Palo Alto Volunteers Act Boldly against Teen Suicides

Caroline Kent, 18, places a flower on a fence near a train crossing where four teens have died of suicide. (Michael Macor, San Francisco Chronicle)

By Franklin Cook, SPNAC Editor

Winston Churchill said, “It is better to do something than to do nothing while waiting to do everything”: With that in mind, I would like to salute a group of community members who are standing watch in Palo Alto, Calif.

Following the suicides of four students from a high school in Palo Alto in less than six months at the same train crossing, residents of the city have formed a volunteer group to patrol the crossing and prevent anyone form dying there.

There is no study showing that what they’re doing will prevent suicide (and I suspect there never will be such a study because this is an isolated incident and there are too many variables involved). For all we know, the added publicity they’re stirring up may be harmful in some way (but I doubt that could be substantiated by research, either).

And we certainly don’t know if they’re going to be successful at stopping this particular cluster of suicides that is tragically occurring at Henry Gunn High School.

Here is what we do know: Four children from the community these volunteers call home died by suicide one right after the other using the same means in the same place, and people said, “That’s not going to happen again here if there’s something I can do to stop it.” And then they did something to stop it.

According to a recent story on NPR’s “Morning Edition,” “Twice each hour, the same routine takes place at a busy railroad crossing that runs through a residential Palo Alto neighborhood.”

First the warning bell sounds, as the crossing gates lower to block access to the tracks. Twenty feet away, parents huddled along a chain-link fence freeze, midsentence, and look down the tracks toward the approaching headlights. They watch as the massive silver commuter train bears down and then hurtles through the crossing. And then, just like that, the train is gone. The gates go up again, faces relax, and the adults resume their quiet conversations.

“We’re out here to show the community and the kids that we care about them and that we want the misuse of the tracks to stop,” said Caroline Camhy. The mother of two small children, Camhy started the Track Watch days after the last suicide occurred at this spot a month ago. As school and city officials agonized and conferred, she and other volunteers felt compelled to act.

“We want the deaths to stop, and we want people to know that if they just open their hearts and look around them, they’ll find people who care,” said Camhy. She added, “We’re not the only ones.”

A few weeks ago in my post about blue lights at train stations as a preventative measure against suicide, I was critical of officials doing “something (whether or not it might be effective) because they had to do something,” and that might seem to contradict what I’m applauding in the case of the Track Watchers. But here’s the difference: We know that removing access to lethal means is generally a very effective intervention to keep people safe who are having thoughts of suicide, but we really know nothing about the effect of blue lights on people who are at imminent risk of killing themselves.

Even so, I worry about how Track Watch might be dramatizing the rash of suicides, about whether the volunteers are properly trained and if they are able to take action that is safe and effective should they encounter a determined suicidal person. There is much more that needs to happen than a group of volunteers standing guard at a railroad crossing.

But for a community to commit itself to stop suicide — to literally put themselves between suicidal people and danger — that boldness and determination deserves praise and support. And it suggests that such a commitment is a good starting place for a community to decide “to do everything” it can do to stop suicide, not just students’ deaths at one train crossing but suicide by people of all ages throughout the community now and in the future.

[Editor's note: The Los Angeles Times story linked to above describes another response to the Palo Alto deaths that bears mentioning, for it focuses on building resiliency by promoting a sense of hopefulness among students at the high school. For more information, please see the "Henry M. Gunn Gives Me Hope" blog.]

[The abridged URL for this post is http://tinyurl.com/PaloAltoSuicides .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Dylan Klebold’s Mom Is a Survivor of Suicide Loss

Dylan Klebold and his mother when he was five years old

By Franklin Cook, SPNAC Editor

The November issue of O, The Oprah Magazine features an essay by Susan Klebold about her journey of healing after her son’s involvement in the Columbine shootings, in which 13 people were murdered and which ended in her son, Dylan, and his partner, Eric Harris, killing themselves. Klebold’s essay is a study in understatement, which obscures the fact that the voice behind the writing is that of an extraordinarily courageous and insightful woman, and I fear that the most important things she writes about will be lost beneath the nightmarish reality of what happened at Columbine on April 20, 1999.

One of the contributions she makes in her essay — a contribution that I think merits careful attention — is highlighting a very common experience of survivors of suicide loss:

While I perceived myself to be a victim of the tragedy, I didn’t have the comfort of being perceived that way by most of the community. I was widely viewed as a perpetrator or at least an accomplice since I was the person who had raised a “monster.”

That sentence, with a few changes in wording, could have been written by countless suicide survivors whose loved ones have been seen by others as weak or misfits or tainted or crazy or “monstrous” in some other way, survivors who themselves have been treated as complicit or blameworthy in their loved ones’ deaths.

This notion — that each of us who grieves over a death by suicide is “a victim of a tragedy” — is central to my own view* of one of the complications of suicide grief; and the value of Klebold’s observations about that phenomenon stems from the horrific nature of the shootings (there were 37 victims, 13 murder fatalities and 24 people wounded in the shootings), which accentuated her treatment as a “perpetrator.” If she has healed as a survivor of suicide in the face of the truly awful and starkly wrong-minded judgments leveled against her — in the most public of forums, the American mainstream media — then her healing journey likely holds lessons for the rest of us.

My interest in Klebold’s story is also based on the two times that I’ve met her.

The first was in April 2005, at the Healing After Suicide Conference of the American Association of Suicidology, which was held in a Denver suburb that year. She and I were among the 25 or so people in attendance at a conference session that closed with time for the audience to ask questions or make comments (I did not know she was in the audience, nor would I have known her if I saw her). In the middle of the Q-and-A, she stood and introduced herself, “My name is Susan Klebold …”

I cannot recount precisely what she said, but I remember a few things very clearly: She said that she had not viewed herself as a suicide survivor for a long time after her son died by suicide because of the circumstances surrounding his death, and she expressed gratitude over discovering that point of view because of how healing it had been for her. She spoke for no more than a moment, and I don’t recall her specifically mentioning Dylan or Columbine or murder, so, in fact, I was not certain who she was or what circumstances she was talking about, except that her name sounded very familiar to me. I was struck by how poignant what she said was, as is often the case when I hear a survivor of suicide loss first share publicly about his or her experience–and it seemed to me that this was the first time she had shared her story publicly as a survivor (although I didn’t know that for a fact).

As she finished speaking and the Q-and-A continued, I turned to a colleague next to me and said, “Susan Kelbold?” And my colleague replied simply, “Dylan Klebold’s mother,” and instantly I knew why the things she had said had struck me as being so powerful.

At the close of the session, a handful of people, myself included, went up and, one-by-one, introduced ourselves briefly. I simply welcomed her and thanked her for being there and for sharing what she had shared. I walked away thinking, “What a courageous woman.”

After that quite ephemeral encounter with Klebold, I had no contact with her until this February, when I had an extraordinary talk with her. I was planning to travel to Denver to deliver a suicide survivor support group facilitator training, and the colleague with whom I would be delivering the training called to ask if I would like to go to dinner with her and Susan Klebold, who had been in contact with the organization that sponsored the training. Because the conversation the three of us had that winter evening was private, I will not share the details of it, but I believe it is appropriate to share a few things in general about the context of the meeting:

• The purpose of the meeting, from Klebold’s point of view, was to explore how she might be helpful to people who are at risk of suicide and people who have lost a loved one to suicide.
• My colleague and I thought she might be tremendously helpful and were very encouraging and affirming about her possible role as an advocate for suicide prevention and suicide grief support.
• None among the three of us had a specific idea about how it might be best to explore her being helpful to the field.

In addition, I will share some of the conclusions I made from the content of the meeting:

• Susan Klebold’s personal journey after the most unimaginably hellish experience of suicide loss possible is one of the most extraordinary and inspiring stories of healing that I have ever heard.
• She left me with a profound sense of her courage, her humility, her strength, her wisdom, and her sincere desire only to be helpful to others.
• She has great insight into the nature of suicidal behavior and the role that mental illness plays in suicide.
• She is a survivor of suicide loss like any other survivor of suicide loss.
• She is also a survivor of a particular type of loss, murder-suicide, that deserves more — and more-compassionate — attention not only from society as a whole but also from the community of suicide survivors and suicide prevention workers and advocates.

One of the reasons for this post today is to state that, now, I do have a specific idea about how she might be most helpful to survivors, to which I’ve alluded, above: She could communicate the story of how she healed. What did she do to rise above the judgments of others? How did she first affirm herself as a victim of a tragedy and then move from there to being the survivor a tragedy? I want to know from her the same thing I cherish knowing from any survivor of suicide: Not just the story of her loss and of where she wound up after her long and painful journey, but also what happened along the path she has traveled between April 20, 1999, and today: What specifically helped her to survive?

*[Editor's note: This recording, of a talk I gave in November 2008, has one statement in it that I would change -- or at least that I would further explain -- if I had been speaking from prepared remarks, which I wasn't. I said that survivors should consider themselves not responsible, in an absolute sense, for their loved one's suicide. I hope it's not confusing to say that, on the one hand, no survivor should take it upon himself to consider that the death is his fault, yet on the other hand, every survivor must struggle in his own way with his own judgments about the role he played in the other's life and death: That is a natural -- and often very complicated and even tormenting -- aspect of many survivors' journeys. FJC]

[The abridged URL for this post is http://tinyurl.com/Klebold-Mom .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Beliefnet Blogger’s Mission Is Healing Depression

Therese J. Borchard, founder of the blog “Beyond Blue” offers an explanation in Huffington Post for why she is on a personal mission to help people who have depression.

After trying 23 medication combinations, working with 7 psychiatrists, participating in two inpatient hospital psychiatric programs, and attempting every alternative therapy out there, I made a bargain with God.

“I will dedicate the rest of my life to helping people who suffer from mood disorders,” I promised, “if I ever wake up and want to be alive.”

Miraculously that day did come … the morning I woke up and thought about coffee.

So here I am. With my mission: to educate folks about mental illness and to offer support to those who, like myself, suffer from mood disorders.

Borchard is the survivor of her aunt’s suicide and a tireless crusader for better treatment and understanding for people with mood disorders and for the cause of suicide prevention. She has a book coming out in January, Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes, which she says was written

So that others might find a seed of hope in my story, and be able to hang on for one day longer. So that anyone who struggles with anxiety or depression–even in the slightest way–might find a companion in me, some consolation in the incredibly personal details of my story, and a bit of hope to lighten an often dark and lonely place.

It’s about my end of the bargain.

[Editor's note: I can't recommend the book without having read it, but over the past year I have read her blog and do recommend it, especially but not exclusively for people who are religious, which is the point of view from which she writes. FJC]

[The abridged URL for this post is http://tinyurl.com/HealingDepression .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Blue Lights: Suicide Prevention or Marketing Ploy?

Keihin Electric Express Railway trains arrive at Gumyoji Station in Yokohama, Japan. (Itsuo Inouye, The Associated Press)

By Franklin Cook, SPNAC Editor

East Japan Railway has installed blue lights in all of its Tokyo central loop train stations because, according to a Nov. 4 Associated Press story “they hope [the lights] will have a soothing effect and reduce suicides.”

Here’s the interesting thing:

There’s no scientific proof that the lights actually reduce suicides.

No scientific proof. Zero. None.

The rationale for installing blue lights, according to a spokesman from another train company that did so on a smaller scale several years ago, was “‘we thought we had to do something to save lives.’”

“We know there is no scientific proof that blue lights will help deter suicides. But if blue has a soothing effect on the mind, we want to try it to save lives,” [said Keihin Railway spokesman Osamu Okawa].

In other words, they did something (whether or not it might be effective) because they had to do something.

Here’s how it works:

The lights, which are brighter than standard fluorescent bulbs, bathe the platform below in an eerie blue light. They hang at the end of each platform, a spot where people are most likely to throw themselves in front of a speeding train.

Using the same “logic,” wouldn’t we be “doing something about suicide” if we treated suicidal people by having them sit in a blue-lit room? Or how about if we start carrying anti-suicide flashlights that cast a strong beam of blue light with which we could “bathe” any suicidal person we encountered with the soothing effect caused in humans by their exposure to the color blue?

Not only is there no evidence now that the train station lights might work, but isn’t it true that there is no way to conduct a future study of their effectiveness in such a large-scale environment? I’m not a scientist, but eight million people use the railway system in question every day, and I don’t see a way to demonstrate — even if fatalities suddenly decreased by a dramatic number — that other factors other than the lights might be the cause of the reduction. (There were 68 fatalities in Tokyo stations operated by East Japan Railway in the most recent year reported.)

It makes me wonder if East Japan Railway spent $165,000, the cost of installing the blue lights in Tokyo, simply to demonstrate that the train company is “doing something” about suicide fatalities on its tracks (but without regard to the plan’s effectiveness).

Even more importantly, shouldn’t this make us all wonder about how many activities in the suicide prevention field overall are being done simply because we think “we have to do something to save lives.” How many programs and practices ostensibly designed to prevent suicide are in place now that lack scientific evidence about their effectiveness? How many are implemented that don’t include a reliable way to measure their effectiveness? The “blue light suicide prevention program” now in use in Tokyo certainly deserves scrutiny. Which suicide prevention programs elsewhere deserve the same scrutiny?

[The abridged URL for this post is http://tinyurl.com/BlueLights .]

[Editor's note: A substantive comment (click on the red "Responses" link below) was posted on Nov. 23 by a psychologist working in Japan, which includes ...

Useful telephone numbers and links for Japanese residents of Japan who speak Japanese and are feeling depressed or suicidal:
Inochi no Denwa (Lifeline Telephone Service)：
Japan: 0120-738-556
Tokyo: 3264 4343
Tokyo Counseling Services:

http://tokyocounseling.com/english/

http://tokyocounseling.com/jp/

http://www.counselingjapan.com

... and it should be noted that the "Need Help?" tab above gives English-speaking readers guidance on what to do if they or someone they know is having thoughts of suicide. FJC]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

In Wake of Fort Hood, Focus Is on Mental-Health Readiness

In “At Walter Reed, a Palpable Strain on Mental-Health System,” Washington Post reporters Anne Hull and Dana Priest use the deadly shooting rampage last week by an army psychiatrist at Fort Hood, Texas, as a backdrop to starkly criticize what could be called the military’s lack of mental-health readiness.

More than two years after the nation’s political and military leaders pledged to improve mental-health care, their promises have fallen short at military hospitals around the country, according to mental-health professionals, Army officials, and wounded soldiers and their families … It isn’t only Walter Reed that is under fresh scrutiny [after the shootings]: Evidence of an undermanned, overworked health-care system stretches all the way to the Pentagon, where all of the top health-policy positions remain unfilled, leaving a void on an issue long fraught with inefficiencies and entrenched bureaucracies.

The report notes that the top civilian position in the Department of Defense focused on healthcare is vacant (Assistant Secretary of Defense for Health Affairs), along with “three other top positions — the principal deputy, the deputy for clinical programs and policy, and the chief financial officer post.”

