicide rate has reached its highest level in almost 30 years.
  • Every 40 seconds, someone dies by suicide.
  • Every year, nearly three times as many Americans die from suicide as from homicide.
  • More Americans kill themselves than die from breast cancer.
  • Suicide is the second leading cause of death among 25- to 35-year-olds.
  • It’s the third leading cause of death among 15- to 24-year-olds.
  • There is one suicide for every 25 attempted suicides.
  • Depression left untreated, undiagnosed or ineffective is the leading cause of suicide.
  • Nine out of 10 people who die by suicide had a diagnosable mental disorder.
  • Only three in 10 who died by suicide received mental health care in the past year.

Fiction: 5 common myths about suicide

Myth 1: Asking someone if they’re suicidal might give them ideas about how to do it or encourage them to follow through.

Fact: Directly asking if they’re considering suicide as an option to their problems won’t increase their suicidal ideation. On the contrary, they may be relieved to talk about it and open to seeking help. It may lessen their loneliness while increasing their sense of belonging.

Myth 2: People who talk about suicide openly won’t follow through with it.

Fact: Many people who ended their lives candidly shared their plans prior to dying by suicide. Suicide can be an impulsive act or premeditated and talked about with others.

Myth 3: People must be mentally ill to kill themselves.

Fact: It’s true some people who think about suicide have a mental disorder, but according to the World Health Organization, it’s common for many people to have considered suicide at least once during their lives. It’s a normal response to depression or overwhelming worries. People who consider suicide also may suffer from:

  • A terminal illness
  • Chronic pain
  • Relationship problems
  • Post-traumatic stress disorder
  • Physical or mental abuse
  • Social isolation
  • Financial difficulties
  • Unemployment
  • Addiction(s)
  • Bullying issues
  • Sleep disorders

Myth 4: Once suicidal, always suicidal.

Fact: Increased suicide risk happens frequently during a crisis. While suicidal thoughts may reoccur, they don’t have to be permanent. In fact, many people who have experienced previous suicidal thoughts, or even attempts, have gone on to live happy lives.

Myth 5: Most suicides happen without warning.

Fact: Although some suicides do occur with little warning, typically there are indications, whether spoken or acted out, that someone is considering taking their life. It’s critical that all health care professionals stay up-to-date on the signs and symptoms of passive and active suicide tendencies. Did you know most people do not leave a suicide note? This is because many feel disconnected from others, making them less likely to reveal their struggles.

Know the issues and warning signs

A lack of sleep can increase the risk of suicide, especially among teenagers

“Sleep deprivation is detrimental at all stages of life, but it’s even more so in the teen years,” said Buff Donovan, director with HAP’s Coordinated Behavioral Health Management department. “Their bodies are still developing and they need quality sleep every night to help maintain a healthy, positive attitude.”

The National Institute of Health recommends teenagers get at least nine hours of sleep a night. Consider these findings from a 2014 University of Utah study:

  • Teenagers are the least likely among any age group to be getting sufficient rest.
  • Over 90 percent of teens are chronically sleep-deprived.
  • For each hour of sleep lost, there was a 58% increase in suicide attempts. 

 Here’s how to help make sure kids get adequate sleep:

  • Create a sleep schedule – for everyone in the house. If you display proper sleeping habits, they may be more likely to follow along.
  • Explain how sleep affects their grades, sports and other activities.
  • Make sure they turn off their electronic devices at night.

 Warning signs someone may be thinking about committing suicide

  • Threatening to kill oneself.
  •  Saying things like "No one will miss me when I am gone."
  • Looking for ways to kill oneself, such as seeking access to pesticides, firearms or medication, or browsing the internet for means of taking one’s own life.
  • Saying goodbye to close family members and friends.
  • Giving away valued possessions

Be willing to listen

  • If you know someone who may be thinking about committing suicide, talk to them about it.
  • Listen with an open mind, and offer your support. Just having someone to listen may make them feel better.
  • Find a quiet place to talk to the person you’re worried about. Let them know you’re there to listen.
  • Encourage the person to seek help from a professional, such as a doctor, mental health professional, counselor or social worker. Offer to accompany them to an appointment.
  • If you think the person is in immediate danger, don’t leave him or her alone. Seek professional help from emergency services, a crisis line (see resources below), health care professionals and family members.
  • If the person you’re worried about lives with you, ensure he or she doesn’t have access to means of self-harm (for example pesticides, firearms or medication) in the home.
  • Stay in touch to see how the person is doing.

