What to do if you or a loved one are suicidal
Suicide rates are sharply on the rise in the United States according to a recent report issued by the Centers for Disease Control and Prevention. The report was further accentuated by the deaths of designer Kate Spade and chef and television personality Anthony Bourdain by suicide the same week. Their deaths put a public face on the private crisis.
In half of the states in this country, including Massachusetts, suicides are up by more than 30 percent. Nearly 45,000 people died by suicide in the U.S. in 2016, making it the tenth highest cause of death. It is the second highest cause of death for young people ages 15 to 34.
Daria Hanson, MD, medical chief of behavioral health at Cape Cod Healthcare explains what family members, friends and the community can do to help prevent these tragedies.
In the CDC report, 54 percent of the people who died by suicide did not have a known mental health condition. What warning signs should people watch for?
People should watch for the following signs of depression:
- Depressed mood
- Change in sleep patterns (too much or too little)
- Change in weight or appetite
- Speaking and/or moving with unusual speed or slowness
- Loss of interest or pleasure in usual activities
- Withdrawal from family and friends
- Fatigue or loss of energy
- Diminished ability to think or concentrate, slowed thinking or indecisiveness
- Feeling of worthlessness, self-reproach or guilt
- Thoughts of death, suicide or wishes to be dead
Not everyone who suffers from depression contemplates suicide. Are there other warning signs that indicate that suicide is a risk?
- Extreme anxiety, agitation or enraged behavior
- Racing thoughts, excessive energy, reduced need for sleep
- Excessive drug and/or alcohol use or abuse
- Neglect of physical health
- Feelings or statements of hopelessness
- Suicidal statements
- Engaging in risky behavior
- Obtaining a weapon or other means of self-harm
- Being preoccupied with death
- Distress about gender identity or sexuality
- Being devastated by a relationship problem or breakup
- Feeling hopeless about a financial or work situation
- Seeming overwhelmed after giving childbirth or talking about harming the baby
- Giving away cherished possessions
If a family member or friend notices these behaviors, what should they do?
If family and friends notice changes in behavior or mood, they should ask their loved one how they’re doing; specifically if there are any communications about suicide or statements about death. These statements should be responded to in the same way that a person would respond if a loved one was choking or having chest pain. Get that person help – call their doctor, go to the emergency center, call the police, or the National Suicide Prevention Lifeline: 1-800-273-TALK (8255).
Death by suicide still carries a lot of stigma. Should people be afraid to bring up the word if they are concerned?
Never underestimate the power of just showing up or reaching out to someone who is suffering. It’s okay to ask someone if they are having suicidal thoughts. You are not going to give them the idea and, if the answer is yes, you will have the opportunity to understand their thoughts and feelings and possibly intervene.
Just try to avoid giving too much advice or to minimize the feelings of depression or suicidal thoughts. You could leave your loved one feeling that you really don’t understand, even if that is the opposite of what you are trying to achieve.
Depression can be a deep, dark, place. Depression lies to the sufferer and convinces them that this will never pass and that they are a burden to those around them. The anguish can be all-consuming.
What if the person I’m trying to help doesn’t want help?
If a person refuses to get help, a family member can call the suicide prevention lifeline or call 911. However, the bottom line is the family should do something. Another important aspect of getting help is for loved ones to educate themselves about mental illness and suicide. Organizations like National Alliance on Mental Illness (NAMI) offer courses targeted to educate and support loved ones of those suffering with mental illness and thoughts of suicide.
Once the person is getting help for their depression, is there more that family and friends can do to help?
There are many things loved ones can do. If a patient is in treatment, family and friends should be aware of the type of treatment their loved one is receiving and the name of the doctor and other providers. They should be encouraging their loved one to follow up with the treatment whether it be medication and/or therapy.
Help them make it easy to get to appointments. Offer to drive them to the appointment, sit with them while they call for an appointment. Help loved ones develop a personal crisis plan that is a written document that can be referred to at a time of crisis. These can be found online and there are multiple apps for this. Just search the internet for “Wellness Recovery Action Plan.”
What services does Cape Cod Healthcare offer to those in mental crisis?
Cape Cod Healthcare has significantly expanded our psychiatric services over the past four years. We have developed teams to assist in psychiatric care wherever the patient may be in our healthcare system. We have a robust team of psychiatric providers in our Emergency Centers at both Cape Cod Hospital and Falmouth Hospital. Our inpatient psychiatric unit serves patients who are most acute. Our Partial Hospital Program serves patients who are requiring more intensive psychiatric services but who are not in need of inpatient level of care.
We also have two outpatient psychiatric clinics located in Hyannis and Harwich where we serve patients throughout the lifespan who are in need of psychiatric care. These clinics offer psychotherapy and medication management. With the assistance of our Physician Hospital Organization we are expanding our behavioral health case management services for patients in need of psychiatric care extending into the community. We work closely with psychiatric visiting nurse services as well. We employ peer navigators to assist in connecting people to the care that they need even after they have left our hospital.
We are also actively partnering with our local police to ensure excellent care for our community members who are in psychiatric crisis. Through the development of a workgroup, CCHC and police are building bridges and facilitating pathways to safely address the needs of the community when there is a mental health crisis.
What are some other resources people can turn to for help?
What can be done at the community level to help?
Cape Cod Healthcare is partnering with multiple local healthcare providers and community organizations to aggressively address suicide prevention on Cape Cod and the Islands. We partnered with the Department of Mental Health and the Department of Public Health Suicide Prevention Program and applied for and received a National Strategy for Suicide Prevention Grant from the Substance Abuse Mental Health Services Administration (SAMHSA).
The main purpose of the grant is to address gaps in the system for people who are at risk for suicide. One aspect of this is to raise public awareness to help people who are at risk access the resources that exist. Another aim of the grant is to provide specialized support for people who are transitioning from hospital-based care back into the community. Crucial to this is also support for their families.
The Cape Cod and Islands Coalition for Suicide Prevention sponsors training for friends and family members on how to talk to someone for whom they are concerned. The goal is to assist in motivating the patient to seek help.
What if I have done everything I can and the outcome is still devastating? How do I cope with my feelings of loss and responsibility?
It is so important that we try to help our loved one find a way out of their pain in a manner that doesn’t include suicide, but we also have to understand that if they eventually complete suicide, it is not because our love and our efforts somehow failed or were not enough. The guilt that family members and friends are left with after a completed suicide can be profound. This is an important time to seek support. It is not your fault. The Samaritans of Cape Cod and the Islands has support groups for suicide attempt survivors, for family members of suicide attempt survivors, as well as survivors of suicide loss.