The vacancies occur as the Army in particular struggles with a soaring suicide rate. In 2009 so far, 117 active-duty Army soldiers were reported to have committed suicide, with 81 of those cases confirmed — up from 103 suicides a year earlier.

Quoted in the report is PFC Sophia Taylor, who is receiving treatment at Walter Reed while the Army prepares to give her a dishonorable discharge, which she plans to oppose.

“The amputees get the great treatment,” Taylor said. “Purple Hearts, money for losing their limbs. I have a lot of respect for them. But I lost my mind, and I couldn’t even get a simple ‘thank you for your service.’”

Related SPNAC post: “Culture of Stigma Is a Key Cause of Military, Veteran Suicides” at http://tinyurl.com/StigmaMilitary .

[The abridged URL for this post is http://tinyurl.com/MentalHealthReadiness .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Malpractice Advice Generates Suicide Intervention Checklist

Dr. Phillip Resnick

An excellent suicide intervention framework is suggested by a recent article in Psychology Today titled “Strategies to Avoid a Malpractice Suit When a Patient Commits Suicide.”

The article, which covers psychiatrist Phillip Resnick’s presentation before the U.S. Psychiatric Congress earlier this week in Las Vegas, can be paraphrased to form a checklist, as follows:

• In order to make it nearly impossible for someone to harm himself or herself, do not leave a high risk person alone or unmonitored.
• Treat prior attempts and feelings of hopelessness as preeminent indicators of suicide risk.
• In determining risk, do not rely only on the person’s denial of suicidal ideas: Take into account
  • the person’s actual behavior and
  • input from his or her family.
• It is critical to assess protective factors, such as
  • “a sense of responsibility to family …
  • a positive support system,
  • a therapeutic relationship, and
  • good coping skills.”

It is interesting to note that the most common error in suicide risk assessment uncovered by litigation over suicide fatalities “is overreliance on a patient’s statements rather than on his observable behavior.”

A psychiatrist may assume a therapeutic alliance with a patient; however, about 25% of patients do not admit suicidal ideation to their health care provider. Once a patient makes up his mind to commit suicide, he may no longer view the doctor as an ally but as an adversary. Resnick said health care providers should not accept a disavowal of suicidal plans at face value — especially if the patient wants to leave the hospital.

Resnick also emphasizes the need for a suicidal person’s family to be involved in both determining and managing suicide risk.

“This is crucial,” he notes, “because a patient who is saying his final goodbye before killing himself has a 60% chance of saying goodbye to his spouse but only an 18% chance of notifying his therapist.” If a patient or a family member reports that the patient has a suicide plan, increased scrutiny is critical: 3 of 4 of these patients go on to attempt suicide.

Finally, the article states unequivocally that “no-suicide contracts may also create a false sense of security for the psychiatrist.”

“A no-suicide contract is alright as long as the psychiatrist doesn’t depend on it,” said Resnick. “I’ve seen nursing manuals that suggest that these no-suicide contracts can be used as a guide to determine whether the patient get privileges. I think that is just a mistake.”

[The abridged URL for this post is http://tinyurl.com/MalpracticeAdvice .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

A Life Saved Connects the Dots on Data from Hotline Study

By Franklin Cook, SPNAC Editor

In March 2005, at the inaugural meeting of the Consumer Survivor Subcommittee of the National Suicide Prevention Lifeline, a troupe of the finest researchers in the field unveiled the results of several key studies of the operations and effectiveness of suicide prevention hotlines, and I was fortunate to be among the newly recruited committee members in attendance.

Of all the things I learned during that meeting at the headquarters of the Substance Abuse and Mental Health Services Administration (SAMHSA) in Rockville, Md. — much of which has continued to guide the committee’s work and the overall development of the Lifeline network of crisis centers — one bit of data stands out to me with utmost clarity: In a relatively larger study, 11 percent of hotline callers said that “the call prevented them from killing or harming themselves.”

Eleven percent! More than one in every 10 people who reached out to a suicide hotline said the call prevented them from making a suicide attempt.

That bit data came to mind today when I read a story from WYFF Television in Greenville, S.C.

On Saturday in the little town of Travelers Rest, a police officer shot a gun right out of the hand of a suicidal man.

The police officers spoke with [Jeffrey] Simpson for more than an hour as Simpson held a gun to his head. The officers said Simpson repeatedly waved the gun around and pointed it directly at the officers, refusing repeated commands to put it down. The officers said as Simpson extended his arm and pointed the gun at an officer, another officer fired, hitting the pistol.

It seems to me as if a life was miraculously saved (especially when one considers how many times incidents such as this end with police killing the gun-wielding suicidal person).

And here’s what brought to mind for me the data about hotlines:

Police said the man … had called the national suicide hotline, who in turn contacted the sheriff’s office. The officers quickly requested assistance from the sheriff’s office SWAT team. The police chief and captain both responded from home to the scene.

Who knows what the long-term story will be in this case (or in any case involving a starkly suicidal person who is rescued), but this much is clear: The man was ambivalent about dying, and he called for help. The people he called sent someone to him who was able to help. And the man lived another day, with a brand-new chance to recover from whatever it is that is causing him pain.

See all five articles related to crisis hotlines from the June 2007 issue of Suicide and Life-Threatening Behavior.

[The abridged URL for this post is http://tinyurl.com/HotlineStudy .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Links to Suicide Grief Stories: November 3, 2009

[Editor's note: "Links to Suicide Grief Stories ..." is a SPNAC series featuring stories of survivors of suicide loss -- about the effect their loved one's suicide has had on them and how they are coping with their grief. FJC]

In “Lidia’s Story” on the National Suicide Prevention Lifeline’s (800-273-TALK/8255) YouTube Channel, Lidia Bernik talks about losing her sister to suicide and how that has shaped her life and her work.

“I say that my family died with my sister because the way that my family was will never be again … Suddenly she was gone, and that is so painful.”

[Lidia is Director of Network Development for the Lifeline. Before that, she worked for the Suicide Prevention Action Network, the role she had just taken on when I first encountered her, at a meeting in Washington, D.C. in the summer of 2004. SPAN was at a crossroads in leadership then, and she made a real difference by speaking passionately (in the way people do when they speak truth to power) about the common ground shared by all survivors of suicide loss. FJC]

Ben Verboom (Melissa Lampman/Kamloops This Week)

In an “Everyday Hero” segment broadcast on Global National, Ben Verboom tells how his father’s suicide led him to start the “Cycle to Help” campaign, a cross-Canadian trek he embarked upon last summer. In a newspaper article published part way through his journey, Ben explained the goals of the ride.

“My main focus is to start a dialogue about the issues — one that’s compassionate and comfortable,” he said. “Suicide is an issue we need to bring to the forefront.”

Although Ben is on a solo physical journey, his dad’s memory is close at hand: Ben is riding his dad’s bike.

“I’m fulfilling that dream, but I’m also coping with his death. It’s been a healing process and I’m feeling really good about it” (Kamloops This Week).

Jan Andersen

In “Mum Hopes Book Will Help To Ease Pain of Suicide,” Jan Andersen recounts how she came to write Chasing Death after her 20-year-old son’s suicide.

“In my frenetic search for understanding and support, I had difficulty finding any resources that truly connected with my raw grief. Most suicide books appear to be remote and academic and focus on suicide rather than relating to the shattered world of those left behind” (This Is Wiltshire).

In “Suicide: Coming into the Light,” reporter Faye Whitbeck of the Daily Journal (International Falls, Minn.) interviews three of Erik Rasmussen’s family members 18 years after he died by suicide. The article closes with a selection of poems by Erik’s brother Matt, who recently received a Bush Artist Fellowship. Here is one of them, titled “Outgoing”:

Our answering machine still played your message / and on the day you died Dad asked me to replace it. / I was chosen to save us the shame of dead you / answering calls. Hello, I have just shot myself. / To leave a message for me, call hell. The clear cassette / lay inside the white machine like a tiny patient / being monitored or a miniature glass briefcase / protecting the scroll of lost voices. Everything barely / mattered and then no longer did. I touched record /and laid my voice over yours, muting it forever / and even now. I’m sorry we are not here, I began.

[The abridged URL for this post is http://tinyurl.com/GriefStories06 .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

SPNAC’s 1st Anniversary Marked by Pause for Reflection

Three walkers view the Black Hills Area Survivors of Suicide support group's Lifekeeper Quilt at the AFSP-Black Hills Out of the Darkness Walk at Fort Meade, S.D., on Oct. 17. (Jenny Sand Photography/Used with permission)

By Franklin Cook, SPNAC Editor

There have been no fresh posts on SPNAC between mid-September and today, for which I apologize.

My workload has been too heavy for me to keep up with some of the volunteer and entrepreneurial activities that I love, so maintaining the SPNAC blog had to be set aside for a brief time. In addition, for the past few months, I’ve been engaged during my time away from work in personally reflecting upon the evolution of community suicide prevention and suicide grief support services in the United States during the decade I’ve been involved in the field, and wondering what the next decade might bring, both for me and for the suicide prevention movement.

The major tasks at hand for me recently have been (1) finishing up three years of work on the S.D. Suicide Awareness Partnership, a Garrett Lee Smith Memorial Act-funded project (a few key elements of which I’ll still be working on through May 2010) and (2) serving as Walk Chairman for the AFSP-Black Hills Out of the Darkness Walk (itself a volunteer endeavor, but one to which I committed myself as if it were a part-time job).

The Suicide Awareness Partnership shifted from being a full-blown project to its current, transitional phase on Oct. 1, and the Black Hills Walk took place on Oct. 17, so I am hopeful that I now can return to composing regular posts for SPNAC, as well as periodically publishing the email newsletter.

The photo above is my favorite one from the Black Hills Walk (because it is a simple photograph that has many dimensions — the people pictured on the quilt, the walkers, the person pictured on their T-shirts, etc., and a personal dimension for me, in that my father’s quilt square is the one in the lower-left corner of the quilt). More pictures, which were taken by one of the walk sponsors, Jenny Sand Photography, can be seen here.

Another notable occurrence passed on Oct. 21, when SPNAC celebrated its one-year anniversary of publication. It was a quiet celebration, indeed, for even I hardly noticed it, but I thought it appropriate to mention it as a second year begins. To date, there have been 191 stories posted to the blog, which has had 29,000 page views. Here are the Top 10 most-visited SPNAC posts in its first year of publication:

1. The Last Word on the Financial Crisis and Suicide Prevention at http://tinyurl.com/LastWord-Economy
2. “Seven Pounds” Is Guilty of Irresponsibility with Suicide at http://tinyurl.com/7poundsGuilty
3. About SPNAC at http://tinyurl.com/SPNAC-about
4. Edwin Shneidman’s Meditations on Death Are Full of Life at http://tinyurl.com/ShneidmanMeditations
5. Youth Suicide among Native Americans Linked to Colonialism at http://tinyurl.com/LinkColonialism
6. Culture of Stigma Is a Key Cause of Military, Veteran Suicides at http://tinyurl.com/StigmaMilitary
7. “Good Grief” Worker Preparing for National Survivors Day at http://tinyurl.com/GriefWorker1
8. Links to Suicide Grief Stories: May 4, 2009 at http://tinyurl.com/GriefStories01
9. Links to Suicide Grief Stories: June 3, 2009 at http://tinyurl.com/GriefStories02
10. 2,000 Walkers Light the Way at Out of the Darkness Overnight at http://tinyurl.com/2000Lights

[The abridged URL for this post is http://tinyurl.com/SPNAC1Year .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Study Gives 1st Picture of Suicide Attempts in U.S.

A news release today from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) “provides important insights into the nature and scope of suicidal thoughts and behaviors.”

Nearly 8.3 million adults (age 18 and older) in the U.S. (3.7 percent) had serious thoughts of committing suicide in the past year according to the first national scientific survey of its size on this public health problem. The study … shows that 2.3 million adult Americans made a suicide plan in the past year and that 1.1 million adults–0.5 percent of all adult Americans–had actually attempted suicide in the past year.

The study also uncovered a strong relationship between substance abuse disorders and having thoughts of suicide or making a suicide attempt.

People experiencing substance abuse disorders within the past year were more than three times as likely to have seriously considered committing suicide as those who had not experienced a substance abuse disorder (11.0 percent versus 3.0 percent). Those with past year substance abuse disorders were also 4 times more likely to have planned a suicide than those without substance abuse disorders (3.4 percent versus 0.8 percent), and nearly seven times more likely to have attempted suicide (2.0 percent versus 0.3 percent).

Dr. Eric Broderick, SAMHSA Acting Administrator, framed the study results as a call to action for establishing suicide prevention as a national priority:

“While there are places that people in crisis can turn to for help like the National Suicide Prevention Lifeline 1-800-273-TALK (8255), the magnitude of the public health crisis revealed by this study should motivate us as a nation to do everything possible to reach out and help the millions who are at risk–preferably well before they are in immediate danger.”

The study, titled “Suicidal Thoughts and Behaviors among Adults,” uses data from the 2008 National Survey on Drug Use and Health, and the full report is available online from SAMHSA.

[The abridged URL for this post is http://tinyurl.com/AttemptsInUS .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Lifeline Offers Veterans Help through Online Chat

In “VA Suicide Assistance: From Hotline to Online,” Canandaigua Daily Messenger staff writer Julie Sherwood reports on the National Suicide Prevention Lifeline’s new Veterans Chat service.

“This online feature is intended to reach out to all veterans who may or may not be enrolled in the VA health-care system and provide them with online access to the Suicide Prevention Lifeline,” stated Dr. Gerald Cross, VA’s Acting Under Secretary for Health,

If the person chatting is determined to be in crisis, the counselor can take immediate steps to transfer him or her the hotline, where the person can receive help in the form of further counseling, referral services and intervention.

Veterans retain anonymity by entering whatever names they choose once they enter the chat room. They are then joined by a counselor who is trained to provide information and respond to the caller’s requests and concerns.

To access Veterans Chat:
• Go to www.suicidepreventionlifeline.org
• Click on the “Veterans” tab in the left-hand menu.
• Click on the “Chat Live” button on the right.
• Read and check the box agreeing to the Terms of Service, which explain the confidential nature of the site and protocols of the Lifeline.

The veterans hotline can be accessed by dialing 1-800-273-TALK (8255) and pressing “1″.

[The abridged URL for this post is http://tinyurl.com/VetsChat .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Prison Program Teaches Self-Care for Mental Health

In “Inmates Learn How To Better Manage Their Mental Illness,” Gannett News reporter Cara Matthews covers the Wellness Self-Management program at New York’s Fishkill Correctional Facility.

“Traditionally mental-health treatment was … that I’m the doctor, you take this medication, you’ll get better,” said Howard Holanchock, assistant mental-health commissioner for the state Department of Correctional Services. “But Wellness Self-Management puts it on the patient, to help the patient develop their kind of individual, kind of personalized goals and relapse-prevention plans.”

