PREVENTING THE TRAGEDY OF SUICIDE
An Op-Ed Column by Jason Eberhart-Phillips, MD
Kansas State Health Officer
September 29, 2010
I will never forget the deep sense of shock I felt when I heard that my sister-in-law had stepped in front of a high-speed train in order to kill herself.
This attractive young woman seemed to have everything to live for. She was a kind and loving wife, and was a talented artist. Beyond this, she was someone who was always quick with a smile and open to others with her big, caring heart.
My sister-in-law was the last person I would have considered to be at risk for suicide.
Now, several years later, the stigma and the pervasive sense of shame around her horrific death still lingers. But today I am not nearly so ignorant about the thoughts and feelings that might lead a loved one toward lethal self-injury.
I now recognize what an enormous – and potentially preventable – public health problem suicide is. Consider these facts:
• On average, one person in Kansas commits suicide every day. For each successful attempt, there are about 20 others who wind up in the hospital with self-inflicted injuries.
• Suicide is most common in middle-aged and older adults, but suicide attempts peak in Kansas in persons 15 to 19 years of age. Males are 4.6 times more likely to die of suicide than females, and Non-Hispanic whites are more than twice as likely to die of suicide than are Non-Hispanic blacks or Hispanics of any race.
• Since the 1950s, suicide rates among adolescents and young adults have tripled. More teenagers and young adults die today from suicide than from cancer, heart disease, AIDS, pneumonia and influenza combined.
• Suicide is now the 11th leading cause of death in Kansas, and our state’s rate of suicide is 13 percent higher than the national average.
What leads some people to kill themselves?
More than 90 percent of people who die from suicide have either a serious mental health disorder, such as major depression, or problems with substance abuse, particularly with alcohol. Many have both of these risk factors, but some have neither. In my sister-in-law’s case it was major depression, which I was unaware of.
Against a background of elevated risk, one’s feelings of purposelessness, hopelessness and isolation can give rise to thoughts that death is preferable to life as it is now being lived. Many who attempt suicide sincerely believe that they have become such a burden to others that it would be better for everyone if they were dead.
Fortunately, most people who feel this way never act upon such thoughts. But a few, particularly those who have suffered trauma or abuse in the past, or have repeatedly witnessed violence, or have already attempted suicide themselves, can overcome their innate resistance to self-harm and become dreadfully capable of taking their own lives.
In these individuals, a suicide attempt will often follow on the heels of a triggering event, such as a broken relationship, a financial loss or a sudden decline in health. Accessibility of firearms, pills or other lethal means will then heighten the risk further.
What can be done to reduce the risk of suicide?
First, we can all learn the signs of acute suicide risk. Does your family member, coworker, neighbor or friend exhibit signs of lost hope, social withdrawal, agitation, or worsening substance abuse? Are they talking about suicide or seeking lethal means? Pay particular attention if they have suffered from a triggering event recently.
If you see any of these signs, or suspect them, ask the person in a non-judgmental way if she or he is thinking about suicide. Don’t worry that bringing up the topic of suicide will plant the idea in the person’s mind.
Just ask and listen for the reply. You could well be saving a life if you do.
If it turns out that the answer is yes, see that the person gets immediate help from their physician, mental health professional, or from the National Suicide Prevention Hotline, available 24 hours a day at 1-800-273-TALK (8255). And stay with them until they are safe.
In the long-term, we can prevent more suicides in Kansas by addressing many of the root causes of self-harm. We can build resilience in people at risk, by ensuring that they can access mental health and substance abuse treatment services, and by making sure that their primary care providers have the best training in recognizing suicide risk.
We can also do more to strengthen our connectedness as people, countering the isolation and self-doubt that commonly plagues people who are contemplating suicide. That means greater investment in social capital, whether it’s in civic organizations, faith communities or informal clubs and networks.
Our greatest protection against suicide is a caring community. I wish my sister-in-law had felt that care in time.
Dr. Eberhart-Phillips is the Kansas State Health Officer and Director of Health in the Kansas Department of Health and Environment. He can be reached at firstname.lastname@example.org. Go to his blog at: www.kdheks.gov/blogs/dr_jasons_blogs.htm.