Spotlight on Suicide Prevention

Mental Health America of Licking County is continually examining new methods to promote our goals of education, advocacy, intervention and prevention.  In the spirit of furthering the mission of MHALC,  we will be spotlighting the programs and support groups associated with this agency.  It is through these programs that we strive to integrate physical health with mental health by proclaiming, “There is no health without mental health”.  This month’s spotlight is on Suicide Prevention. 

The Suicide Prevention Progam at MHALC is a program that focuses on nurturing the mental health of the youth in Licking County through activities like Share the Love, which is featured on the agency's website, http://mhalc.org.  This will be an evening of encouragement and outreach.  Students are invited to bring their electronic devices in order to reach out to friends and family to let them know they are loved.  Through this activity, we hope to provide inspiration to others and to also teach students the value of caring for their community.  Share the Love is an excellent approach to creating awareness in a positive and compassionate manner. 

But, Share the Love is only one of the many  functions of the Suicide Prevention Program.  Justina Wade, Program Coordinator for Suicide Prevention, travels to schools in Licking County daily. Justina is happy to say that, as of this year, Suicide Prevention has reached 90% of the schools in Licking County.  Throughout the month of January, Justina organized depression screenings in Licking County high schools. The goal of these screenings is to empower students to seek the help they need and to reduce the number of suicide deaths.   15% of the students screened indicated they would like to talk to someone about mental health issues and all were referred to guidance counselors.  35% of the students were red-flagged for depression during these screenings and were immediately evaluated by a mental health professional.  Within this group, many admitted to contemplating or even attempting suicide.  Many times, these screenings offer students an opportunity to talk about issues they find difficult to talk about at home.       

In addition to many school activities, Suicide Prevention at MHALC is also part of the Licking County Suicide Prevention Coalition.  This Coalition was established in 2002 with the mission to reduce the number of deaths by suicide in Licking County and to increase willingness to seek help. The Coalition is made up of private citizens, staff of various social services and mental health organizations, a deputy coroner, and school staff.  This coalition meets once each month to discuss the suicide statistics in Licking County.  A large portion of this meeting is spent discussing better ways to educate and create awareness in this community.

Another educational component of Suicide Prevention that Justina coordinates is the Gatekeeper Training Program.  This training program is provided to businesses, individuals or agencies that deal with people on a regular basis.  Based on research, this training helps individuals understand the signs of suicide and the proper way to proceed in getting help to the person in crisis.  MHALC also partners with Mental Health & Recovery for Licking and Knox Counties to offer Mental Health First Aid. This is another specialized training course designed to develop skills for an individual experiencing a mental health crisis. Please visit the MHALC website for more information on these training programs.     

According to MHALC’s statistics, Licking County has an average of 14.5 suicides per 100,000 people, which is higher that the national average of 13 per 100,000.  The time has come for this community to become more aware and concerned about those who are struggling with mental illnesses. Individuals who are suffering must be encouraged to seek treatment.  As a community, we need to take steps to eradicate the stigma attached to mental illness.  In the words of  Penny Sitler, the Executive Director of MHALC, “Stigma often causes people to hide their illness or the fact that a family member is dealing with mental health issues because they’re embarrassed or afraid of how they will be treated.”  We must be equally concerned with the mental health of our children, as the screenings performed in the schools have shown us, they are struggling as well.  It is time to understand the need to integrate physical health and mental health, because we simply cannot continue to nurture one and neglect the other.  Programs like Suicide Prevention are critical for our community, but we need to be willing to do our part.  Mental Health America of Licking County urges local individuals, organizations, and businesses to participate in the training offered by this agency.

For more information, or for information on how to get plugged into this program, visit the MHALC website at  http://mhalc.org.  Justina and all of the staff members at MHALC are available Monday through Friday from 8:00 until 5:00 to answer any questions regarding these important issues at (740) 522-1341.    

Jill Goddard

Development/Program Manager

Mental Health America of Licking County

jgoddard@mhalc.org

(740) 788-0301

Justina Wade

Suicide Prevention Coordinator

Mental Health America of Licking County

suicideprevention@mhalc.org

(740) 788-0353

Losing

Last week, I came across this video post...

It's hard to watch because it feels very honest and direct.

As adults, we are caught off-guard.  It challenges our ideals of what childhood should be like knowing full well that, at the same age, we all kept secrets and pretended to be somebody who only really existed in family snapshots. 