The report states that “about 15 percent of the approximately 59,000 state prisoners, some 8,000 people, are being treated for mental illness.” One of those 8,000 is Scott Collins, who has been in the Wellness Self-Management program for five months.

“It’s helped me get out of my shell a lot. I usually isolate,” Collins said as he sat in a circle with seven other inmates and three staff members in a basement classroom at the medium-security prison. “Being here has helped me a lot.”

The program is small (it can serve up to 160 inmates), but it is being evaluated for how prisoners who complete it “fare in terms of disciplinary actions in prison and relapse, recidivism and hospitalization after they are released.”

[The abridged URL for this post is http://tinyurl.com/PrisonSelfCare .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Ban of “60 Minutes” Stirs Debate on Media-Suicide Link

LATEST UPDATE: In an Aug. 24 article in the Sydney Morning Herald, Kellee Nolan reports that the Nine Network stopped pressing its objections to the ban of the “60 Minutes” segment.

The Supreme Court of Victoria … heard the Nine Network had agreed never to broadcast the segment, which was about four students from the same Geelong high school who committed suicide in a six-month period this year. The court heard Nine had agreed not to broadcast “on ‘60 Minutes’ or any other program … the segment ‘Searching for Answers,’ or any part of it.”

Beyondblue chairman Jeff Kennett, who had initiated the original injunction preventing the show from being broadcast, said

“We just don’t ever want to see programs that provide some solace, that may provide some acceptability to ending a life, particularly for those who at the time of receiving that information, may be at risk.”

Nine Network stood by its story, but issued a statement that said, “t was pretty clear there was not going to be a consensus relating to this story in the short term, so we felt it was best not to further contest the matter.”

ORIGINAL STORY:
Two articles from The Age update the story about a court injunction against the Australian broadcast by TV news magazine 60 Minutes, of a program about teen suicide at a high school in Geelong.

One article announces that “the broadcaster [Channel Nine] had reached agreement with the State Government not to air the program or any part of it until the matter returned to court on August 21.”

[Channel] Nine sought the adjournment so that the Government and anti-depression organisation beyondblue could consider the proposed segment.

In the other article, reporter Michael Bachelard explains that Beyond Blue chairman Jeff “Kennett began his crusade against the publication of stories about suicide long before he took 60 Minutes to the Supreme Court last week to prevent it from airing a report on a cluster of teen deaths at a Geelong high school.”

Kennett’s objection are grounded in the theory that there is a relationship between media coverage about suicide and suicide contagion.

When covering suicides, Australia’s media are governed by a voluntary code of practice, the first question of which is whether the story should run at all. The answer is most often “No.”

Mr Kennett’s action in the Geelong case was informed by clear advice from adolescent psychologist Michael Carr-Gregg, and he was swiftly joined by the State Government in enforcing an injunction on Channel Nine.

The confrontation between the producers of the 60 Minutes segment, titled “Searching for Answers,” and the parties who have taken court action to halt its broadcast, both Beyond Blue and the Victorian Education Department has highlighted the debate over media coverage of suicide.

60 Minutes declined to comment for this article, citing the injunction. But in an earlier comment, a spokesman said that the program had the support of some of the families involved, and that it constituted “careful and appropriate treatment,” which “offers hope to young people in very difficult circumstances.”

Fairfax radio’s Derryn Hinch said this week that the program should have gone to air because, “talking about it, getting kids to watch and to listen, is much better than banning a TV show and making it all sound mysterious and illicit and maybe — to a gullible teenage mind — something rebellious and enticing.”

That approach finds some support in the British media code. Their guidelines, like Australia’s, encourage sensitivity and warn against sensational treatment, but they add that “censorship or misinformation about suicide is unhelpful,” and say that “media professionals should not seek to hide the facts.”

Kennett says his opposition to airing the program follows Carr-Gregg’s about suicide contagion and the media. Carr-Gregg had been interviewed previously in an article in The Sunday Age:

“I do not mind there being factual reporting of an incident. [But when] there are then programs … that increase the risk of there being repeat episodes, it is those programs that I call into question.”

A particular concern was that 60 Minutes was saying that a 17-year-old boy, “who obviously featured in the program,” would be available online to answer viewers’ questions. “That is not an expert … you just can’t do that. On a subject like that, it’s manifestly not something you can do,” Dr Carr-Gregg said.

[The abridged URL for this post is http://tinyurl.com/60MinutesBan .]
.

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Teen Suicide Show Pulled over Contagion Fear, Injunction

A blockbuster television news program, CBS’s 60 Minutes, has been compelled by an organization battling depressive illness, Beyond Blue, to pull a segment that was supposed to have aired Sunday night in Australia. The segment covered the suicide of four teens at the same high school in Geelong, Australia in the past six months, and the organization’s objection to it on concerns about the show contributing to suicide contagion.

According to a story in The Australian,

Beyond Blue chairman Jeff Kennett won an eleventh-hour injunction in the Victorian Supreme Court to block the current affairs program “60 Minutes” from airing a segment on teen suicide at a Geelong high school.

In his affidavit … Mr. Kennett said he was concerned the potential for another suicide at the Geelong high school — where four teenagers have taken their own lives in the past six months — was very high …

In a statement released by 60 Minutes this morning [Monday], the program’s executive producer Hamish Thomson said: “We are extremely disappointed that we were not able to broadcast the story, but we of course fully understand suicide is a deeply sensitive and difficult issue.”

Mr. Thomson said 60 Minutes continued to believe the story should be told.

“60 Minutes has the support of the families involved and has consulted with mental health experts in producing the story,” he said. “We believe our careful and appropriate treatment handles the issue of suicide sensitively, and offers hope to young people in very difficult circumstances.”

The matter is listed to be heard again on Wednesday morning when 60 Minutes will apply to have the injunction lifted.

[The abridged URL for this post is http://tinyurl.com/ShowPulled .]

Related SPNAC post: “Ban of ‘60 Minutes’ Stirs Debate on Media-Suicide Link” at http://tinyurl.com/60MinutesBan

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Readers Respond to Story of National Guardsman’s Suicide

(New York Times graphic)

The New York Times story that SPNAC summarizes in “Suicides in Guard Unit Emblematic of Army’s Dilemma” generated a number of letters to the editor that the Times published today.

In one letter, Kenneth Bacon, who was chief spokesman for the Pentagon under President Bill Clinton, writes that the solution to military suicide doesn’t require “new scientific discoveries.”

We’re talking about combining proven responses to alcoholism, depression and post-traumatic stress syndrome with the need for individual and family therapy. Failure to address these issues today is nothing short of criminal.

In another letter, a Houston man who served as a chaplain in Vietnam writes

It causes the deepest trauma to see comrades torn to pieces and to hear the screams of the dying — screams that I have heard in my dreams for these past 40 years. Sometimes the screams were so loud that I woke up in sweat and in tears.

Suicide sometimes seems like the only relief — a thought I have had a thousand times. Even today I often cry myself to sleep. And I was a Catholic priest!

Douglas Jacobs, president and chief executive of Screening for Mental Health/Military Pathways, writes

“One of the greatest challenges in addressing the problem of suicide in the military is stigma. Service members are trained to be physically and mentally tough, and as a result seeking help is often seen as a sign of weakness. But it takes courage to ask for help.”

And John Draper, Director of the National Suicide Prevention Lifeline, tells readers that the federally funded crisis line for veterans is being used by 10,000 callers per month.

Veterans, family members and concerned friends should know that help is only a toll-free phone call away … It is free, confidential and available 24/7. Our veterans deserve our care. This hot line is one important service that helps to support them through readjustment challenges after service to our country.

Veterans can call the Lifeline at 800-273-TALK (8255), and press “1″ to be routed to the Veterans Suicide Prevention Hotline.

[The abridged URL for this post is  http://tinyurl.com/GuardSuicide .]

Related SPNAC post: “Culture of Stigma Is a Key Cause of Military, Veteran Suicides” at http://tinyurl.com/StigmaMilitary

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Links to Suicide Grief Stories: August 7, 2009

[Editor's note: "Links to Suicide Grief Stories ..." is a SPNAC series featuring stories of survivors of suicide loss -- about the effect their loved one's suicide has had on them and how they are coping with their grief. FJC]

Jack Clarke, Peter Johnston and Matt Gardner, 22, began their walk from Sydney to Brisbane on July 4.

In “Trio Walk from Sydney to Brisbane To Tackle Depression,” reporter Daniel Hurst bids farewell to Peter Johnston and two of his friends as they embark on a 1,000-kilometer (621-mile) journey.

The 22-year-old video producer, whose mother killed herself after a 10-year battle with depression, joined his friends Matt Gardner and Jack Clarke at the Sydney Opera House early this morning [July 4] to set off on the 23-day trek.

Mr. Johnston grew up with his mum after his parents separated, but she felt isolated as a deaf woman and had attempted suicide several times … [He] said the group started planning the “Steps 4 Survival” walk three months ago as a way to tackle depression among young people.

“I had a few breakdowns this year, and to make myself feel better I decided I had to do something for myself and to help others,” he said. “I’m looking for healing and this is definitely going to do that” (Brisbane Times).

SPNAC readers may visit the three young men’s Facebook page. [I couldn't find news about the completion of the walk, so hopefully someone will comment with an update. FJC]

Cheryl Softich views a photo of her son, Noah Pierce, during the “Always Lost: A Meditation on War” exhibit. (Cathleen Allison, Nevada Appeal)

In “A Personal War: Mother Hopes Soldier Son’s Poetry Keeps Others from Suicide,” reporter Teri Vance goes with the mother of an Iraq war veteran who died by suicide to a multimedia exhibit that features the young man’s poetry.

On Thursday, Softich wept as she read the poems hanging in the hallway of the Bristlecone Building. She kissed her fingertips and touched them to the glass of her son’s portrait.

“I promised Noah when he was alive that I would get his work published and out there,” she said. “In death, his words are reaching out and trying to help others not to do what he did” (Carson City Nevada Appeal).

At Camp Stepping Stones, a large heart-shaped puzzle is among the activities that await children.

In “Stepping Stones Brings Grieving Families Together,” reporter Max Bowen interviews Melanie Lausier, a survivor of her husband’s suicide, about grief services that have been helpful to her children, Kami, 8, and Darren, 10.

The family has been to different counselors and bereavement services and found that with Camp Stepping Stones … the loss has become easier to talk about.

“You don’t have to hide anything from anybody,” Melanie said. “It doesn’t make anybody feel uncomfortable, because you’re all in the same boat.”

[The] … summer program has helped families form relationships with others who can relate to what they have experienced, said Pediatric Palliative Care Coordinator Maureen Forbes. The process is especially helpful for the children, who can find it difficult to talk about such losses with their friends.

“Some of these feelings they have never experienced before,” said Forbes. “We try and make it a safe and comfortable place where they feel secure enough” (Billerica Minuteman).

SPNAC readers may view a photo gallery from the 2008 Camp Stepping Stones program.

Kim and Robert Cutts

In “The Trauma of Husband’s Suicide Lingers,” columnist Kristi O’Harran covers one woman’s acount of the aftermath of her husband’s suicide, particularly problems with how she was treated by the medical examiner’s office.

Her husband … left a lengthy suicide letter saying he loved his wife very much, had lost his faith in God and felt the “weight of the world” on his shoulders. Life doesn’t get any worse than that, but for Kim Cutts, it was not the bottom of the pit. She said she was treated callously by workers at the office of the county medical examiner and at the evidence room. Routine procedures were devastating, she said.

Cutts said she was given back a bloody gun, provided explicit paperwork she didn’t want to read and shown little courtesy when she retrieved her husband’s personal effects.

“I was widowed by my husband,” Cutts said, “And lost by the system.”

O’Harran interviewed a Snohomish County official, who said that employees “prepare the family for what they might see, which was done in this case” (Everett Daily Herald).

Within hours after her death in a murder-suicide, a candlelight vigil brought friends of 18-year-old Ashley DeWitte together near her home in Mesa, Ariz. (Ralph Freso, East Valley Tribune)

In “Friends Remember Victim in Murder-Suicide,” reporter Mike Sakal captures the scene at a candlelight vigil for “an 18-year-old Mesa[, Ariz.,] woman [who] was shot and killed in her front yard by an ex-boyfriend who then turned the gun on himself.”

Many of Ashley DeWitte’s friends shared memories near her home … late Wednesday [June 24]. The friends, led by DeWitte’s close friend Heather Harris, told stories about DeWitte, whom they described as “the girl with the bleached blond hair who could say something positive after everything.”

“Ashley was an awesome person,” Harris said. “Even knowing this girl the slightest bit lightened your world. I’ve got many memories of Ashley, and I’ll always carry them in my heart” (East Valley Tribune).

["Links to Suicide Grief Stories ..." includes articles about all "kinds" of survivors who are affected by suicide -- including those left behind in a murder-suicide, both the survivors of the person who died by murder and the survivors of the person who died by suicide -- because we share a common bond in our grief. FJC]

[The abridged URL for this post is  http://tinyurl.com/GriefStories05 .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Feds Give Funds to Hotlines to Help with Economy Calls

The U.S. Substance Abuse and Mental Health Services Adminstration (SAMHSA) has announced that it will provide more than $1 million to help crisis centers in the National Suicide Prevention Lifeline (NSPL, 800-273-TALK) network deal with what SAMSHA Acting Administrator Eric Broderick calls “a critical situation.”

“Calls into suicide crisis centers have substantially increased during the past year — 54,054 calls in the last recorded month alone — with between 20 to 30 percent of calls being specifically linked to economic distress,” said … Broderick. “These funds will help provide desperately needed assistance to those on the front lines, responding to this urgent public health need.”

A press release from SAMHSA notes, in addition:

Many of these [crisis] centers must cope with a sharp rise in the number of callers in crisis (often because of financial problems). At the same time these centers are threatened with significant cutbacks in funding from state and local governments and other sources of support.

According to the Lifeline website,

The National Suicide Prevention Lifeline 1-800-273-TALK (8255) is a 24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress. By dialing 1-800-273-TALK, the call is routed to the nearest crisis center in our national network of [140] crisis centers. The Lifeline’s national network of local crisis centers, provide crisis counseling and mental health referrals day and night.

• Call for yourself or someone you care about
• Free and confidential
• Available 24/7

[The abridged URL for this post is http://tinyurl.com/EconomyCalls .]

Related SPNAC post: “The Last Word on the Financial Crisis and Suicide Prevention” at http://tinyurl.com/LastWord-Economy

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Iraq Vet and Teen Say “Thank You” to Lifeline via Avatars

Since last December, when I invited SPNAC readers to share their stories through the avatar-based interface on the Lifeline Gallery, there have been at least two noteworthy developments that I haven’t yet reported.

