TRACI CHUR, MA MARY BROOKS, MS Suicide 101. Myths vs. Facts of Suicide Myth: People who talk about suicide don’t complete suicide. Fact: People who die.

TRACI CHUR, MAMARY BROOKS, MS

Suicide 101

Myths vs. Facts of Suicide

Myth:People who talk about suicide don’t complete

suicide.

Fact:People who die of suicide have given definite

warnings of their intentions.

Myths vs. Facts of Suicide

Myth:Suicide happens without warning.

Fact:Most people communicate warning signs of how they are

reacting to or feeling about stressful events in their lives whether it be a problem with a significant other, family member, best friend, superiors, financial matters or legal issues. Warning signs may present themselves as direct statements, physical signs, emotional reactions, or behaviors such as withdrawing from friends. When stressors and warning signs are present suicide may be considered as the only option to escape pain, relieve tension, maintain control, or cope with stress.

http://www.usmc-mccs.org/suicideprevent/myths-facts.cfm

Myths vs. Facts of Suicide

Myth:Suicidal people have every intention on dying.

Fact:Most suicidal people are ambivalent about their

intentions right up to the point of dying. Very few are absolutely determined or completely decided about ending their life. Most people are open to a helpful intervention, sometimes even a forced one. The majority of those who are suicidal at some time in their life find a way to continue living.

http://www.usmc-mccs.org/suicideprevent/myths-facts.cfm

Myths vs. Facts of Suicide

Myth:There is no correlation between sex/gender and

suicide.

Fact:Numbers from the National Center for Health

Statistics show this clearly. In the year 2000, the latest year for which statistics are available, men died four times as often as women did when they attempted suicide, even though women were three times more likely than men to try it in the first place.

http://www.medicinenet.com/script/main/art.asp?articlekey=52099

Myths vs. Facts of Suicide

Myth:Asking a person about suicide and talking about

suicide will push them to complete suicide.

Fact:Talking about suicide does not create nor increase

the risk. The best way to identify if someone is thinking about suicide is to ask them directly. Avoiding the subject of suicide may contribute to suicide. Avoiding the subject reinforces a suicidal persons thought that no one cares.

http://www.usmc-mccs.org/suicideprevent/myths-facts.cfm

Myths vs. Facts of Suicide

Myth:If the person seems better after

hospitalization the risk is over.

Fact:Compared with controls, patients in the first week of

psychiatric hospitalization had significantly increased risks for suicide (60 times higher for men and 82 times higher for women). Patients in the week after hospital discharge also had significantly increased suicide risks (102 times higher for men and 246 times higher for women).

http://psychiatry.jwatch.org/cgi/content/full/2005/608/3

Myths vs. Facts of Suicide

Myth:Suicide increases over the holidays.

Fact:CDC’s National Center for Health Statistics

reports that the suicide rate is, in fact, the lowest in December.2 The rate peaks in the spring and the fall. This pattern has not changed in recent years. The holiday suicide myth supports misinformation about suicide that might ultimately hamper prevention efforts.

http://www.cdc.gov/ViolencePrevention/suicide/holiday.html

Risk factors

Psychiatric DisordersAt least 90 percent of people who kill themselves have a diagnosable and treatable psychiatric illnesses -- such as major depression, bipolar depression, or some other depressive illness, including:SchizophreniaAlcohol or drug abuse, particularly when combined with depressionPosttraumatic Stress Disorder, or some other anxiety disorderBulimia or anorexia nervosaPersonality disorders especially borderline or antisocial

Risk factors

Past History of Attempted SuicideBetween 20 and 50 percent of people who kill themselves had previously attempted suicide. Those who have made serious suicide attempts are at a much higher risk for actually taking their lives.

Genetic PredispositionFamily history of suicide, suicide attempts, depression or other psychiatric illness.

Risk factors

NeurotransmittersA clear relationship has been demonstrated between low concentrations of the serotonin metabolite 5-hydroxyindoleactic acid (5-HIAA) in cerebrospinal fluid and an increased incidence of attempted and completed suicide in psychiatric patients.

Impulsivity Impulsive individuals are more apt to act on suicidal impulses.

DemographicsSex: Males are three to five times more likely to die by suicide than females. Age: Elderly Caucasian males have the highest suicide rates.

http://www.afsp.org/index.cfm?page_id=05147440-E24E-E376-BDF4BF8BA6444E76

Youth

In 2005, suicide ranked as the third leading cause of death for young people (ages 15-19 and 15-24); only accidents and homicides occurred more frequently.

Suicide rates, for 15-24 year olds, have more than doubled since the 1950’s, and remained largely stable at these higher levels between the late 1970’s and the mid 1990’s. They have declined 28.5% since 1994.

Males between the ages of 20 and 24 were 5.8 times more likely than females to complete suicide. Males between 15 and 19 were 3.6 times more likely than females to complete suicide (2005 data).

Firearms remain the most commonly used suicide method among youth, accounting for 49% of all completed suicides.

http://www.suicidology.org/c/document_library/get_file?folderId=232&name=DLFE-24.pdf

Some warning signs

Talking about wanting to die or to kill oneself. Looking for a way to kill oneself, such as searching online or

buying a gun. Talking about feeling hopeless or having no reason to live. Talking about feeling trapped or in unbearable pain. Talking about being a burden to others. Increasing the use of alcohol or drugs. Acting anxious or agitated; behaving recklessly. Sleeping too little or too much. Withdrawing or feeling isolated. Showing rage or talking about seeking revenge. Displaying extreme mood swings.

http://www.suicidepreventionlifeline.org/GetHelp/SuicideWarningSigns.aspx

Signs of a potential suicide crisis

Precipitating EventA recent event that is particularly distressing such as loss of loved one or career failure. Sometimes the individuals own behavior precipitates the event: for example, a man's abusive behavior while drinking causes his wife to leave him.