To watch this is to have unfocused outrage.  Tillie has experienced things that no child should experience, even though to be an adult is to experience everyone of them in some form or other.

We want to help, to reach through the little YouTube window and try in some way to make it better even though we would, at best, only be delaying the inevitable disappointments of adulthood.

The real message of this video is not in the incidents of her life--shocking though they may be--but in how she has chosen to respond.  The take-away is that, after all that has happened to her, she is still accepting, still willing to listen, still thinks that everybody, no matter who they are, is "beautiful."

* * *

One of my jobs is to keep the Agency's Facebook pages supplied with new material.  To do that, I look at lots of blog posts, news stories and videos from all over the world.  Lately, there has been a whole lot of material relating to teen suicide.

It doesn't seem to matter whether the suicide happened in the developing world, the developed world, across the street or across the country, it was remarkable to me how similar the stories are one to another.

The players in each of these dramas have experienced loss, or have been threatened with loss; have been shamed, or believe they have brought shame to their families.

One story that has produced a number of different articles concerns a murder-suicide in Mississauga, Ontario near Toronto.  A 16 year-old male jumped from an overpass onto a busy expressway just prior to the discovery of the body of his 17 year-old female friend.  The young man survived the fall and being struck by at least one car only to succumb to his injuries a week later.

In the days since this double tragedy, it has come out that the male and female were friends, but that the male wanted more of a romantic relationship and the female did not share the same feelings.

The impact of this story and others like it on adults is generally one of shock and surprise.  We can't seem to understand why the young man would take the life of his friend and then try to kill himself.  Surely, this was just a case of unrequited puppy love.  What's the big deal?  Right?

The arc of childhood development is the evolution of empathy.  As infants we are completely self-obsessed and, hopefully, before we are turned loose on the world, we have some sense that others may have equally, if not more, compelling needs and desires than our own.

Researchers are now telling us that the brain is not fully developed until the mid-twenties.  Seen in that context, the challenges of navigating high school and relationships--romantic and otherwise--seem much more perilous.  As adults, we think we are lucky when we find the love of our life, but, as teenagers, every relationship is the love of your life.

I remember the last day of elementary school very clearly. 

It was a bright late June day and I was walking home from school crying.

I was absolutely inconsolable because I was never going to see Jane again.

This WAS a big deal.  For most of the previous 7 years, Jane had been part of my life.  She, along with the Wood sisters, was one of the three who were perpetually ahead of me in terms of grades. 

It's not like she and I were friends, but now that school was over, we never would be.  She and her family were moving to Ottawa and I wasn't.

I think I can still find the park bench that I collapsed on and where I spent what seemed like an eternity sobbing.

I was learning about loss. 

And it was more than the loss of a pet, or a cherished toy, or even a beloved relative:  this was the loss of an idea.  A secret vision of a theoretical future that was so special that I had dared not speak of it to anyone.  In fact, I don't think I really understood how I felt about Jane until I realized that I would never see her again and even that wasn't really real until after I had seen her for the last time.

But when I did, it hurt a LOT.

Everyone has had an experience like mine; one where you figure out what you want and then learn that not only can you not have it now, you won't ever have it.  The kind of want that so easily gets mistaken for need.  The kind of want that makes your heart race and your chest feel tight and your breath seem hard to catch.  The kind of want that makes an 11 year-old kid think that he could take a 90-minute bus ride to Ottawa despite having no earthly idea where to find Jane and a sneaking suspicion that she wouldn't exactly be happy to see me if I showed up.

Everybody has been that way about something, or somebody and so, no matter how hard we might wish to deny it, we all have a way back to understanding what it is, and how it is, that our teenagers are thinking. 

We can make that journey--make that connection--if we want to.

But, paradoxically, to be a teenager is to be in a rush to be an adult and we learn from our parents that teenage thinking is not nearly as important as adult thinking.  Teenagers are encouraged to "grow up" and to "get serious" even while their brains are still changing and their passions are so monumental because they are so new.

After the constant upheaval of being a teenager, what is desired is to have "adult passions" that are properly sized, proportional, manageable.

It is only after having been an adult for a while that you recognize the trade off that has been made and the space that has been emptied of outsized passions and filled with many too-small and far too trivial sentiments.

* * *

I try to take my dog for a walk every night after work.  I should be better about doing this considering all of the things he continues to teach me.