One was shared just last month by Amanda Lehner of Lifeline in a post on the network’s Crisis Centers blog:

Two recent avatars stories (from an Iraq combat vet and a 13 year-old girl) on www.lifelinegallery.org specifically thank Lifeline for helping to save their lives.

The other development appeared several months ago when Dr. Phil shared a suicide prevention message through his avatar on the Gallery.

– FJC

[The abridged URL for this post is  http://tinyurl.com/LifelineAvatars .]

Anti-Depressant Use Doubles; Joint Psychotherapy Decreases

According to an article in USA Today by reporter Liz Szabo, “the number of Americans using antidepressants doubled in only a decade, while the number seeing psychiatrists continued to fall.” The article is based on a “study of nearly 50,000 children and adults,” which appears in the current issue of Archives of General Psychiatry.

According to the USA Today report,

About 10% of Americans — or 27 million people — were taking antidepressants in 2005, the last year for which data were available at the time the study was written. That’s about twice the number in 1996 … Yet the majority weren’t being treated for depression. Half of those taking antidepressants used them for back pain, nerve pain, fatigue, sleep difficulties, or other problems, the study says.

Among users of antidepressants, the percentage receiving psychotherapy fell from 31.5% to less than 20%, the study says. About 80% of patients were treated by doctors other than psychiatrists …

Olfson says his study shows that doctors need more training in mental health. And he says he’s concerned about the decline in patients receiving psychotherapy. Patients who receive only medication may not get the help they need, he says.

[The abridged URL for this post is http://tinyurl.com/AntiDepressantUse .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Suicides in Guard Unit Emblematic of Army’s Dilemma

Sgt. Jacob Blaylock was praised as a good soldier during his tour in Iraq.

Reporter Erica Goode, writing for the New York Times, tells in intimate detail the story of a National Guard unit, the 1451st Transportation Company, in which four soldiers killed themselves after returning from Iraq — all within less than a year.

The four suicides, in a unit of roughly 175 soldiers, make the company an extreme example of what experts see as an alarming trend in the years since the invasion of Iraq.

At the heart of the story is the suicide of Sgt. Jacob Blaylock.

Blaylock’s family and fellow soldiers, as well as records of his military service and treatment in the veterans health system, show that his tendencies toward depression and self-destructive behavior were longstanding and clear. But while friends and others who cared about him tried to help, his vulnerability was missed, or minimized, by many of the people whose job it was to intervene.

Sergeant Blaylock’s case particularly raises questions about the way the military screens those it sends to war. Discharged several years earlier for mental health problems, he was called back up in late 2005, when the Army was desperate for troops to combat rising violence in Iraq. And he was deployed even though at least three other soldiers had warned mental health screeners about his instability.

But as the story notes,

“Suicide is a complex act, a convergence of troubled strands. Researchers who have examined military suicides find not a single precipitating event but many: multiple deployments, relationship problems, financial pressures, drug or alcohol abuse.”

And “three of the four men who would later commit suicide had a direct connection to” the combat deaths of two of their fellow soldiers in Iraq, less than two weeks before the 1451st’s deployment was to end.

Guilt is a common theme in the narratives of soldiers haunted by war. The bonds of loyalty and shared obligation the military instills to forge an effective fighting force can, in the aftermath of battle, curdle into obsession with failures, real or imagined. The bomb that killed Sergeants [Brandon] Wallace and [Joshua] Schmit — planted by an unseen enemy on a dark road — left Sergeant Blaylock and many others in the 1451st feeling that the deaths were, in some way, their fault.

Sgt. Blaylock died by suicide on Dec. 9, 2007 at the age of 26.

On Dec. 16 … Sergeant [Jeffrey] Wilson, 31 … died after taking an overdose of antidepressants.

Sergeant [Roger] Parker went to Sergeant Wilson’s wake in December … Seven months later, on July 19, 2008, Sergeant Parker, 41, hanged himself at his home in Saluda, N.C.

On Sept. 19, Specialist [Skip] Brinkley, 32, shot and killed a sheriff’s deputy who responded to a 911 call from his home in rural Caldwell County, N.C. After a five-day manhunt, he was found in a remote area of his property, dead of a self-inflicted gunshot wound.

Goode’s story chronicles Blaylock’s (and some of the other suicide fatalities’) visits to VA health care after his return from Iraq as well as some of the difficulties he experienced in his personal life, both before and after he saw combat duty. But whatever one can say about his mental health or his problems in living,

Sergeant Blaylock was a good soldier, promoted three times in 15 months. His M-16 was immaculate. He was brave on the road, serving for months as the gunner in the scout truck of the third platoon’s third squad, surviving three attacks with homemade bombs.

The story leaves one with only unanswered questions: Should people with Blaylock’s history be sent to war? Is the Army’s screening for mental health problems adequate? Is the VA’s care for soldiers after combat dealing effectively with the trauma they’ve experienced. Is suicide nothing more than another of the many tragic but unavoidable costs of war? And it leaves one with the feeling that there are many more unanswered questions — all of them difficult and none of them having simple or straightforward answers.

[The abridged URL for this post is  http://tinyurl.com/ArmyDilemma .]

Related SPNAC post: “Culture of Stigma Is a Key Cause of Military, Veteran Suicides” at http://tinyurl.com/StigmaMilitary

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Parents’ Haunting Film about Son’s Suicide Is Also Healing

Evan gives his mom, Dana Perry, a kiss on the cheek, when he was a toddler at the beach.

UPDATED Aug. 4: Boy Interrupted, a documentary film by Dana Perry about the death by suicide of her son, Evan, premiered on HBO on Aug. 3 and will be rebroadcast throughout the month. SPNAC readers may refer to the list of show times from HBO for a viewing time in their locale.

There is a superb review — by Penelope Andrew, Women Film Critics Circle — of Boy Interrupted, which was published yesterday on Huffington Post. Andrew says the film “captures a bit of magic.”

When authenticity, generosity, traumatic memory, recorded history, and creativity collide, an effective documentary such as Boy Interrupted emerges. The musical score strikes notes that enhance the mood of this film that masterfully frames the devastated faces of Evan’s family and friends and makes sure we will not forget him and the health-care enigma and challenge he represents.

POSTED AUG. 3: Perry is a filmmaker, and her husband, Hart, is a cinematographer, so they used the medium they knew to tell the story of Evan’s life, and of their loss and their grief. Dana says, in a Wall Street Journal video interview before the film’s release at the 2009 Sundance Film Festival in January,

“I don’t really want to tell this story, but I have to tell this story, and I’ll use the means that I know. I mean, who would film there own son’s funeral? … What normal, sane person would allow this to happen? Not only allow it to happen but make it happpen? And all I can say to that is, ‘Grief deranges one.’”

“The process of this grief is something like taking a teaspoon to an ocean of tears: You can spoon a little, but if you keep going at it, you might actually make a dent in it … I would never say, though, that that process is done or will be done. I don’t think it will.”

A review in Variety after the film debuted at Sundance calls it “beautifully put together”:

Mournful, pained and beautifully put together, “Boy Interrupted” is about a mentally ill 15-year-old who committed suicide, and the [film] could only have been made by his parents. [It] is, in fact, such an immersion in pain that had anyone other than Dana and Hart Perry cut this elegiac little gem, those filmmakers would be accused of grief exploitation. HBO has the film, and that’s probably best: Perhaps families will watch together and share a good cry.

Here is an excerpt from Sundance’s description of the film:

What defines this film as a remarkably unique and truth-telling achievement is the way it explores how filmmaking can create closure for its creators as well as its audience. Dana Perry has gathered home movies, photographs, and a variety of different documents to tell the story of her son, Evan: his bipolar illness, his life, and his death, and their impact on those who loved him the most. She interviews his siblings and friends, his doctors and his teachers, and in the process, she chronicles a harrowing and difficult journey. The camera provides insight and revelation, and yet “Boy Interrupted” is a film that is also full of despair. The film’s saving grace is that it functions, in the final analysis, as therapy for both its viewers and its subjects at a most fundamental level.

[The abridged URL for this post is  http://tinyurl.com/FilmIsHealing .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Suicides in Farm Country Covered in “Weekly Spark”

“Farmer suicides spotlight lack of mental health care in rural America” appears in the July 30 editon of The Weekly Spark, the Suicide Prevention Resource Center’s (SPRC) newsletter:

Crisis help lines for agricultural workers are serving an important support role for farmers in economic distress. However, accessing mental health care can be a challenge in rural farming areas, with some residents having to travel long distances to access a mental health service provider. According to Mike Rosmann (executive director of the nonprofit corporation AgriWellness), other challenges to achieving rural mental health parity include uneven training for behavioral health professionals who intend to work in rural communities, and the reimbursement structure for mental health services.

See the original story in the Iowa Independent, by freelance writer Lynda Waddington, a New Journalist Fellow with the Center for Independent Media.

Story Indicts Lack of Help for Co-Occurring Disorders

In a remarkable story in the Washington Post, reporter Tom Jackman chronicles the life and death of Danny Watt, who “was a walking symbol of a phenomenon called co-occurring disorders, or dual diagnosis, which is estimated to affect 7 million adults in the United States.”

These people are both seriously mentally ill and abusing drugs or alcohol. About half of all adults who are seriously mentally ill are also thought to be addicted. The mental health community calls this “self-medication.” The federal government estimates that 90 percent of people with co-occurring disorders do not get the treatment they need.

Danny’s death shows how hard it can be to treat people with co-occurring disorders and why so many die young.

Danny died by suicide in April 2008 when he was 21 years old. Jackman’s in-depth report, which is “gleaned from his mental health records, extensive interviews with his family and Fairfax County mental health officials, and from [Danny's] own notes,” describes in poignant detail his downward spiral and years and years of decisions that did not take into account the nature of Danny’s illness and of intervention after intervention that were, at best, unhelpful and, at worst, harmful to Danny.

In the end, the article is an unequivocal indictment of the mental health care system’s failure to adequately treat dual diagnosis patients.

E. Fuller Torrey, a psychiatrist with the Treatment Advocacy Center in Arlington and a prominent critic of the widespread deinstitutionalization of psychiatric patients, says forced treatment is essential when people are too mentally ill to realize they need help.

Saying that Danny had responsibility for his care is “fine for someone with substance abuse, but if you’re dealing with psychosis, then there’s no way you’re going to treat someone like that in an unlocked facility,” Torrey said. “What you’re looking at is the system is not set up to treat the difficult patients.”

Danny’s parents came to that belief repeatedly.

“It was always, ‘Get him stable, get him out,’” said Bobby Watt [Danny's father]. “No long-term plans. . . . We wanted him in a place where he was locked up with proper medical attention until he became stable. I begged them to put him in a mental hospital. I told them, ‘If you put him out on the streets, he’ll be dead in a week.’”

That was April 3, 2008. Eleven days later, Danny was dead.

Jackman’s story is accompanied by an unforgettable video interview with Danny’s parents.

[The abridged URL for this post is http://tinyurl.com/LackOfHelp .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Links to Suicide Grief Stories: July 28, 2009

[Editor's note: "Links to Suicide Grief Stories ..." is a SPNAC series featuring stories of survivors of suicide loss--about the effect their loved one's suicide has had on them and how they are coping with their grief. FJC]

Ryan Mattocks earned his high school dipoma from Hope Online Academy in June. (KUSA-TV photo)

In “Student Turns to Online School after Friend’s Suicide,” reporter Nelson Garcia, talks to Thorton, Colo., teen Ryan Mattocks about how the suicide of his friend, Jordan Scull, made him rethink his own life, including enrollment in an innovative online high school called Hope Online.

Mattocks says [he and Scull's other friends] were all living the party life — drinking more than attending classes at Horizon High School … Mattocks enrolled in the Hope Online Learning Academy Co-op.

“It’s a lot like a second chance,” [he said], “because a lot of kids that are at that school either got kicked out of the traditional high school or were failing at the traditional high school … I think that [Jordan] would be glad that he had that much impact on all of our lives after he passed away. He is a big inspiration to me” (KUSA-TV)

Laurie Miller displays a photograph of her son Ben (Hamilton Spectator photo).

In “The Dark Abyss of Drug Addiction,” columnist Susan Clairmont tells the story of Laurie Miller, whose 29-year-old son Ben died by suicide while struggling with addiction to OxyContin.

Laurie got him a spot at a Toronto-area detox centre. But it would be a month before Ben could start. He wasn’t able to wait that long. On Nov. 30, 2004, Ben killed himself. He was 29. He did not leave a suicide note. Just his OHIP (health insurance) card propped against an illegal bottle of OxyContin.

After Ben’s death, Laurie “began volunteering at the Men’s Withdrawal Management Centre in Hamilton.”

Many of the guys there use Oxy. She tells them Ben’s story. She listens to theirs. Laurie also works weekends at The Living Rock, and says she makes a special point of connecting with street youth who talk about Oxy. She tells them about Ben.

“I’m going to try to help one person if I can,” she says (Hamilton Spectator).

Curt Chisholm is a civil servant turned mental health advocate. (Eliza Wiley, Helena Independent Record )

In “Personal Tragedy Drives One Man’s Crusade,” reporter Eve Byron uncovers the motivation behind a well-known Montana state agency leader’s push “to try to get better help for people and families struggling with mental illness,” including organizing the NAMI walk in Helena for the past five years.

Only a handful of friends know Curt Chisholm as the heartbroken father of a son who committed suicide eight years ago …

Chisholm has returned to his roots with the government … advocating … to anyone willing to listen.

“The state doesn’t understand what it takes to treat mental illness, and how important it is to treat in the community,” Chisholm said … “They need to establish a pattern that’s consistent at the community level and get good, [effective] diagnosis and early intervention at an in-patient level” (Helena Independent Record).

[Editor's note: Curt Chisholm's story is part of an in-depth investigative report by the Helena Independent Record on mental health care in Montana.]

In “Springfield Mom Testifies on Bullying,” Boston Globe correspondent Stephanie Vallejo reports on “ordinary working mom” Sirdeaner Walker’s testimony before Congress about her 11-year-old son Carl Walker-Hoover’s suicide.

“What could make a child his age despair so much that he would take his own life?” Walker asked during a panel on “Strengthening School Safety Through Prevention of Bullying.” “I will probably never know the answer. What we do know is that Carl was being bullied relentlessly at school.”

Walker supports a bill that would require states that receive grants for safe and drug-free schools to invest in bullying prevention programs (“Political Intelligence“)

In Ms. Walker’s Congressional testimony,, she says,

“The most important thing I have learned that bullying is not an inevitable part of growing up. It can be prevented, and there is not a moment to lose” (YouTube video).

A BBC report, “Website’s Support after Suicides,” tells the story of the Choose Life page, which was created by teens and is hosted on the Bridgend County Borough Council’s Website. Bridgend, in the U.K., has experienced a cluster of suicides.

One of the youngsters, 17-year-old Rhys, said he and his friends decided to create the website because they did not think there was enough access to information about the effects of suicide.

