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Suicide—undiscussed, unacknowledged, uncomfortable.

It is a reality that has touched the lives of many people. Sadly, it is not uncommon that the topic still hides in the dark, often due to the stigma of shame, embarrassment or guilt.

The stigma surrounding suicidal thoughts and mental illness as a whole isn’t helping anyone get the assistance that they need. Thankfully, in recent years, there are signs that things may be changing.

In 2020, almost 46,000 people died by suicide throughout the nation, ending up as the 12th leading cause of death. An awful number, yet smaller than it was in 2019, and smaller yet than the numbers in 2018 — a two year decline.

How can communities encourage the downward trend and continue to reduce the number of suicides every year, advocate for mental health and be a part of suicide prevention?

To start, it’s important to recognize the signs that might mean someone is struggling or reaching out for help.

If someone is making direct or indirect verbal statements such as, “I’m thinking of ending it,” or “I wish I were gone,” or speaking with hopelessness or using hopeless statements, Trevor Undseth, region program manager for Lakeland Mental Health Center’s (LMHC) suicide prevention program, recommends taking signs seriously.

Other risk factors that may be clues that someone is thinking of ending their life are previous suicide attempts, a recent purchase of a firearm, giving away prized possessions, drug and alcohol abuse or unexplained aggression or irritability.

There are also some situational cues to be aware of: the death of a loved one, the ending of a relationship through a breakup or divorce, disruption of social life such as getting expelled or moving, legal issues and financial issues.

If these signs are present, it may be time to be there for that person and show some support. One of the most important things to do is to simply ask the person if they are considering suicide.

“Certainly, if you yourself are worried that someone is thinking about (suicide), then chances are they probably have (considered it),” said Undseth. “Asking somebody about suicide does not increase their risk of dying by suicide.”

“Be direct,” said Del Nasri, crisis services supervisor for the mobile mental health crisis response team for LMHC. “Sometimes we can be afraid to ask those questions.” But, he said that being direct and asking is a way to lead someone toward getting the help they need.

Undseth and Nasri both stressed that it’s important not to confront the person in an aggressive way, but to show compassion and a willingness to listen. They people encouraged not to react with judgment. Undseth also recommended asking someone in a one-on-one, private setting, and suggested leaving time so one will be able to listen and talk for a while, if needed. He also recommended having a number handy in order to get the individual connected to the help they need.

If one feels uncomfortable asking a struggling person about suicide, Nasri and Undseth suggest finding someone who will ask the question.

Allison Shaikoski, nurse manager at Bridgeway Care Unit and Clinic Psychiatric Services explained that having open and honest communication with family, friends and loved ones is extremely helpful in nurturing good mental health and preventing suicide. “Make it known that you are supportive of each individual’s needs and that they can feel free to come to you with their thoughts without fear of judgment,” she explained. “Many patients that we see admitted following a suicide attempt or voicing suicidal thoughts have family members or friends often say ‘I had no idea you were feeling this way.’”

Those feelings and those thoughts may be more common than people realise.

“About 1 in 4 adults and 1 in 10 children are affected with mental illness,” shared Undseth. “Depression is a somewhat common mental illness and is more than just feeling sad. Untreated depression can lead to thoughts of wishing to be dead, but most do not want to die or go on to seriously attempt suicide. The vast majority of people want to live, and may just need encouragement to get help.”

Cory Solberg, a recent suicide survivor, spoke about the importance of seeking help, making the point that mental health care is health care. “I like to say if you break your arm, you’re going to the doctor. You wouldn’t try to treat yourself and fix yourself,” he shared. “But, since we can’t see (the brain) physically, people think they’ll get over it, that they’re just going to get through it, stuff like that. But a lot of people don’t. And that’s why I think talking is so important.”

Solberg, a teacher at Perham High School, described his job as the best job in the world and his family as the best family in the world — he described everything as fantastic. But, after a cancer diagnosis, his mental health went into a steep decline. “When I say this can happen to anybody … this can happen to anybody.”

He was diagnosed with cancer in the spring of 2020, and schools went to distance learning shortly after. Solberg described his first set of treatments as “easy” and “smooth;” because he was teaching remotely, he kept his cancer diagnosis mostly a secret.