We have two or three routes that we take on a rotating basis.  A couple are pretty short and one is so long that he is dragging his tail before we are two-thirds done.  I try to mix them up just to keep it interesting for him--go a different route every day--but what I have come to understand is that it really doesn't matter.  We could walk the same route every day and it would be the same treat for him.  The choice to change up routes is one that I am really making for myself.  As far as the dog is concerned, so long as he is out walking, he's happy.  I might not be able to tell, but every tree--even though it was in exactly the same spot yesterday--is a new discovery, a chance to catch up on current events.

I have to keep reminding myself of this.

I watch him engage with his world from the other end of the lead.  I have to correct myself, stop myself from getting impatient as he makes his tree-by-tree, post-by-post inventory of the neighborhood.  I catch myself thinking how could he possibly be interested in smelling the same dried smells that he smelled the day before.  To him, they are of course fascinating and nuanced because he receives a lot of his information about the world through his nose.  I get much of my information about the world through my head.  I associate new information with old information, I see, or perceive, patterns based on experience.  As I get older, it takes less and less input to create new, fully formed impressions of the world.  My dog gets up every day thinking that it is the best day ever.

* * *

I'm much older now.  In theory, I could go to Ottawa any time I wanted. 

In theory.

I want to be absolutely clear. I have no interest in tracking down Jane, or anybody else.  I'm married and have a dog.  (We have a cat too, but we're never sure he's made up his mind to stay with us.)

In theory I could do a lot of things, but the other lesson you learn as an adult is that every choice has a consequence, every decision to move toward something is to move away from something else.  And choice by choice, day after day, the once seemingly endless possibilities of your future become the responsibilities of your present. 

Instead of treating each new opportunity as a sensation to be experienced, it become an obstacle over which it becomes harder to see from where you have come and that blocks your path to the future.

Tillie, for all the growing up she has already done, has not yet done so much that she can't see her future.

We all know a Tillie, probably more than we realize.  Get to know their stories.  Listen without judging.  Acknowledge them.  If you're feeling brave enough, tell them what scares you.  The life you save, just might be your own.

--Graham Campbell
Associate Director

Fakery

The news this morning is very different than the news last night.

A little more than 12 hours ago, all we heard about was a 6 year-old boy who may, or may not, have become trapped in a homemade weather balloon that was drifting through the skies of Colorado.

This morning, there is much speculation that the whole thing may have been a stunt designed to land the boy and his family a reality show.

Yesterday, there was concern that the boy might, at any moment, plummet to the ground at the end of a long silver streamer.

This morning, there is debate around who should be held accountable and pay for the cost of scrambling the Air Force.

Compassion is a precious commodity and becoming more so in our increasingly cynical age. It's a natural resource in humans and, like other natural resources, it is finite in supply. The body can make more blood, but compassion once invested can never be replaced.

Since yesterday's incident, it has come to light that balloon boy's family had been on "Wife Swap" a reality show where two very different families trade their matriarchs for the benefit of the TV audience.

Armed with this piece of information, radio talk show hosts are this morning parsing a comment made by the boy in an on-camera interview last night. He is alleged to have said that he "did it for the show."

Whether it was for the TV show that they supposedly want, or for the "show" of all the first responders, including the United States Air Force, trying to safely resolve a potentially high-risk situation has not been made clear and will doubtless keep many a radio host's phone lines lit for the rest of the day.

But now that that conversation is out there, now that the public's reflexive compassion has been challenged, deflated by the prospect of some ulterior motive, it will only serve to make it that much harder to feel compassionate the next child at risk.

Asking people for support--whether emotional, or even financial--is a trust-based transaction. People call us looking for help every day, but they can only do that once they have accepted that we will not take advantage of their vulnerability. Even in today's warts-and-all culture, it takes a lot for people to disclose that they are experiencing a mental illness, or have a family member who is.

Usually, when they call us it's because they want to speak to Paddy. After 28 years she has a proven track record of being a compassionate and discrete advocate. When Paddy is out of the office, or otherwise unavailable, it is often harder, or even impossible, for them to work with any of our other staff. The callers don't know us and are not yet sure that they can trust us. We have to earn that trust.

Doing this work takes money and a good portion of the money that comes to us as personal donations is in recognition of Paddy's service to the donor, or the donor's family. If, for any reason, those donors questioned her discretion, that money would evaporate.

And it's not just stigma issues relating to mental health that can compromise our compassion. People donate money based on emotion and when those feelings are called into question, then barriers are go up. 17 years ago, the president of the national United Way resigned over a misuse of funds scandal that still influences donors. Locally, we hear almost annually about how there are donors who won't support the Red Cross because they charged for donuts during World War II.

