By Andrew Sassani, M.D.
If you or someone you know is experiencing a mental health, suicide or substance use crisis or emotional distress, reach out 24/7 to the 988 Suicide and Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) by dialing or texting 988 or using chat services at suicidepreventionlifeline.org to connect to a trained crisis counselor. You can also get crisis text support via the Crisis Text Line by texting NAMI to 741741.
If you are reading this, you likely know that suicide is often a product of incomprehensible pain, and results in the heavy grief that suicide loss leaves in its wake.
As behavioral health professionals, concerned family members and friends, we know even the most radiant individuals have attempted and died by suicide. Where others see statistics, we recall faces and names.
This National Suicide Prevention Awareness Month, it is important that we assess the state of suicide and take a few moments to remind ourselves of the basic, and sometimes overlooked, steps we can take to help those at risk of suicide.
In June of 2020, researchers at the Centers for Disease Control and Prevention (CDC) found that about twice as many people reported having serious thoughts of suicide than they did prior to the pandemic. Although the pandemic did not lead to the dramatic increase in completed suicides as some had predicted, rates remain high. The most recent full-year statistics, for 2020, found that 45,979 people died of suicide.
The CDC also found that suicide was the second leading cause of death among people ages 10-14 and 25-34. Research also found that some 1.2 million Americans attempted suicide and rates of suicide are highest among American Indian/Alaska Natives and people over the age of 85.
The pandemic created more stressors to mental health issues, adding to an already strained mental health crisis. Multiple issues continue to fuel it, among them young peoples’ social media-influenced feelings of inadequacy, increasing rates of substance abuse, financial stress caused by inflation and an increasingly divisive political landscape.
It is fitting that September is also National Recovery Month. In 2020, 40.3 million people in the U.S. over the age of 12 had a substance use disorder in the past year. Our national substance abuse crisis continues to dramatically impact suicide rates today.
The demand for mental health services continues to outpace available resources. Many mental health providers who transitioned to Telebehavioral health during the pandemic do not wish to go back in-office. The rents and general costs of maintaining an office have gone up, and many providers would rather not have those expenses. Although these providers are still available via Telebehavioral health, members may face a shortage if they prefer to see a provider in person.
While there are disparities among different populations, many still experience stigma surrounding mental health and suicidal ideation. However, we’re seeing some progress, particularly among younger generations that increasingly see the value and need for mental health-oriented care. The rollout of the 988 Suicide and Crisis Lifeline also reflects a dramatic shift in public attitudes towards suicide prevention and is a significant victory.
Given the state of suicide, how can we, as behavioral health professionals, concerned family members and friends help prevent suicide? The first step is to revisit the basics:
Successful public health efforts incorporate public advocacy and learning. We must continue to advocate for depression and suicidal ideation screening in every primary care visit. Just as importantly, education is crucial. This includes helping family members and friends have easy access to informational resources they can use to help those in mental distress.
Indifference, prolonged sadness and a sudden desire to give away prized possessions, are just a few of the signs to watch for. Individuals who are experiencing a crisis, like the death of a loved one, the end of a relationship, the loss of a job or a significant financial loss are also at increased risk of depression and by extension possibly suicidal ideation.
Don’t be afraid to ask someone how they feel, if something is wrong or share with them that you have noticed they are not their usual self. Then listen without judgment.
Those contemplating suicide may hesitate to get help on their own, but you can help by offering to accompany them to visit a provider, to stay with them while phoning the 988 Suicide and Crisis Lifeline or even call 988 yourself to get help for someone else who is in crisis. Never underestimate the value of your presence when a loved one needs support.
Andrew Sassani, MD is a vice president at Magellan, and its chief medical officer for behavioral health in California.
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