Intense Affective State in Addition to DepressionDesperation (anguish plus urgency regarding need for relief), rage, psychic pain or inner tension, anxiety, guilt, hopelessness, acute sense of abandonment.

Changes in Behavior Speech suggesting the individual is close to suicide. Such speech may be indirect. Be alert to such statements as, "My family would be better off without me." Sometimes those contemplating suicide talk as if they are saying goodbye or going away.Actions ranging from buying a gun to suddenly putting one's affairs in order.Deterioration in functioning at work or socially, increasing use of alcohol, other self-destructive behavior, loss of control, rage explosions.

http://www.afsp.org/index.cfm?page_id=05147440-E24E-E376-BDF4BF8BA6444E76

What can you do to help?

Too often, victims are blamed, and their families and friends are left stigmatized. As a result, people do not communicate openly about suicide. Thus an important public health problem is left shrouded in secrecy, which limits the amount of information available to those working to prevent suicide.

Talk about suicide

Listen

Offer non-judgmental support

Educate

Listen

Let them tell their storyDon’t be afraid of emotionAsk questions

• Are you thinking about suicide?• What thoughts or plans do you have?• How long have you been thinking about suicide?• Have you thought about how you would do it?• Do you have __? (Insert the lethal means they have

mentioned)

Having the conversation of suicide

• Be direct but non-confrontational • Reflect what you hear• Take ALL talk of suicide seriously

If you are concerned that someone may take their life, trust your judgment!

• Use language appropriate for age of person involved Do not worry about doing or saying exactly the "right"

thing. Your genuine interest is what is most important.

What is a Safety Plan

A list of coping strategies and resources to use during a suicidal crisis.

Helps with a sense of control over suicidal urges and thoughts.

Can serve to motivate.

It is NOT a no suicide contract, we are not asking or telling them to stay alive.

A safety plan is developed together with a caring individual.

Helps to enhance individual’s sense of control or empowerment over the suicidal urges or thoughts.

Involving family members and/or friends with the safety plan can help de-stigmatize the suicidal thoughts.

What is helpful about a Safety Plan

Can be done at anytime a person is exhibiting suicidal urges or thoughts.

Is developed after the imminent risk of suicide or crisis is dealt with.

Not appropriate when someone is at imminent risk for suicide or has profound cognitive impairment.

When to complete a Safety Plan

Listen

Let them tell their story.

Hear why they want to die, with no judgment.

Don’t be afraid of emotion.

Don’t rush them.

How to complete a Safety Plan

Step 1: Warning signs:1._____________________________________________________________2._____________________________________________________________3._____________________________________________________________4._____________________________________________________________

Step 2: Internal coping strategies - Things I can do to take my mind off my problems without contacting another person:1. ____________________________________________________________2._____________________________________________________________3._____________________________________________________________

Safety Plan Steps

Step 3: People and social settings that provide distraction: 1. Name_________________________________ Phone__________________2. Name_________________________________ Phone__________________3. Place___________________________________4. Place___________________________________

Step 4: People whom I can ask for help: 1. Name_________________________________ Phone___________________2. Name_________________________________ Phone___________________3. Name_________________________________ Phone___________________

Safety Plan Steps

Step 5: Professionals or agencies I can contact during a crisis: 1. Clinician Name_________________________ Phone____________________

Clinician Pager or Emergency Contact #________________________________2. Clinician Name_________________________ Phone____________________

Clinician Pager or Emergency Contact #________________________________

3. Suicide Prevention Lifeline: 1-800-273-TALK (8255)

4. Local Emergency Service __________________________________________Emergency Services Address_______________________________________Emergency Services Phone ________________________________________

Step 6: Making the environment safe:1. _______________________________________________________________2._______________________________________________________________

Safety Plan Steps

Resources

National Suicide Prevention Lifeline 1-800-273-8255

24 Hour Crisis Line for Beltrami County & Mobile Crisis Team 1-800-422-0045

Crisis Connection 612-379-6363 or 1-866-379-6363

Further Information on Safety Planning:

Gregory K. Brown, Ph.D.Research Associate Professor of Clinical Psychology in PsychiatryDepartment of PsychiatryUniversity of Pennsylvania3535 Market Street, Room 2030Philadelphia, PA 19104-3309Office: 215-898-4104

[email protected]

Barbara Stanley, PH.D. Director, Suicide Intervention CenterResearch Scientist, Department of NeuroscienceLecturer, Department of PsychiatryColumbia University/New York State Psychiatric Institute1051 Riverside Drive, Unit 42New York, NY 10032Phone: 212 543 5918 Fax: 212 543 6946

[email protected]

Contact Information

Traci Chur, MAText CoordinatorAnd Crisis Line

CounselorHSI-Crisis Connection

PO Box 23090Richfield, MN 55423

612-852-2206fax 612-379-6391

[email protected]

Mary Brooks, MSCrisis Line Counselor, Volunteer Supervisor and Registered ASIST

TrainerHSI-Crisis Connection

PO Box 23090Richfield, MN 55423

fax [email protected]