“Losing someone close to you is indescribable really,” he said.

“The devastating effects it had on myself, my close friends and family, it does bring you to tears just thinking about it.

“I think if this can be prevented, why should someone suffer from it?” (BBC News)

[The abridged URL for this post is  http://tinyurl.com/GriefStories04 .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Citizen Journalist Tells Story of a Life Saved by Texting

Hunter Thompson, doing what teens do: texting. (Photo by Dana Brandorff)

Citizen journalist Dana Brandorff’s YourHub.com story recounts how a sustained episode of text messaging by 15-year-old Hunter Smith saved a life. The incident began when “a friend of hers [who] was emotionally distraught” texted Hunter to let her know what was happening.

For several hours, the two texted back and forth until he calmed down. Hunter says, “At the time, I really thought he was going to do something to himself, so I felt compelled to stay ‘with him.’” In between texts, she disclosed the situation to her parents who instructed her to inform the school counselor about the situation.

“My parents explained that I could and should support my friend, but that the counselors were trained and equipped to handle these types of situations,” says Hunter. “One question I asked myself was,’How would I feel if my friend hurt himself and I could have prevented it?’

Indeed, Hunter did confide in the school counselor concerning her friend.

“She did the right thing,” says Michele Campbell, a former high school counselor who currently has her own private therapy practice focusing on adolescent issues. “At this age, emotions are real, tangible, and acute.”

Campbell says it’s best to err on the side of “worst case” and not just assume that these types of text messages are a form of teenage angst.

Hunter’s experience helping her friend also shows that “high tech tools can also be used for good, and a cell phone can become a lifeline for some.”

“The positive is that teens are reaching out to someone. But it’s not just the communication that’s important. It’s also what the person on the receiving end does with the information. It’s listening and knowing where to turn if a friend is in trouble that counts,” says Campbell.

[The abridged URL for this post is  http://tinyurl.com/SavedByTexting .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Columnist’s Story of Depression and Suicide Hits Home

Marc Hansen

In a column in the Des Moines Register, Marc Hansen tells the story of a 46-year-old man who died by suicide and, in doing so, clearly describes how clinical depression can be both insidious and undetected — and fatal.

The suicide of Matt Duncan garnered the columnist’s attention because he is the son of Randy Duncan, a University of Iowa football standout who played in two Rose Bowl championships. Hansen describes Matt Duncan as “big, strong, smart, compassionate” and as a person who appeared healthy and exuberant:

After turning 40, he decided he’d train for a Toughman competition. Why not? He had a blue belt in tae kwon do. At 6 feet, 3 inches and 225 pounds, he was in great shape.

When people asked Duncan how he was doing, he’d say, good, great, couldn’t be better, when nothing could be further from the truth.

But Matt’s case is one in which “depression … wears a mask,” writes Hansen. “There’s no pool of blood, no broken bones, no scar tissue.” He tells the story of Matt’s depression through the reflections of Matt’s father:

“Growing up, he was a normal, great, happy kid,” Randy Duncan says. “There were no signs at all.”

But then Matt took a high-pressure job with a big law firm in Washington, D.C. All he did was work. He had no social life.

“It kind of started then. He became more of a recluse. He wasn’t going out with friends or answering phone calls. We got him to a psychiatrist. Doctors made the diagnosis in 1998.”

Matt moved home and took a job with his father’s firm and tried to stay on top of it.

“He did everything you’re supposed to do,” his father says. “It was a chemical imbalance.”

Hansen notes that this same type of “chemical imbalance” is present in “millions of Americans [who] suffer from clinical depression,” and he goes on to summarize the malady’s symptoms.

According to guidelines set forth by the American Psychiatric Association, depression is diagnosed when at least five symptoms are present for most of the day, nearly every day, for at least two weeks: Constant sadness, irritability, hopelessness, trouble sleeping, low energy or fatigue, feeling worthless or guilty for no reason, significant weight change, difficulty concentrating, loss of interest in favorite activities. At least one of the symptoms must be persistent sad or empty feelings or loss of interest in activities.

He closes his column by recommending that anyone who experiences those symptoms should seek medical help “immediately, if not sooner.”

By making the direct link between clincial depression and suicide using the example of a man who is the son of someone who is known and admired by people across the state, who is truly a “son of Iowa,” Hansen renders a valuable service to his readership. There are too many men like Matt Duncan — men in their middle years who are known for showing up and taking care of business in every aspect of their lives, but who are struggling with depression and suicidal thoughts — and hopefully his story will encourage them to seek the help they need.

[The abridged URL for this post is  http://tinyurl.com/HitsHome .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Sen. Franken Says Service Dogs Might Prevent Veteran Suicide

Al Franken’s first legislation as the newly-sworn-in Senator from Minnesota proposes providing hundreds of service dogs to veterans, which he writes in a column in the Minneapolis Star Tribune, “can be of immense benefit to vets suffering from physical and emotional wounds.”

There is evidence to suggest that increasing their numbers would reduce the alarming suicide rate among veterans, decrease the number of hospitalizations, and lower the cost of medications and human care. Veterans report that service dogs help break their isolation.

Franken is proposing the service-dogs-for-veterans program not as an arbitrary, “feel good” initiative, but as an honest-to-goodness scientific study, piloted in such a way as to prove its effectiveness and expand its reach if it measures up.

It costs on average about $20,000 to train a service dog and another $5,000 to place the dog with the veteran. It is my strong belief that a service dog will more than pay for itself over its life, and my bill is designed to determine the return on investment with a pilot program that provides service dogs to hundreds of veterans. My bill will help train a statistically significant number of dogs to measure the benefits to veterans with physical and emotional wounds. The program would be monitored and refined over a three-year period to optimize its effectiveness.

Whatever one can say about the viability of his proposal, it would be difficult to quibble with his earnestness–or to take issue with the the genesis of his idea, which came from meeting a wounded Iraq veteran who depends on his service dog in fundamental ways.

This January, I met Luis Carlos Montalvan and his service dog named Tuesday, a beautiful golden retriever, at an inaugural event in Washington. Luis had been an intelligence officer in Iraq, rooting out corruption in Anbar Province. In 2005, Capt. Montalvan was the target of an assassination attempt. Now he walks with a cane and suffers from severe post-traumatic stress disorder. Luis explained that he couldn’t have made it to the inauguration if it weren’t for his dog.

And, even if nothing comes of his first attempt at legislating, Franken should get credit for “thinking outside of the box” in support of suicide prevention for a population that merits extra attention.

[The abridged URL for this post is http://tinyurl.com/DogsForVets .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Attempt Survivor Finds Self-Help Support in DBSA

Reporter Paula Rhoden of the Prescott Daily Courier tells the story of Joel Kobren, whose bipolar disorder drove him to a suicide attempt and whose recovery connected him with the Depression and Bipolar Support Alliance (DBSA), where he is now a leader in the self-help movement for people with depression in Arizona.

Kobren encountered DBSA after his nearly-lethal attempt led to discovering the nature of his mental and emotional challenges:

Finally, after 58 years, doctors diagnosed him with bipolar disease, a diagnosis that truly changed his life. Kobren said he was no longer an “underachiever” who could not keep a job or maintain a relationship; there was a real reason for his “mood swings.”

As part of his therapy, Kobren started looking for a self-help group. He said “suicide survivor” groups were really grief groups for families and friends of people who committed suicide … Kobren said he could not find what he really needed — a depression group. Kobren’s search led him to the national Depression and Bipolar Support Alliance.

Kobren is now involved, along with Henry Willey, president of the DBSA Yavapai County Chapter and others, in developing a statewide DBSA organization that they hope, in turn, will develop chapters throughout Arizona, each with its own peer-led support group.

Peer groups allow people to talk to others dealing with depression or bipolar disease, and learn what may or may not work, Willey said.

“DBSA is not a 12-step program and it is not a therapy group. It is just peers helping peers … Personally, I have been bipolar since elementary school but was not diagnosed until I was 35 years old. I have been through everything.”

Kobren said, “DBSA gave me the avenues to fulfill the goals I set as part of my recovery. As an organization, it has opened doors and been very welcoming. At the same time, there is no pressure. DBSA does not expect anything from me. It just opened the next door for me to go through when I am ready.”

SPNAC readers can search for a DBSA support group near them at this site.

[The abridged URL for this post is http://tinyurl.com/DBSA-SelfHelp .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Suicide Prevention Action Alliance Seeks Grassroots Input

The Suicide Prevention Action Network (SPAN USA) invites you to participate in this survey if you are among “the grassroots network of survivors of suicide loss, suicide attempt survivors, national, state and community leaders, public and mental health providers and officials, coalition members and leaders, and researchers” involved in suicide prevention.

The survey is designed, according to Bob Gebbia, Executive Director of the
American Foundation for Suicide Prevention (AFSP) “to assist our staff and volunteer leadership as we prepare a summary of the progress made in preventing suicides since the National Strategy for Suicide Prevention was launched in 2001.” Gebbia wrote in an email invitation to fill out the survey,

Perspectives from you … are essential to understanding the accomplishments and challenges of the suicide prevention movement. The information we collect will be used to guide the continuing development of a National Action Alliance for Suicide Prevention, in collaboration with the Suicide Prevention Resource Center (SPRC), and to inform decisions on key priorities for the Action Alliance to address.

The National Action Alliance for Suicide Prevention is the leadership group that was called for in 2001 in the National Strategy for Suicide Prevention:

Objective 2.2: By 2002, establish a public/private partnership(s) (e.g., a national coordinating body) with the purpose of advancing and coordinating the implementation of the National Strategy. Leadership and collaboration are the keys to success of the National Strategy. The establishment of a public/private coordinating body will stimulate the requisite national attention to the issue. Such a body will help to ensure that suicide prevention is perceived as a national problem and the NSSP as a national plan. The partnership will help establish momentum for the plan and will provide continuity over time and legitimacy through the involvement of key groups. And finally, the coordinating body will oversee the implementation of the National Strategy.

[Editor's note: Please respond to the survey if you'd like to add your voice to the process. It will be available online only until midnight ET on July 27. Also, please pass this URL -- http://tinyurl.com/NSSPsurvey -- along to anyone you know who is a member of the suicide prevention network described above. FJC]

[The abridged URL for this post is http://tinyurl.com/NSSPsurvey .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Cop Handles Crisis with Listening, Not Lethal Force

Denver Police Sgt. Greg Jones refused to be the "cop" in a high-intensity "suicide by cop" situation. (Karl Gehring, Denver Post)

Reporter Mike McPhee’s Denver Post story about a policeman receiving an award also highlights an important lesson about the most important tool in a suicide intervention: listening.

Last week, [Denver Police Seargeant Greg] Jones, 49, received the Crisis Intervention Teams of Colorado Association’s top award for his long-term commitment to crisis negotiations and specifically for his handling of a situation … when a 2-year-old boy had been shot dead in the arms of his father.

When Jones … answered a 911 call at East 13th Avenue and Madison Street on Oct. 12, 2008, Earl Ryan was on the front porch, waving a gun and threatening suicide. Ryan was determined to kill himself and had even planned it for the next day, Jones would learn.

As Jones approached with a rifle, Ryan yelled about “suicide by cop,” as if he could antagonize Jones into killing him.

But Ryan had the wrong cop. After negotiating with Jones for two and a half hours, Ryan laid his gun down and gave up.

“It’s not what you say to the person,” Jones said. “It’s what you listen to. You don’t talk someone out of a building, you listen them out.”

[The abridged URL for this post is  http://tinyurl.com/HandlesCrisis .]

Related SPNAC post: “Crisis Line Worker Says Honesty Is the Best Intervention” at http://tinyurl.com/BestIntervention

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

“Cyberbullying not epidemic … not killing our children”

Larry Magid, a journalist whose roles include Technology Analyst for CBS News, has weighed in with a thought-provoking blog post on legislation that has come to the foreground recently to counter cyberbullying. Here’s his opening paragraph:

The first things you need to know about cyberbullying are that it’s not an epidemic and it’s not killing our children. Yes, it’s probably one of the more widespread youth risks on the Internet and yes there are some well publicized cases of cyberbullying victims who have committed suicide, but let’s look at this in context.

On the topic of cyberbullying “killing our children,” Magid writes that “bullying has always been a problem among adolescents and, sadly, so has suicide.”

In the few known cases of suicide after cyberbullying, there are other contributing factors. That’s not to diminish the tragedy or suggest that the cyberbullying didn’t play a role but — as with all online youth risk — we need to look at what else was going on in the child’s life. Even when a suicide or other tragic event doesn’t occur, cyberbullying is often accompanied by a pattern of offline bullying and sometimes there are other issues including long-term depression, problems at home, and self-esteem issues.

His argument against classifying cyberbullying as an epidemic is that the numbers describing “the extent of the problem [are] all over the map.”

I’ve seen some reports claim that up to 80 percent of online youth have experienced cyberbullying, while two national studies have put the percentage closer to one-third … A recent study by Cox Communications came up with lower numbers, finding that approximately 19 percent of teens say they’ve been cyberbullied online or via text message and 10 percent say they’ve cyberbullied someone else.

His post, titled “How To Stop Cyberbullying” was published yesterday on Magid’s blog at safekids.com, a site he founded to promote Internet safety. He offers these solutions to the problem of cyberbullying:

1. Identify the children doing the bullying, then work with them on their behavior and on “their needs — including problems at home.”
2. Deliver to children who bully “educational programs that stress ethics and cyber citizenship.”
3. Teach “kids … what to do if they are victims of bullying.” He offers, for instance, these safety tips.

Magid advises that “we need to be careful about any legislation that outlaws cyberbullying.” Using the Megan Meier Cyberbullying Prevention Act (H.R. 1966) as his example, he repeats UCLA law professor Eugene Volokh’s criticism of the bill, which, in brief, is that the behavior it criminalizes is stated in such an overly broad way that a lot of behavior that is not targeted by the law would also be criminalized.

There is a bill before Congress, as well — the School and Family Education about the Internet Act” (S. 1047) — that emphasizes the educational approach to the cyberbullying problem that Magid favors.

[The abridged URL for this post is http://tinyurl.com/CyberbullyingNot .]

Related SPNAC posts:

“Children’s Deaths Cause Anti-Bullying Outcry” at http://tinyurl.com/ChildrensDeaths
“Father Crusades against Cyberbullying after Son’s Suicide” at http://tinyurl.com/FatherCrusades
“Cyberlaws Are Coming into Play around Internet Safety” at http://tinyurl.com/NetSafetyLaws
“Obama Urged To Take the Lead on Internet Safety” at http://tinyurl.com/ObamaInternet
“Verdict Shows Parents, Internet Should Both Protect Kids” at http://tinyurl.com/ProtectChildren

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

CSAT Manual on Suicide in Alcohol/Drug Treatment Is Free

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released TIP 50, “Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment,” which is available online and in print (the publication is free).