However, his second round of treatment wasn’t the same. “This round of treatment was way different… it felt different in my body. It was like heating up,” he explained. “Everything was awful.” He felt like he was burning.

Despite his pain, both physically and emotionally, he went back to teaching in person. “I felt awful, and I was still trying to hide it by still going to school,” he explained. “I can’t believe when I look back that I would have a treatment on Monday and I would go back to school on Tuesday. I shouldn’t have been doing that, just for my own sanity.”

He remembered that at that time he started to isolate himself from others more than usual. “I didn’t really tell anybody that I wasn’t feeling great,” he said. “And it really started to feel like cancer had won — like cancer had beat me.”

He described how his mental health experienced a steep, quick drop. “It really felt like I was done. Whatever I had done, whatever I was doing wasn’t going to work and that I couldn’t win this fight,” he said. “So, the only thing that I could control was when I was going to be done.”

He recalled how close he was to showing his wife his goodbye email the night before he attempted suicide, noting that telling her how he was feeling would have changed his life. But, he didn’t.

Now, he talks about his experience openly, hoping to help others. He is also working on his mental health through regular meetings with a therapist. “The best part of doing some of this recovery stuff is talking about it,” explained Solberg. “I really wish that I had probably talked with somebody professionally, because for me, right now, that’s one of the best parts of (recovery).”

Solberg recognizes that there is a stigma attached to suicide as well as mental heath more generally, but he sees hope when he looks at younger generations. “I think it’s a generational thing a little bit,” he said, noting that unfortunately, some older generations think people are “crazy” or “weak.” He shared that he felt ashamed or embarrassed too, thinking that something was wrong with him. “But, through talking with people, my thoughts about how I was feeling, my thoughts about cancer and depression — all that stuff is normal. I unfortunately tried to carry it out. That’s not the normal part. But everything else is everyday thoughts that a lot of people have … Everybody is fighting something. I do not know what. I don’t know to what degree; but, everybody is fighting something.”

Undseth voiced a similar thought, “With the pandemic, it seems that as a society we have increased our understanding that no one is immune from experiencing mental or substance disorders, and seeking help should be seen as a step toward recovery.”

Training people to be more aware of what someone may be fighting is one of the goals of a program called Question, Persuade and Refer (QPR). QPR, much like CPR, is for the general public and anyone can get trained. It’s a suicide prevention training designed to teach people how to recognize the warning signs of a suicide crisis and how to respond. Anyone who is interested in preventing suicide can take the course so that they can see the signs, not miss the signs.

Along with programs such as QPR, preventing suicide by taking mental health more seriously and caring for it like any other health need is becoming more common place. Talking about mental health as part of regular health care visits is becoming an ordinary occurrence as well.

Developing behaviors such as drinking water, eating healthy, physical movement, sleeping and maintaining meaningful social connections is also helpful and can impact mental health in a positive way.

These things may not eliminate suicide from communities, but each step and each listening ear can have an impact on keeping the suicide rates in decline.

“Suicide is devastating for so many reasons,” said Undseth. “Any number of lives we can save just by people being comfortable talking about suicide and checking up on each other … that’s the only way we’re going to continue to make some progress. It’s everybody’s business to be concerned and reach out to each other.”

Below are some resources aimed at preventing suicide:

The Mobile Mental Health Crisis Response team through Lakeland Mental Health Center provides 24/7 phone support and face to face dispatches to anyone in Clay, Wilkin and Otter Tail counties. 800-223-4512. The Crisis Text Line is also 24/7, and can be reached by texting MN to 741741 or by searching for Crisis Text Line on Messenger or WhatsApp. It is also available in Spanish. The National Suicide Prevention Lifeline has over 100 call centers in the US, including in this region. It is available 24/7 via phone at 800-273-8255 or via chat on their website at suicidepreventionlifeline.org/.The National Alliance on Mental Illness Minnesota (NAMI MN) offers free educational seminars and classes on an ongoing basis. They also facilitate many in-person and virtual support groups for both those struggling with mental health as well as for family members. Information can be found on their website at namimn.org/.

It’s recommended to call 911 if one is worried that someone is at imminent risk of harming themself or others.

This is the first article in an enterprise series regarding suicide and mental health.

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