Once stories like that get out there, they impact donations to all organizations. Donors who, for whatever reason, have invested their compassion in a cause, or a news story, or even another person and later learn that that decision was unwise, or worse, foolish, think twice about making their next investment.

Nobody likes to get played.

I have a family member who has, on more than one occasion, disclosed that he has attempted suicide.

His disclosures were, by definition, always in the past tense and generally took the form of "You know, last winter, I went into the woods to kill myself." (I didn't know that he had been planning any of these attempts and was grateful that, for whatever reason, he had not been successful.)

I have neither the credentials nor the skill to attempt to analyze his motives, but earlier this fall, he called me and I noted that his tense had shifted from the past to the future. He was talking about "getting out of town" and how he "couldn't take it anymore." He engaged in what is described as "settling of accounts," saying good-bye in one form or another.

I spoke with his mother and she was concerned that she could not get in touch with him and that he had been talking about suicide.

I called his cell phone and got his voice mail. I don't remember what I said exactly, but my intent was to get him to come back from "the woods."

A little while later he called me and in the course of our conversation indicated that he had taken something--he kept asking if his speech was clear. He said several times that he could not take the "ostracization" from the rest of the family. He felt isolated and alone. He also indicated his approximate location by saying that he couldn't talk anymore because he was losing cell service.

I called the police. I believed that he had taken an overdose and was on the verge of passing out.

After a lengthy interview with the police, they took his cell phone number and called it in an effort to determine his location.

Sometime later, my family member called me and said "if that's you're game, I'm one step ahead of you."

He had talked to the police and assured them that he was not near death and nowhere near where he indicated to me that he was.

I cannot condense my relationship with my family member with any skill and ably convey its complexity and accumulated failures over the course of 5 decades. I know I did not always behave as I should have, nor did I respond to every request for help. I do however feel that I had always demonstrated my compassion and this incident was the last straw.

He tried to call back several times later that day, but I would not take his calls. I have nothing left to give to him. What I had had, he took advantage of.

Trading on the compassion of others has real consequences both for those involved in the transaction as well as others. I will not be so fast to respond to his threat of suicide, or other cry for help. He has proven himself to be one who does it "for the show."

There are many sad aspects to his story, but using the currency of suicide to get attention diminishes the impact of authentic attempts. It's like crying wolf, or telling the authorities that your child is trapped in a silver weather balloon.

Nobody likes to get played.

--Graham Campbell
Associate Director

Responding After Suicide

Paddy Kutz, Executive Director, Mental Health America of Licking County

For all the talk about it, suicide is still a fairly rare event, but if you lost someone to suicide, there are some things you need to know.

• Most people won’t ever know anyone who ended his or her own life, so most people don’t think about it very much. Most people don’t have to.
• Most people have never thought about what it is like to “survive” the death of a loved one, relative, friend or co-worker.
• If you are like most people, you probably didn’t think that much about it either, so it’s little wonder that you may be confused and uncertain about what to do should you experience a suicide. You may wonder:

What to say to others?

What to expect as you grieve?

What to expect from others who are also grieving?

How to explain this to someone else?

How to explain this to yourself?

Why did this happen?

etc. etc. etc.

There will be a mixture of sadness, bewilderment, and uncertainty and lots of questions and concerns.

Unfortunately, most people don’t know this and there aren’t any easy solutions to the difficult situations a death by suicide presents. Sometimes there aren’t any answers for the questions raised.

• “Why didn’t I see any warning signs?” They may not be easy to spot. Many signs such as changes in behavior, may develop slowly – if at all. People who are planning a suicide may hide their feelings and plans from others.
• “How could he or she have done it?” It is natural to feel angry and resentful toward the person who died. Acknowledging these feelings can be an important part of the healthy process.
• “Was it my fault?” You may feel guilty or wonder if you could have done more to help the person. Or you might worry that you somehow caused the person to choose suicide. Remember, it is NOT your fault.