Offer resources before it’s too late

There are many good resources to turn to if you or someone you know might be thinking about suicide. 

Resources

HAP’s Coordinated Behavioral Health Management

HAP’s Coordinated Behavioral Health Management is the division of HAP that manages behavioral medicine services for members. Behavioral medicine refers to both mental health and chemical dependence (addiction) problems. Our focus is to match members with the best care and to monitor that care throughout treatment.

  • You can contact CBHM Monday through Friday from 8 a.m. – 5 p.m. at (800) 444-5755.
  • Or complete our online contact form, and one of our nurses will contact you.
  • For urgent situations, a clinical case manager is available 24 hours a day, seven days a week at (800) 444-5755.

Reducing suicide: Can we lower the rate to zero?

In 2003, Henry Ford Medical Group’s Behavioral Health Services set a goal of zero suicides among all patients they treated. Many people thought the goal was too ambitious, but they set the bar high.

“If you say you’re OK with five a year, one of those five might be your brother or your friend,” said Doree Ann Espiritu, psychiatrist and head of the Zero Suicide program at Henry Ford Health System. “We aim for zero because it reminds us of what we would want for ourselves.”

The program started with primary care doctors asking every patient two questions:

  1. How often have you felt down in the past two weeks?
  2. How often have you felt little pleasure in doing things?

High numbers led to questions about sleep disturbances, changes in appetite and thoughts of self-harm.

From 2003 to 2014, suicide among the 200,000 Henry Ford Medical Group HMO members was down 80% over the previous 12 years, and the medical team achieved their goal of zero suicides for more than two consecutive years! Behavioral health programs nationwide have adopted the Henry Ford program. 

Still, suicide is a growing problem, and it’ll probably get worse unless we make some major changes in how we address it. I’m not a doctor, or a psychologist, or a therapist. I’m just a dad who has seen suicide turn his daughter’s world inside out. I feel horrible about what it’s done to her, but I can’t imagine what it’s like to be Nicole’s parents and have to live with that loss every day. We all need to do what we can to avoid that loss.

As a writer, one thing I can do is share my daughter’s story about Nicole, and give you a real-world example how devastating suicide can be. I also can let you know what I’ve learned. More than anything, I’ve learned talking about it is important. In fact, talking about it could be the best thing for the person considering it. If we ask questions and offer help, maybe more lives could be saved. And one of those lives could be someone in your family, or your best friend.

 

Citations:

"Suicide Facts." Suicide Awareness Voices of Education.  http://www.save.org/index.cfm?fuseaction=home.viewPage&page_id=705D5DF4-055B-F1EC-3F66462866FCB4E6.

"Suicide Facts at a Glance." Centers for Disease Control and Prevention.  Suicide Facts at a Glance 2015 - cdc.gov.

McIntosh, Ph.D., John L., and Christopher W. Drapeau, M.A.. "U.S.A. SUICIDE: 2014 OFFICIAL FINAL DATA." American Association of Suicidology. http://www.suicidology.org/portals/14/docs/resources/factsheets/2013datapgsv2alt.pdf.

“What Happens If You Try to Prevent Every Suicide” http://www.npr.org/sections/health-shots/2015/11/02/452658644/what-happens-if-you-try-to-prevent-every-single-suicide

University Behavioral HealthCare. "Facts about Suicide and Mental Disorders in Adolescents." Rutgers,The State University of New Jersey. http://ubhc.rutgers.edu/tlc/docs/suicideAwareness/Facts%20About%20Suicide%20and%20Mental%20Disorders%20in%20Adolescents.pdf.

Mental Health Drug and Alcohol Office, NSW Department of Health. "NSW Suicide Prevention Strategy 2010–2015." New South Wales Ministry of Health. http://www.health.nsw.gov.au/mentalhealth/programs/mh/Publications/suicide-prev-strategy.pdf.

National Institutes of Health. "Suicide in the U.S.: Statistics and Prevention." NIMH. https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml.

Categories: Get Involved

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