08/20/14

Suicide is NOT Painless

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image credit: iStock

Recently we all heard of the successful suicide of Robin Williams. The media aftermath has stirred up a shit-storm of debate and controversy. I asked someone who lost a loved one to a completed suicide how they reacted to the news. The person’s hope was that since Robin Williams was a celebrity, that a constructive dialogue would occur and help someone else decide not to try suicide. So I want to introduce you to some suicide statistics that relate directly to the tragic loss of Robin Williams. And perhaps start us thinking about how we can help prevent other people from trying to end their life.

The Center for Disease Control and Prevention (CDC) maintains a wealth of statistics on suicide at “National Suicide Statistics at a Glance.”  Among the trends in suicide rates for males between the age of 45 and 64, suicide by firearms were most common, 15.52 per 100,000 in 2009. Suicide by suffocation was second. “Suffocation suicide rates among males aged 45 to 64 years have increased 103.5% since 2001 from 2.91 to 5.92 suicides per 100,000 in 2009.”

“From 1991 to 2009 the suicide rates were consistently higher among males 65 years and older compared to the younger age groups.” But they were decreasing, from 40.12 per 100,00 in 1991 to 29.09 in 2009. HOWEVER, the rates of males between 25 and 64 increased from 21.27 per 100,000 in 2000, to 25.37 per 100,000 in 2009.

I then looked at the latest census figures available on the US census website for males between the ages of 25 and 64 to estimate the number of males these suicide statistics would reflect. Roughly 2,000 men like Robin Williams between the ages of 25 and 64 successfully completed suicide—480 who did so by suffocation—in 2009, the last year statistics were available. So there were 479 other families who suffered the pain of a completed suicide, as does the family of Robin Williams.

What can you do to help prevent more suicides? Look at the website for the National Strategy for Suicide Prevention  (NSSP) for information. The NSSP has a number of goals and objectives to facilitate suicide prevention:

  • Foster positive public dialogue; counter shame, prejudice, and silence; and build public support for suicide prevention;
  • Address the needs of vulnerable groups, be tailored to the cultural and situational contexts in which they are offered, and seek to eliminate disparities;
  • Be coordinated and integrated with existing efforts addressing health and behavioral health and ensure continuity of care;
  • Promote changes in systems, policies, and environments that will support and facilitate the prevention of suicide and related problems;
  • Bring together public health and behavioral health;
  • Promote efforts to reduce access to lethal means among individuals with identified suicide risks;
  • Apply the most up-to-date knowledge base for suicide prevention.

From the revised NSSP, the Action Alliance selected four priorities in suicide prevention that, if accomplished, they hope will help the group reach its goal of saving 20,000 lives in the next five years. These priorities are:

  1. Integrate suicide prevention into health care reform and encourage the adoption of similar measures in the private sector.
  2. Transform health care systems to significantly reduce suicide.
  3. Change the public conversation around suicide and suicide prevention.
  4. Increase the quality, timeliness, and usefulness of surveillance data regarding suicidal behaviors.

One agency I worked for required counselors to complete the background paperwork and have the necessary forms signed during the initial session with a new client NO MATTER WHAT. In a way that was understandable, because if the person never returned and you didn’t have the right forms signed, the agency wouldn’t get paid for the time you spent with the individual. But it made it difficult for the counselor if someone was in crisis, or needed some encouragement. One time I broke that rule and inadvertently helped prevent a suicide.

The more information and forms I completed, the greater was my impression that the woman was discouraged and hopeless. So I stopped the paper pushing and really talked with her about her problems. She had struggled off and on with drug use for over twenty years and didn’t have much hope at that moment that she could stop and get her life together. Her last relapse had led to the breakup of a long-term relationship. We talked and I was able to help her see she could re-establish abstinence; maybe even reconcile the relationship. There was some hope.

When she returned for the second appointment we completed the required paperwork that I didn’t do during the first session. And then she told me she had decided before our first counseling session that if she felt as hopeless after the session as she did before it, she had intended to kill herself. People will sometimes say that they intended to kill themselves, but not really have more than the idea of suicide. But she has a prior history of attempts; and she had a plan that would have been successful if she attempted it.

We have a responsibility to be with one another, to make space for one another, to be kind to one another… and hopefully through doing so, we make life that much more bearable. We do our best suicide prevention by letting go of the goal of suicide prevention, and, instead, creating alternatives.

I think this quote’s essay is headed in the right direction for suicide prevention. Maybe the best technique is to simply be committed to letting people know that you care enough about them to enter their darkness and help them move out into some light.

What more can you do to help prevent the pain of suicide?