Understanding Your Feelings

A person grieving after a suicide often experiences:

• Shock and denial – at first, you may feel emotionally numb or have a hard time believing the person is truly gone. You may even try to deny the cause of death.
• Anger – you may feel angry with yourself and others for not being able to “save” the person. You may also feel angry with the person who died by suicide.
• Guilt – it’s common for suicide survivors to blame themselves for things they did or didn’t do. But remember, you couldn’t know what would happen.
• Shame – you may worry that others will criticize you or judge you harshly.
• Loneliness and fear – as initial feelings of shock wear off, you must begin to face the finality of your loss. You may feel insecure and afraid to face the future.
• Hopelessness and sadness – feelings of hopelessness and sadness may seem overwhelming. You may wonder if you’ll ever feel joy and pleasure again. Watch out for depression setting in. Grieving is natural, but depression is a treatable illness, which you must deal with appropriately. Get help!
• Acceptance and hope – with time you will learn to accept your loss and feel hopeful again.

Your feelings may surprise you, but they are a natural part of the grieving process. Most people feel strong emotions when they lose someone and the shock of a death by suicide may cause even more intense feelings. Trying to hide or ignore your feelings won’t make them go away. It may take time, but you can learn to copy with these intense, and sometimes confusing, feelings.

“Why suicide? There is no single cause. Generally, the answer is that the person felt trapped by what they saw as a hopeless situation, worthlessness, they felt isolated and cut off from life. They felt intense pain and anguish. They probably weren’t choosing death as much as choosing to end the unbearable pain, whether from problems and losses or from the symptoms of a mental illness or both.

Mental Health America of Licking County has a Survivors After Suicide support group. It is free and can be so helpful in the healing process. The group meets at our office at the rear of 65 Messimer Drive the third Tuesday of the month at 7 pm. We have many suggestions on how to handle these difficult situations. You can call us at 740-522-1341 or email at mhalc@alink.com. Our website is www.mhalc.org for information and resources as well.

Three Noses

When I first applied for the position as Suicide Prevention Coordinator, I told several of my close acquaintances. When I got the interview, I told more people about the job. Since my first day on the job, I have told even more people about my job.

Nearly every time I tell someone that I am the Suicide Prevention Coordinator at Mental Health America of Licking County, I am given either strange or sympathetic looks. (Thankfully, I do get the occasional look of admiration, along with the comment that I am doing very tough work.) At first, I understood why people I knew gave me the looks of sympathy or fear. Suicide is one of the last taboos in America. We can freely talk about sex, pedophilia, homosexuality, HIV/AIDS, and abortion. But mention suicide, and people take several steps back, like you’ve just grown a second nose.

This is why I have a job. Since people don’t talk to their friends, parents, children, and so on about suicide, not many people know the truth about it. Unfortunately, this also means that the rate of suicide in America is still alarmingly high. Most of the completed suicides stem from mental illness, most often depression. Depression is a treatable brain disorder (another word for mental illness). Logically, this means that suicide is preventable if depression is caught early enough. Having just attended Gatekeeper training with the Ohio Suicide Prevention Foundation, I would like to impart some of my knowledge about how to prevent suicide to you.

When we encounter stressful or threatening situations in our lives, our brain (three pounds of protoplasm housed in our skulls) helps protect us. With the way the economy and politics are going, more Americans will be facing stressful and threatening situations in their lives. Our brain, or more specifically, our amygdala, releases three different hormones that are related to fight-or-flight. We become equipped to either stand up for ourselves (fight) or escape the danger (flight).

• Testosterone is what gives us strength in our muscles to either fight or run away.



• Epinephrine (also known as adrenaline) moves blood flow from body functions that are not necessary for the fight-or-flight response, like digestion, to our muscles and brain.



• Cortisol soothes the body after fight or flight has taken place. (Ever used hydroCORTISONE cream to make swelling go away?)

There is only one problem. These days, none of us are chased by saber-toothed tigers or giant wooly mammoths; instead, we sit at our desks or on our couches, and when stressful or threatening situations occur, we don’t use up the testosterone, epinephrine or cortisol that are released into our system. As beneficial as these hormones are to our body, too much of them in our system destroy little things in our brains called neurons. Most often, the neurons in the part of our brain that stores short-term memory, mood and emotions, the hippocampus, are affected. The breaking down of the neurons that determine our emotions and moods causes people to become depressed.

Like I mentioned earlier, 90% of people who die by suicide suffer from some form of brain disorder (mental illness), mostly depression. Depression, like other mental illnesses (thanks, Kristen!), is highly treatable with medications and therapy. If we begin to screen everyone for depression, we can catch it, treat it, and prevent suicides.

I do hope that one day, I work myself out of a job, but there is much work to be done until then.

Oh yeah, and exercise as much as you can, and you can help save your neurons from destruction!

--Brittany Schumann

Suicide Prevention Coordinator