According to an announcement from Anara Guard, Deputy Director of the Suicide Prevention Resource Center (SPRC), the new manual “offers substance abuse counselors a four-step process for addressing suicidal thoughts and behaviors in substance abuse treatment.”

The TIP is organized in three parts, which the publication’s introduction describes as follows:

Part 1 of the TIP is for substance abuse counselors and consists of two chapters. Chapter 1 presents the “what” and “why” of working with clients with substance use disorders who have suicidal thoughts and/or behaviors … Chapter 2 presents the “how to” of working with clients with suicidal thoughts and/or behaviors … Part 2 is an implementation guide for program administrators … Part 3 of this TIP is a literature review on the topic of depressive symptoms …

Here is the description of the TIP series, which is developed by SAMHSA’S Center for Substance Abuse Treatment (CSAT):

[TIPs] are best-practices guidelines for the treatment of substance use disorders. CSAT draws on the experience and knowledge of clinical, research, and administrative experts to produce the TIPs, which are distributed to facilities and individuals across the country … [including] public and private treatment facilities … [and] practitioners in mental health, criminal justice, primary care, and other healthcare and social service settings.

[The abridged URL for this post is http://tinyurl.com/CSAT-TIP50 .]

Related SPNAC posts:

• “1/4 of Suicides in Large Study Exceeded Legal Alcohol Limit” at http://tinyurl.com/SuicidesAlcohol
• “Alcohol Screening Linked to Youth Suicide Prevention” at http://tinyurl.com/AlcoholScreening
• “Federal Agency Examines Substance Abuse, Suicide Link” at http://tinyurl.com/AOD-Suicide

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Army Commanders’ Caregiving Plays Role in Suicide

By Franklin Cook, SPNAC Editor

A USA Today story by reporter Gregg Zoroya focuses on Army commanders “failing at the day-to-day task of monitoring troubled young soldiers in their barracks back home, which is helping push suicides to record numbers.”

The Army has built a fighting force second to none, says Brig. Gen. Colleen McGuire, [director of the Army Suicide Prevention Task Force], but “we have young leaders who have not been trained in the art of … just taking care of soldiers,” particularly after they return home from combat.

McGuire’s findings come after three months spent reviewing records of Army suicides, talking to soldiers and commanders, and visiting installations throughout the country, she said.

Here are the annual U.S. Army suicide numbers, which were reported in an article this January at injuryboard.com, citing Army sources:
2004: 64
2005: 87
2006: 102
2007: 115
2008: 128 (with additional deaths still under investigation)
2008: 143 (according to today’s USA Today article)

Here is the latest report, from a U.S. Department of Defense news release just last week:

There have been 88 reported active-duty suicides in the Army during calendar year 2009. Of these, 54 have been confirmed, and 34 are pending determination of manner of death.

“Most suspected suicides are later confirmed as suicides, records show,” states today’s USA Today article.

Concerning the role of Army commanders, it states

Managing soldiers at home is different than in combat, McGuire says. Often, commanders can lead troops in battle but lack the skills to monitor troops closely at home.

The Army’s failure to police risky behaviors has made it harder to identify and seek help for the smaller numbers of soldiers who may be suicidal, she says. “(It’s) talking to soldiers. ‘Who’s the loner? Who’s isolated? What are you guys doing this weekend?’ ” McGuire says.

The Army’s review of records on suicides shows that

About two-thirds of suicides occurred in or around installations … Half are among combat veterans. The other half are soldiers who never deployed. About one-third of suicides occurred in either Iraq or Afghanistan.

David Rudd, dean of the College of Social and Behavioral Science at the University of Utah, a leading authority on civilian and military suicides, points out that improved caregiving by military leaders is only part of the picture.

The longer the wars in Iraq and Afghanistan continue, Rudd says, the more likely it is that soldiers who have seen combat will kill themselves. Also, young men, in the military and civilian life, are often reluctant to seek help, he says.

SPNAC has weighed in on the topic of suicide in the military several times (please type the word “military” into the search box below), and the post “Culture of Stigma Is a Key Cause of Military, Veteran Suicides,” hones in on the same concern Rudd emphasizes above, help-seeking, especially among young men in the military. The post asserts  that the most vital question at hand is this:

What is military (and civilian) leadership doing –- besides issuing orders, which is a necessary but not sufficient step — to decisively lessen the stigma against help-seeking that is killing so many of those whose sacrifices make our freedom possible?

Although I might rephrase the question to be less melodramatic if I were to compose it all over again today, I continue to adamantly believe that a bold, insightful, decisive, culture-changing look at stigma around help-seeking in the military could carry the battle against suicide.

[The abridged URL for this post is  http://tinyurl.com/CommandersCaregiving .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Links to Suicide Grief Stories: July 12, 2009

[Editor's note: "Links to Suicide Grief Stories ..." is a SPNAC series featuring stories of survivors of suicide loss--about the effect their loved one's suicide has had on them and how they are coping with their grief. FJC]

Ryan as a toddler gets a hug from his mom, Joyce Venys. (Family photo)

“Parents speak out: ‘Suicide Is a Big, Dark Secret’”; “A Talented Teen Becomes a Suicide Statistic”; and “Deceased Teen’s Art Exhibited” comprise a package of items put together by reporter Mary McCarty about the family, friends, and community of Ryan Venys of Dayton, Ohio, who died by suicide in 2007. The coverage is in-depth and comprehensive, including how Ryan’s death affected his school:

His former girlfriend, Danielle Snyder, is one of many who have undergone counseling to cope with the loss. At first, she blamed herself. “We broke up,” said Danielle, who was 15 at the time. “The last time I saw him at piano, I wasn’t very nice. I wouldn’t talk to him. He looked so sad … I was afraid if I were too nice to him, he would think I wanted to get back together.”

That was the day before his death.

It was a tragic loss for entire student body,” recalled Stivers [School for the Arts] principal Erin Dooley. “A lot of teachers simply adored him. We’re not over it yet. One of the things that makes it so tragic is that everyone was very surprised.”

Only in retrospect did his teachers and friends see signs. Ryan was especially close to Cissy Matthews, the head of the piano department, and often practiced in her studio after school. The day before he died he stopped by to say he couldn’t make it to a performance at the Racquet Club later that week. “I just wanted to say ‘bye,’” he said casually. As he walked from the room he turned around and said, “I really like you, Mrs. Matthews” (Dayton Daily News).

Mariette Hartley

In “Actress Mariette Hartley Counsels Families Torn by Suicide,” West Coast Bureau Chief Mike O’Sullivan tells of Hartley’s response to multiple suicide deaths in her family, her uncle in 1959, her father in 1963, and her cousin a few years ago.

She says she realized that suicide survivors experience similar stresses to combat veterans: “They [suicide survivors] fought in a war that they didn’t ask for necessarily. They saw atrocities that they’ve never been trained to process, and then they come back into society, and nobody wants to talk about it” (Voice of America).

In “After Suicide, Veteran’s Widow Comforts Others,” reporter Ray Collins interviews Carla Patton, whose Marine husband died by suicide 15 years ago and who is now a grief counselor.

“For me, It’s really coming full circle and taking a very tragic circumstance and making something so positive that come out of it for the greater good,” [she said in the video interview as she was headed to Washington, D.C., to lay a wreath at the Tomb of the Unknowns on Memorial Day]. “The most sacred place in the United States would be at Arlington National Cemetery on Memorial Day” (Fox 13, Tampa Bay).

Anna and her dad, Charles Dunn. (Family photo)

In “She’s Still Dancing,” reporter Billy Watkins profiles Anna Dunn, 18, of Madison, Miss. On the day the story was written, she was experiencing her second Father’s Day without her dad, Charles, who died by suicide early last year. The dancing reference in the article’s title stems from Anna recently vying for the Top 20 in the TV show “So You Think You Can Dance.”

“Last Father’s Day was probably the hardest day yet. But I try to take things a day at a time. And I think it’s important that we view days like this more as a celebration, and not mourn so much. I want to try and remember all the good times and not get stuck on the reality of what happened.”

Says Pat Dunn [Anna's mother]: “We’re doing good. Some days, certain events, really hit you hard. Graduation, for instance. There is always somebody missing.

“How can a family survive a suicide? Some look at it and say, ‘I probably couldn’t.’ But we have had such great support — from people at church, from friends, from other dance mothers. And, of course, Anna had dance” (Jackson Clarion-Ledger).

In “How Suicide Changed My Life,” Joseph Speranzella, a member of the Secular Franciscan Order who blogs regularly on Catholic topics, writes:

In leaving us this way, what ever pain [my sister] released herself from was only passed on doubly to her loved ones. She left us misery and questions that will never fully be answered. A cloud was cast over our hearts that has since shaded everything. My family feels that as hard as life can get, Mary had no real reason to end her life. The resulting “cloud” has caused me to evaluate my thoughts about life and death — what they are, and what I want out of both …

How suicide changed my life is precisely this: I have consciously and decisively determined that my life will be geared toward its end, not in a morbid sense but in a way that I will master the art of living and of dying … Facing death–rather than forcing death–with grace is the fulfillment of life regardless of what you believe will follow.

[The abridged URL for this post is http://tinyurl.com/GriefStories3 .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

“Weekly Spark” Shares News One Might Otherwise Miss

Today’s “Weekly Spark,” a newsletter from the Suicide Prevention Resource Center (SPRC), pointed to an article that I missed in my review of suicide-related news last week: “Chasse case helps spur creation of mental health crisis center.” The story is important both because of the value of mental health crisis services such as the one established in Portland and because of the role of advocacy in bringing about change in society’s response to mental illness. Here’s the story summary, from the “Weekly Spark”:

A new 16-bed mental health crisis center in Northeast Portland will accept people who are suffering a mental health crisis such as suicidal or violent thoughts, hallucinations or severe anxiety. The center will serve as an alternative to jail or the emergency room for people who are in danger of harming themselves or others, and will provide up to 10 days of assessment and treatment. The center was created to improve the county’s response to people in mental health crisis. The issue was brought to the forefront by the 2006 death, in the back of a patrol car, of a man with schizophrenia.

Kudos to SPRC staff for its newsletter, which has led the way in bringing authoritative news to both the specialist and the general reader on a wide range of topics related to suicide prevention. If you’re interested, please sign up for SPRC’s mailing list.

– FJC

[The abridged URL for this post is http://tinyurl.com/SharesNews .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Catholic “Day for Life” in U.K. Will Focus on Suicide

UPDATE 07/10/2009: A London Telegraph story today features an interview with the Rt Rev Bernard Longley, who explains that “church teaching on suicide had not changed but its understanding of mental health had altered.”

“Suicide is a grave sin, but an individual must be mentally healthy to be fully aware that what they are doing is a sin. When a person commits suicide, they are generally so clouded by confusion and despair as to be no longer in full control of their mental faculties. God does not condemn anyone not fully aware of what they are doing: His mercy is without end.”

Bishop Longley said the families and friends of people who committed suicide suffered “acutely” and suicide should never be romanticised or encouraged.

But he said attempting suicide was “typically” the act of a desperate person and it should be greeted with compassion rather than with blame.

Original Post 07/09/2009: The Bishops’ Conferences of the Catholic Church in Ireland, Scotland, England  and Wales are working together this year during the annual “Day for Life” observance to take an in-depth look at the church’s point of view about suicide. According to a press release,

Day for Life — the day in the Church’s year dedicated to celebrating the dignity of life from conception to natural death — will this year focus on the theme of suicide. The main emphasis of Day for Life in 2009 will be on the pastoral dimensions of this difficult and sensitive subject.
It will highlight why the Church believes that every life is worth living and look at the reasons why people contemplate suicide, including acute mental illness and the possible spiritual factors involved. It will also point towards the support that the professional services can bring and hopefully help to reduce the stigma too often associated with mental illness and depression.

The online coverage of the topic includes  a blog section featuring posts from “people whose lives have been touched by suicide and mental illness.”

[Editor's note: Does anyone know if a similar observance is happening (or has happened) in North America? Please comment below.]
[The abridged URL for this post is  http://tinyurl.com/DayForLife .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Wednesdays and July, August Most Likely Times for Suicide

A USA Today story by Sharon Jayson covers a University of California, Riverside study showing that, regarding when suicides occur in the United States, “summer is the most common season and Wednesday the most likely day.”

Common beliefs about suicide being more likely on Mondays and during the winter aren’t really true … July and August are the most common months for suicide … [and] 24.6% of suicides were on Wednesdays.

The study was recently published online in the journal Social Psychiatry and Psychiatric Epidemiology.

It is based on data on almost 132,000 suicides from 2000-2005, from the U.S. Multiple Cause of Death Files, at the National Center for Health Statistics.

“What people believe to be the case — in sociology, frequently you find it is not the case,” says [the study's co-author, Professor Augustine Kposowa]. “People believe because the weather is cold and people are depressed in the winter, there are more suicides, but in sociology, what we find is that the highest number of suicides are in spring and summer.”

[The abridged URL for this post is  http://tinyurl.com/SuicideTimes .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

CBT Shown To Be Preventative with Teen Depression

A post by Nancy Shute last month in her U.S. News & World Report “On Parenting” blog covers a study showing that “cognitive behavioral therapy can prevent teenagers from becoming clinically depressed.”

That’s great news, because serious depression afflicts 2 million teenagers each year and puts them at greater risk of suicide and depression throughout life.

The findings of the study were published in the Journal of the American Medical Association.

Half of the 316 teenagers in the study, led by Vanderbilt University psychology professor Judy Garber, took part in eight weekly, 90-minute group sessions, in which they were taught problem-solving skills and practiced them. Cognitive behavioral therapy isn’t traditional, long-term “talk therapy”; it’s a short-term treatment, usually lasting no more than 20 sessions, based on the idea that people’s thoughts cause their feelings and behaviors. Thus if people change how they think about a situation and how they respond to it, they can feel better, even if the situation hasn’t changed.

Shute notes that “finding cognitive behavioral therapy can be tricky, because it’s advertised more than it’s actually delivered” and gives a description of CBT, from the Association for Behavioral and Cognitive Therapies, which she points out, “also has a decent online therapist finder”:

In cognitive therapy, a person learns to:

• Distinguish between thoughts and feelings.
• Become aware of how thoughts can influence feelings in ways that sometimes are not helpful.
• Learn about thoughts that seem to occur automatically and how they can affect emotions.
• Evaluate critically whether these “automatic” thoughts and assumptions are accurate or perhaps biased.
• Develop the skills to notice, interrupt, and correct these biased thoughts.

[The abridged URL for this post is http://tinyurl.com/CBT-Preventative .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Canada’s Prime Minister Eulogizes MP Lost to Suicide

A momentous occasion unfolded on Saturday when a head of state spoke both insightfully and eloquently about depression and suicide. The occasion, sadly, was the funeral of Dave Batters, a Member of Parliament who died by suicide the end of June, and the speaker the Prime Minister of Canada, Stephen Harper, who told Batters’ family and the other mourners gathered in Regina, Saskatchewan,

We need to know that mental illness like Dave’s is shockingly common in our society. It affects the great and the small alike despite the stigma that still too often surrounds it.

