Suicide
“Ah’m tired of livin’ / An’skeered of dyin’” –Jerome Kern, ‘Ol’ Man River – from the musical “Showboat.”
This past Tuesday I was honored once again to be asked by Mike Williams and Ted Adams to be a guest on their radio show, “Community Alert”, on KZSB 1290. This time to discuss the issue of suicide. For those that were not able to listen in on the show, I wanted to present the highlights to today’s readers.
The bottom line is…suicide happens. It is a tragic and potentially preventable public health problem. In 2007 (the latest year for which we have national statistics), there were 34,598 suicide deaths in the United States. Suicide is the eleventh leading cause of death in this country. Among the young, however, it ranks third. In that same year suicide was the sixth leading cause of premature death in Santa Barbara County, with 28 total suicides translating into an estimated 722 years of life lost. Ninety percent of people who die by suicide have a diagnosable psychiatric disorder at the time of their death, most often unrecognized or untreated depression.
Suicidal behavior is complex, and is one of the most vexing problems that confront mental health providers, patients, and their families. Some risk factors vary with age, gender and ethnic group, and may even change over time. However, suicide can be prevented. While some suicides occur without any outward warning, most people who are suicidal do give warnings. Most people at risk either communicate their intent or are in position to be noticed, observed, and asked questions.
The emotional crises that usually precede suicide are often recognizable and treatable. Although most depressed people are not suicidal, most suicidal people are depressed. Serious depression can be manifested in obvious sadness, but often it is rather expressed as a loss of pleasure or withdrawal from activities that had been enjoyable. One can help prevent suicide through early recognition and treatment of depression and other psychiatric illnesses.
Warning Signs and Risk Factors
- Observable signs of serious depression:
Unrelenting low mood
Pessimism
Hopelessness
Desperation
Anxiety
Withdrawal
Sleep problems
- Increased alcohol and/or other drug use
- Recent impulsiveness and taking unnecessary risks
- Threatening suicide or expressing a strong wish to die
- Making a plan:
Giving away prized possessions
Sudden or impulsive purchase of a firearm
Obtaining other means of killing oneself such as poisons or medications
- Unexpected rage or anger
A copycat suicide is defined as an imitation of another suicide that the person attempting suicide knows about either from local knowledge or due to accounts or depictions of the original suicide on television and in other media. A well-known or highly publicized suicide serves as a model, in the absence of protective factors, for the next suicide. This is referred to as suicide contagion. They occasionally spread through a school system, or through a community. When that occurs it is called a suicide cluster. Just a couple of examples are:
- The Manasquan, N.J. High School cluster whereby in a small area of New Jersey, a prominent group of seaside towns and tranquil bedroom communities, nine teenagers and young adults have killed themselves in the past three years. Among them were several gifted students and standout athletes at Manasquan High School. Their futures, it seemed, were unlimited. Six ran into the paths of speeding commuter trains. Three hanged themselves.
- Between mid-January and mid-February of this year, in just a single 4-week period, four NYPD officers committed suicide. A 14-year veteran of the New York Police Department shot himself to death on the afternoon of February 13 after finishing his shift, becoming the fourth NYPD officer to commit suicide in less than a month. He had finished his shift in Queens, N.Y., and then shot himself under the chin off of the Long Island Expressway in Jericho. The married father of three had texted his sergeant minutes before to tell him goodbye. Just eight days earlier, another longtime officer shot himself in his Suffolk County home after arguing with his wife at a party. The 20-year veteran was a father to 5-year-old twins. In late January a 28-year-old officer killed himself while on duty after receiving a call from his fiancé, who reportedly told him she called his precinct about the depression he was struggling with. The officer shot himself in the head in front of his partner while on the scene of a car burglary in Queens. And, just four days before that, on January 15 a 23 year old officer shot himself in his parents’ home in Yorktown Heights after getting into a car accident. Apparently he had been arguing with his girlfriend on his cell phone at the time of the accident.
Suicide Is Preventable
Early detection, referral and treatment modes are effective in detecting and helping those at risk. The risk of suicide can be reduced by limiting access to firearms and stockpiles of prescription medications, providing mental health counseling services, and staying with people who are suicidal. Hotlines and crisis centers serve as gatekeepers for those in crisis and can effect referrals to community caregivers. School screening programs are similarly able to identify and refer those at risk students at the time of screening.
Throughout the country the ‘211’ suicide helpline provides 24-hour support for people who are considering suicide. Santa BarbaraCounty operates the Crisis Recovery and Emergency Services program which also provides 24-hour crisis intervention through a hotline (888-868-1649) as well as a mobile psychiatric assessment team (805-884-6850). If you or someone you know is struggling with severe depression and persistent and lingering thoughts of suicide please…please do NOT wait to address the problem. Contact a mental health professional or your primary care physician immediately. If that is too long to wait, get you or your loved one to the nearest Emergency Room or call one of these crisis hotlines. Trained emergency intervention can, and does, save lives from the tragedy of suicide.