Other politicians have carried the same burden. In fact, perhaps the two greatest English-speaking politicians in history, Abraham Lincoln and Winston Churchill, struggled with depression.

Harper also spoke of Batters with an emphasis on how he lived not just on how he died, a point many survivors of suicide suicide feel is missed by society as they grieve the loss of their loved ones.

This we know: in his struggle, Dave achieved a life worth living, a simple but profound truth, a goal we all aspire to, and he reached it. Dave’s family can take great pride in this.

For Dave made a significant contribution to the lives of others. Another great goal in life, and one he achieved so ably.

When he ran for public office, Dave did not do so for selfish reasons. He responded to the tragedy of another, the murder of his friend Michelle. He heard, and answered a call to service and he did so with conviction, distinction and success.

Depression didn’t stop that. It was his decency that drove him forward, that defined him in life, that will define him in death.

The Prime Minister also reached out to everyone who suffers from depression or who has been touched by suicide, declaring that “Dave is not alone” and recognizing the thousands of others who die by suicide every year.

The science has progressed, but we still don’t know enough about depression, and less about suicide.

But we know this much: depression can strike the sturdiest of souls. It cares not how much you have achieved nor how much you have to live for …

Unlike its myth, depression is not a function of character except that to fight it summons a strength of character, and a great strength of character like Dave’s to fight it as long as he did. Dave dealt with his illness head-on. That takes courage.

To Dave’s family, we mourn and share your loss. But so too do we share your pride in Dave’s life and in the greater good he served through elected office and through his public battle with depression from which we can all learn.

[The abridged URL for this post is http://tinyurl.com/PM-Eulogizes .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Judge Overturns Verdict in Cyber-Harrassment Case

Lori Drew — the Missouri woman who created an online hoax that triggered a series of events ending in the suicide of 13-year-old Megan Meier — will be acquitted of the charges for which she was previously found guilty. The Los Angeles Times reports that

The decision by U.S. District Judge George H. Wu, which will not become final until he files a written ruling, was a blow to prosecutors who had hoped to send the message that cyber-bullying is a crime. Wu had repeatedly delayed sentencing to consider a defense motion to dismiss the entire case.

U.S. Atty. Thomas P. O’Brien, whose office prosecuted the woman, said after the decision was announced that the law needed to be strengthened. “We call it cyber-bullying and we don’t have a law to address it,” he said.

A Wired News article by John Abell summarizes the point of view of those who support the judge’s decision:

Drew could be ostracized, she can be sued for damages in a civil proceeding, she can become a pariah. I would not like to know her. I am not a lawyer, but for the state to deny her liberty for lying when she created an account on a social network would be excessive and chilling and imperil hundreds of thousands of people who, while doing the TOS [terms of service] version of jaywalking, set themselves up for selective prosecution if some chain of evidence or events can associate them to someone else’s tragedy …

Wu was correct to conclude that conviction would have made unelected legislators of the people who create the terms of service for any site, conditions almost nobody reads and which are chiefly aimed at indemnifying the owners for the behavior of their customers and only consequentially enabling nice sandbox play.

“It basically leaves it up to a website owner to determine what is a crime,” Wu said on Thursday. “And therefore it criminalizes what would be a breach of contract.”

MSNBC’s “Today Show” on Friday features an interview with Tina Meier:

“As Megan’s mom, I wanted to see her go to jail, because I think it needed to set a precedent. I think it needed to let people know: You get on the computer, you use it as a weapon to hurt, to harm, to harass people, this is not something that people can just walk away from.”

Still, Meier said, her daughter’s death focused attention on cyber-bullying and led to several state laws and a proposed federal law to address the growing problem. In that sense, she said, there is some justice for her tragedy.

“For me, because we’ve continued to be able to get the word out and hopefully share the story and hopefully make changes in households, making teens maybe think once or twice, absolutely I think there is justice in Megan’s name.”

For important background about children and bullying on the Internet, see the previous SPNAC post “Cyberlaws Are Coming into Play around Internet Safety,” which features an insightful discussion among experts on cybersafety for children, “Protecting Kids in the Digital Age,” a roundtable from the 2008 Tech Policy Summit.

Also see the related SPNAC post “Verdict Shows Parents, Internet Should Both Protect Kids.”

[The abridged URL for this post is http://tinyurl.com/OverturnsVerdict .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

2,000 Walkers Light the Way at Out of the Darkness Overnight

By Franklin Cook, SPNAC Editor

As in years past, the 2009 AFSP Out of the Darkness Overnight Walk ended with the final few hundred yards of the walkers’ path being marked by rows of small lights in hand-decorated receptacles. Each of the 2,000 lights represents a loved one who has died by suicide or someone who survived an attempt or someone who struggles with the kind of pain that might cause suicide. SPNAC readers may view the video“‘Out of the Darkness’ Path Illuminated with Thousands of Lights”, which shows the lighted path from this morning’s walk (Sunday, June 28 in Chicago).

At the conclusion of the Walk, Bob Gebbia, AFSP Executive Director, announced that Overnight walkers in 2009 had thus far raised $1.2 million for suicide prevention research, training, and education.

[The abridged URL for this post is http://tinyurl.com/2000Lights .]

Additional videos about a few of my own reflections on the Overnight Walk are available at http://tinyurl.com/MakingMeaning-OOD2009 .

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

I’ll Be at the Out of the Darkness Walk on Saturday in Chicago

I just wanted to let SPNAC readers know that I’ll be traveling to Chicago early tomorrow morning (Saturday, June 27) to participate as a Crew Member in AFSP’s Out of the Darkness Overnight Walk. This will be my fourth Out of the Darkness Walk (I walked in Washington, D.C., at the first Walk in 2002, then at the second walk in Chicago in 2005, then I started volunteering as a Crew Member in 2007 at the Walk in New York City). My community, the Black Hills of South Dakota is having its first AFSP Community Walk in October of this year (Rapid City, where I grew up, is in the central Black Hills, about 20 minutes from Mount Rushmore).

SPNAC readers may view a video sharing the stories of some of the people who took part in the walk last year in Seattle.

Franklin Cook, SPNAC Editor

[The abridged URL for this post is http://tinyurl.com/OOD-2009 .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Compassion, Courage Mark Story of Woman’s Rescue

Reporter Kevin Castle of the Kingsport Times-News tells the story of Moriah May, who survived a December 2007 suicide attempt when she was 21 years old. His report illustrates a suicidal person’s back-and-forth struggle between the urge to die and the desire to live, and it describes her rescue by a real-life hero, an 18-year-old who pulled May from her sinking car in Tennessee’s Fort Patrick Henry Lake.

May put her Kia Rio in gear and drove into the cold lake waters.

“I mean, it was like something took control, made me touch the gas (pedal) and drive. That was something that I could never imagine that I could do,” she said.

“But there I was in this zombie-like state, and I never saw anyone around when I was going into the water, and I thought that no one was going to be there. It was December, and I thought there weren’t many people around, but suddenly all of these people were near the bank.”

One person who saw the car go into the water was Lindsey Witherspoon, a King College student, swim team member, and former pool lifeguard. She jumped into the frigid waters and swam to the car …

As water filled the car, May’s desire to die turned into a fight for survival.

“Water was starting to rise … going into my nose and throat. That’s when panic took me,” May said.

May broke a window to escape from the car, and Witherspoon, who was 18 at the time, helped her get safely to shore. Then another woman, whose name May still doesn’t know, comforted her.

“This woman, she’s an older lady and I didn’t get a real good look at her face, but she just hugged me. I kept trying to push her away … and she just held onto me, like she knew that I was just breaking,” said May.

“She was moving my hair out of the way, kind of stroking it, and saying, ‘You’re beautiful. You’re a beautiful person. Why do you think you have to do this?’ And I said ‘because I’m gay’ and she said ‘God is not going to turn you away because you are gay.’

“It was just an inspiration to me that day to see a stranger just take me in like that. I didn’t feel like I deserved to be alive. This woman made me feel like I deserved to be here, and that was amazing. From that day, I felt like I should be alive.”

[The abridged URL for this post is http://tinyurl.com/Compassion-Courage .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

1/4 of Suicides in Large Study Exceeded Legal Alcohol Limit

Staff writer Kristina Fiore reports in MedPage Today on a study from the Centers for Disease Control and Prevention (CDC) showing that almost one-fourth of suicide fatalities in a large database “had a blood alcohol level above the legal limit for driving a car.” The findings are especially significant because they are based on data from almost 19,000 suicides in 17 states over a two-year period, 70% of which included toxicology results for alcohol.

The percentage of suicides with high blood alcohol levels was greatest among American Indian/Alaska Natives at 37%, followed by 29% for Hispanics — findings that hold implications for culturally specific intervention programs, [said Dr. Alex Crosby of the CDC's National Center for Injury Prevention and Control].

“Alcohol is connected to suicides across all [racial and ethnic] groups,” he said. “When programs try to address suicide prevention, they should definitely include alcohol as one component.”

The findings aren’t a surprise, since alcohol is a known risk factor in suicide, said Eric D. Caine, MD, chair of psychiatry at the University of Rochester Medical Center.

But the study is unique because it examines the role of alcohol in suicides across all ethnic groups — data that has been limited in prior studies, Dr. Crosby said.

“This is a really important paper because it underscores how much a common risk factor such as drinking contributes to something like suicide,” Dr. Caine said. “Here’s more data on how something like alcohol is fuel on the fire, and we need to ask ourselves what we are going to do about it.”

The paper by Dr. Crosby and his colleagues appears in the June 19 issue of “Morbidity & Mortality Weekly Report.” SPNAC readers may download a copy of the paper.

The data are from the National Violent Death Reporting System, which “collects data on violent deaths from a variety of sources, including death certificates, police reports, medical examiner and coroner reports, and crime laboratories,” according to the NVDRS website.

Individually, these sources provide fragmented data that explain violence only in a narrow context. Together, these sources offer a more comprehensive picture of the circumstances surrounding a homicide or suicide. As a result, NVDRS provides insight into the optimal points for intervention, thus improving violence prevention efforts.

Because of its importance in making suicide prevention efforts in the United States more strategic and more effective, expanded funding for the NVDRS is one of the current public policy priorities of the Suicide Prevention Action Network (SPAN USA).

[The abridged URL for this post is  http://tinyurl.com/SuicidesAlcohol .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Interfaith Dialogue Results in Consensus Statement on Suicide

“Consensus Statement on Suicide and Suicide Prevention from an Interfaith Dialogue”

The following statement was developed at an Interfaith Suicide Prevention Dialogue held March 12-13, 2008 in Rockville, Maryland. The dialogue was sponsored by the Suicide Prevention Resource Center and was funded by the Substance Abuse and Mental Health Services Administration. The participants included representatives from the Buddhist, Christian, Hindu, Jewish, and Muslim faith communities.

Life is a sacred gift, and suicide is a desperate act by one who views life as intolerable. Such self-destruction is never condoned, but faith communities increasingly support, rather than condemn, the person who contemplates or engages in suicidal behavior. They acknowledge that mental and substance use disorders, along with myriad life stressors, contribute significantly to the risk of suicide. And they reach out compassionately to the person who attempts suicide and to families and friends who have been touched by a suicide or suicide attempt. This increasingly charitable understanding finds agreement between the historic precepts of faith and a contemporary understanding of illness and health. It renders no longer appropriate the practice of harshly judging those who have attempted or died by suicide.

Life is a complex journey viewed through different lenses by different faith groups. But the varied eyes of all our traditions increasingly see the great potential of people of faith to prevent the tragedy of suicide. Spiritual leaders and faith communities, and now the research community, know that practices of faith and spirituality can promote healthy living and provide pathways through human suffering, be it mental, emotional, spiritual, or physical.

Faith communities can work to prevent suicide simply by enhancing many of the activities that are already central to their very nature. They already foster cultures and norms that are lifepreserving. By providing perspective and social support to their members and the broader community, they compassionately help people navigate the great struggles of life and find a sustainable sense of hope, meaning, purpose, and even joy in life.

The time is right for the life-enhancing strengths that are the foundations of our most ancient faith traditions to find application in preventing suffering and loss from suicide. Suicide prevention will take a quantum leap forward as members of faith communities gain understanding and the necessary, culturally competent skills to minister to people and communities at heightened risk for suicide and to support the healing of those who have either struggled with suicide themselves or survived the suicide of someone they love.

Common Themes

• All faith groups have a strong reverence for life. Regardless of what might happen after a person dies, this life is precious and a gift to be treasured.
• A wide range of opinions and beliefs about suicide exist among people in all faith groups. While most agree on the destructive and painful aspects of suicide, there is an increasing understanding that the decision to take one’s own life is influenced by many variables including mental illnesses. Judgment is often tempered by compassion and by the belief that the individual will ultimately be judged by God who understands the full intent of one’s heart. However, within each faith group, some people are still judgmental and believe the person who died by suicide simply did not hold onto the beliefs or pray and practice the rituals of his faith diligently enough.
• Except in the case of Hindu “honorable” suicides, suicide is not condoned by any faith group.
• Most suicides can be prevented. We are responsible for each other, and we need to be proactive in promoting hope and meaning in life for people in distress.
• Suicide is a tragedy and a terrible loss for the victim’s friends, family, and community. However, it is also an opportunity to “change poison into medicine” by spurring people into action to promote connections with others and prevent high-risk behaviors such as drinking and gambling.
• The causes of any suicide are multiple and complex. However, a person who takes his own life often has a number of risk factors, such as mental illnesses and substance use disorders that are not offset by protective factors such as caring relationships with friends and family and a strong connection to a faith community.
• Stigma, lack of culturally acceptable “language,” and lack of culturally appropriate mental health services prevent many people from seeking help.
• Except for Hindu and Buddhist priests whose roles are mainly ceremonial, most clergy are likely to agree to be involved in suicide prevention efforts. Within the Hindu and Buddhist communities there are many other people and organizations that would welcome the opportunity to engage in suicide prevention.
• Clergy and other leaders in faith-based communities need training and access to sound information regarding mental health, mental illnesses, and suicide prevention.
• Many perspectives in addition to those represented at this small meeting would contribute in important ways to this dialogue.

SPNAC readers may download the complete source document, “The Role of Faith Communities in Preventing Suicide.”

[The abridged URL for this post is http://tinyurl.com/InterfaithConsensus .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Cop Helps Suicidal Woman with Heart-to-Heart Cat Chat

[Editor's Note: Because this story is so poignant as well as brief, I am sharing it in its entirety. The author is Adam Bosch of the Times Herald-Record, reporting from Saugerties, NY. FJC]

A Saugerties woman loaded her rifle, ready to end her life late Friday night, but a police negotiator who knew that the woman loved cats convinced her that suicide wasn’t the answer.

Town police surrounded the home on Parr Shale Road after the woman, who has a history of mental illness, called the police station and threatened to kill herself. The woman had just been in an argument over the telephone with her daughter, who wanted to move her to an assisted-living home.

The standoff, which started at 11:30 p.m. Friday and lasted more than 2 hours, was fraught with sensitive moments. At one point, a Saugerties police dispatcher convinced the woman to put back the safety on her loaded .22-caliber rifle, but shortly after the woman became angered and hung up the phone.

Detective Bob Haberski, who knew the woman from previous calls, got her back on the phone.

“I tried to have her focus on the fact that there’s a lot to live for,” Haberski said.

What’s more, Haberski and the woman began chatting about one of her favorite topics: cats.

“I knew she loved cats, so I focused on that to redirect her emotion,” Haberski said.

After she calmed down, the woman agreed to meet Haberski face to face. Police watched through a window as the woman moved her rifle from the kitchen counter to a back bedroom.

She was taken without incident to Benedictine Hospital in Kingston for a psychiatric evaluation.The identity of the woman is being withheld because of the nature of incident.

ORIGINAL STORY

[The abridged URL for this post is http://tinyurl.com/HelpfulChat .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Links to Suicide Grief Stories: June 3, 2009

[Editor's note: "Links to Suicide Grief Stories ..." is a SPNAC series featuring stories of survivors of suicide loss--about the effect their loved one's suicide has had on them and how they are coping with their grief. FJC]

In “Glitterati help erase mental illness stigma,” Society Editor Frank Brown interviews Sam Bloom, a long-time suicide prevention advocate in California, who reflects on recipients of the Didi Hirsch Community Mental Health Center’s “Erasing the Stigma” leadership award. Bloom and his wife, Lois, lost their son Sammy to suicide in 1982.

“Stigma prevents people from seeking help,” said Sam Bloom … “The way we reduce stigma is to make the public aware that mental illness is a brain disease much like cancer is a cellular disease or diabetes a disease of the blood.” (Palos Verdes Peninsula News)

In “One person can help prevent suicide, forum hears,” writer Julie Slack reports on a forum held in Peel, Ontario, Canada, where David Harris, a survivor of his son’s suicide in 2005, told the assembled crowd about CameronHelps, the teen suicide awareness organization he launched.

In an emotional presentation, Harris said he turned to friends who are there to guide him through his grief. He made a pact to run 19 consecutive Mississauga Marathons, one for each year of Cameron’s life. After last Sunday’s race, he has 14 more to go. Harris also decided to hold what he hopes will become an annual five-kilometre run/walk in Port Credit, as part of the Mississauga Waterfront Festival. Called “Find a Way,” the first run is slated for June 21. (The Missauga News)

In “Amid grief, love blossoms,” reporter Claire Martin recounts how an Aspen, Colo., couple were brought together by their grief over the deaths of family members. Art Daily’s wife and two children died in an accident in 1995, and upon hearing of the tragedy, Allison Snyder, who had lost her brother to suicide, sent a gift to Daily. The two corresponded, and …

After a courtship that swung between caution and impetuousness–what about their 25-year age difference, would Allison always dwell in the shadow of Art’s grief?–they married, roughly 15 months after the Glenwood Canyon accident.

Now, more than a dozen years later, Daily and Snyder have written a book, Out of the Canyon, which “is devoted to the singular story of how Art and Allison met” and includes “an afterword, ‘Grief Has No Rules,’ sharing their thoughts on mourning and on the best ways to comfort someone in the wake of a death.”  (The Denver Post)

In “Friends honor Seibert, raise awareness about teen suicide,” Gracie Bonds Staples reports on how a half a dozen of a young suicide victim’s friends launched The Seibert Foundation in his memory.

More teenagers and young adults die from suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease combined. For Kyle Murphy and six of Ben [Seibert]’s other friends, those statistics translate into human lives.

“Suicide is not inevitable, and the only thing you can do wrong is nothing,” Murphy said. “Everybody can do something to participate.” (Atlanta Journal-Constitution)

In “Parents reach out through their grief,” reporter Cathy Dyson covers the journey of Todd and Michelle Brown, whose daughter, Carol Anne, died by suicide in April.

Carol Anne’s obituary spoke of her many attributes–her smile and her ability to accept people for who they were. It hailed her as an accomplished equestrian, lacrosse player and actress, a young woman who accumulated 300 hours of community service with groups that help animals and handicapped children, and whose organs were donated after her death.

Then the obituary mentioned something not found in most death notices–that “Carol Anne suffered from the destructive illness of depression and bipolarism.” The Browns encouraged others to seek medical attention for loved ones who suffer from “this dreaded illness, especially teenagers during these most fragile years.”

Dyson’s report is accompanied by a video by Rebecca Sell, “Reaching out for Carol Anne,” in which the Browns talk about their daughter’s struggles in the last three years of her life. In the end, says Todd Brown,

“This can happen to any family, and we have to just be more diligent in looking for it.” (Fredericksburg Free Lance-Star)

[The abridged URL for this post is http://tinyurl.com/GriefStories02 .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Media Coverage of Canandaigua Suicide Misses Key Truths

By Elana Premack Sandler, LCSW, MPH

On May 5, 17-year-old Thomas Kane died by suicide at his school, Canandaigua Academy in upstate New York. Police investigation following the death showed that Kane had at the ready in his locker a shotgun, extra ammunition, and two Molotov cocktails, and in his car he had liquid accelerant and three lighters.If Kane’s original intentions weren’t made abundantly clear by what police discovered in his possession, he also kept a journal in which he laid out his plans to kill others in his school.

The reason I–a Bostonian by way of being a Washingtonian with few connections to teens living in upstate New York–know these details of a young man’s life and the tragedy that occurred in his school is because they were reported by local Canandaigua media outlets. The media covered Kane’s death in depth, probably because it occurred in a public place and definitely because of the information about the police investigation that came out within days of his suicide.

Explicit journal excerpts were published in one newspaper. While initially one television station chose not to use Kane’s name in their reports , once the information about his possible plans to kill others in his school was released, the station identified Kane.

At first, I questioned why media would report such details. Why would journal excerpts be included in news articles? Isn’t it sensationalizing a tragic death to draw attention to the intimate details of a young man’s psyche? But then I realized that I wanted to capture those same details as I told the story to you, for those very details are part of what makes Kane’s story newsworthy. However, if there could be such a thing as “just another school shooter,” a phrase Kane himself used in his journal, Kane certainly did not fit that description. Ultimately, he decided not to kill anyone but himself. That fact highlights a sad trend in media coverage: Whenever there is a school shooting, the significance of the suicide is lost because of the drama of the murders, yet the part of the story about the person’s suicide deserves attention.

In an age when schools are reeling from previously unimaginable violence that has occurred in their classrooms and cafeterias, troubled teenagers make news. Those of us who work in violence and suicide prevention are at times looking for the same elusive clues as PTA presidents and so-called soccer moms, seeking a better understanding of what drives young people to take their own lives and, along the way, the lives of others.

In this instance, the possibility of homicide being involved eclipsed Kane’s personal story, and he was represented as “just another school shooter” without even being one, his story destined to be told in the way it didn’t end instead of in the way it did.

The complexity of suicide is not a story many media venture to cover. But because of the public safety implications and their duty to cover news that matters, media have an obligation to cover stories that ended the way Kane’s could have. If it had been a school shooting, we would all still be asking how it could have been prevented, but the focus would be almost entirely on the school shooting and hardly at all on the suicide. That focus has caused us to miss the point about suicide itself in stories such as this one. [continued ... read the full article here]

[The abridged URL for this post is http://tinyurl.com/KeyTruths .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

TAPS Reaches Out To Military Families Grieving after Suicide

Connie Scott displays a picture of her son, Brian Williams, who died by suicide when he was 20 years old. (Sarah L. Voisin, The Washington Post)

By Franklin Cook, SPNAC Editor

Never before has suicide by U.S. military personnel and veterans caught the nation’s attention as it has since the 2003 invasion of Iraq. Thankfully, the plight of the families left behind after a loss by suicide is also getting some much-needed attention, as was evidenced during the Memorial Day weekend at the National Military Survivor Seminar put on by TAPS, the Tragedy Assistance Program for Survivors. The seminar was covered for the Washington Post by reporter Steve Vogel.

Mirroring a rise in suicides in the military, many of those participating in the 15th annual TAPS seminar are families of service members who took their own lives.

“A third of the calls we’re getting now are from families with suicides,” said Bonnie Carroll, executive director of TAPS.

Suicides in the Army, already at a record rate in 2008, surpassed the number of combat deaths for the month of January. As of the end of April, the Army had lost 64 active-duty soldiers to likely suicides.

Several survivors at the seminar were struggling–even as they view their loved ones as having died in the service of their country–with the stigma related to a death by suicide.

Mary Clare Lindberg’s son, Army Sgt. Benjamin Jon Miller, was home in Minnesota on leave from Iraq in June when he shot and killed himself. In March, Lindberg made a pilgrimage to Fort Campbell, Ky., to visit the post where her son served with the 101st Airborne Division. While it was comforting to meet with the soldiers with whom her son had served, Lindberg was upset when she saw the unit memorial. The names of two soldiers from her son’s brigade who were killed in combat were on the memorial, but Ben Miller’s name was not.

“Because my son was a suicide home on leave, his name was not on the memorial wall at Fort Campbell, and that’s just not right,” said Lindberg, who said her son was suffering from post-traumatic stress disorder from his experiences in Iraq.

Crying as she spoke Friday, Lindberg was comforted by several other women who had lost sons or husbands in the military to suicide.

“Our loved ones are casualties of the war, but they are not remembered,” said Connie Scott, whose son, Pvt. 1st Class Brian M. Williams, also killed himself while home on leave from Iraq.

In an Army Times article earlier this year, staff writer Karen Jowers reported on how TAPS is reaching out to suicide survivors, using the approaches it has always used with families who lose a loved one in war.

“TAPS has seen a tragic increase in families whose loved ones lost their very personal battles,” said Bonnie Carroll, the group’s founder … “We embrace these families with a wide array of programs offering comfort and care …”

TAPS offers peer-based support, crisis care, casualty casework assistance, and grief and trauma resources, all free. Unlike most programs offered through the military, TAPS provides ongoing help to anyone grieving the death of a loved one in the military, regardless of the relationship to the deceased, where they live, or the circumstances of the death.

TAPS can also help connect service members, families and others to free, confidential … counseling through partnerships with the Veterans Affairs Department’s Vet Centers, Give An Hour, and the Association of Death Education and Counseling.

During the past 40 years, peer-led support groups across America have become a mainstay of the grief services available to people who have lost a loved one to suicide. The experience of those groups shows that, for many, there is no better help available than spending time with others who have also suffered the death of a loved one by suicide. In a similar fashion, it looks as if TAPS is using its experience with peer outreach to help military families who are bereaved by suicide.

“It’s brought me back to square one,” said [Kim] Ruocco, whose husband, Marine Corps Reserve Maj. John Ruocco, killed himself in a hotel room near Camp Pendleton, Calif., three months after returning from Iraq. “I’m exhausted with the subject of suicide, but I can’t rest because there’s too much to be done.”

Ruocco and another widow of a Marine suicide, Carla Stumpf-Patton, have begun coordinating TAPS’ nationwide peer support group program specifically for survivors of suicide.

The TAPS 24-hour crisis line is 800-959-TAPS (8277).

[The abridged URL for this post is http://tinyurl.com/TAPS-reaches.]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Research on Meds Must Safely Include Suicidal People

[Editor's note: It is my pleasure to share with SPNAC readers the first guest article to be posted on Suicide Prevention News and Comment. Several other noteworthy authors have been invited to make contributions, and I am hopeful that items such as this will become a regular feature. FJC]

By DeQuincy A. Lezine, Ph.D.

Patients in antidepressant drug trials are not representative of patients in the United States who might need antidepressant medication. That is the conclusion of a recent study by Dr. Madhukar Trivedi of the University of Texas Southwestern Medical Center and colleagues appearing in the May issue of the American Journal of Psychiatry. The report comes from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, funded by the National Institute of Mental Health (NIMH). The $35 million study included 2,855 patients with depression and lasted six years.

MedPage Today senior editor John Gever writes in a May 14 article that pharmaceutical drug trials for antidepressants generally exclude many potential participants, such as those with “more than one concurrent general medical condition or Axis I psychiatric disorder in addition to depression, or current episodes lasting more than two years.” A May 12 article in The Medical News notes that potential participants “who have previously tried treatment, have suicidal thoughts or have other psychiatric illnesses” would have been excluded. In fact, nearly 80 percent (4 out of 5) of the patients included in STAR*D would have been excluded from other antidepressant clinical trials.

The problem of excluding suicidal individuals from research studies has been noted for some time, with some solutions initially covered in a 2001 article by Jane Pearson (NIMH) and colleagues. This research issue will only intensify as we continually recognize and treat depression and other mental illnesses earlier, especially if we continue to find that comorbidity is the norm rather than the exception.

While prior studies have noted that patients in drug trials differed from other patients based on demographics and clinical characteristics, the current study also documented differences in outcomes. According to the MedPage Today article, findings from drug trials probably “paint a rosier picture than should be expected in ordinary practice” because patients who would have been excluded from drug trials

• were less likely to respond well to the antidepressants (39%) compared to those included in drug trials (52%) …
• were less likely to achieve remission from depression (25%) compared to those included in drug trials (34%) …
• were more likely to require psychiatric hospitalization (2.5%) compared to those included in drug trials (0.3%) …
• were more likely to experience severe or intolerably intense side effects compared to those included in drug trials.

These findings call into question whether the information provided to patients who receive antidepressant medications overstates the potential benefits, including response rates, and understates the potential side effects and risks. Can patients truly give informed consent without accurate information?

According to Dr. Trivedi, “We are basing our judgment of clinical care in the United States on samples of patients that are totally different than the patient population actually treated in primary care and mental health facilities.” The patients who would have been included in drug trials had “shorter bouts of depression, quicker response to medication, less severe side effects and fewer adverse events compared with those people with depression who would have been excluded from such a trial” [continued ... read the full article here].

[The abridged URL for this post is http://tinyurl.com/SafelyInclude .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Suicide Prevention Pioneer Edwin Shneidman Dies at 91

(Genaro Molina, Los Angeles Times)

By Franklin Cook, SPNAC Editor

Edwin S. Shneidman–a heroic figure in the field of suicide prevention, a man whom I often call the father of modern suicidology–died Friday at his home in West Los Angeles at age 91.

Los Angeles Times senior editor Thomas Curwen followed Shneidman’s life, and in an obituary today, summarizes highlights of his career and his thinking about the nature of suicide and its prevention:

Shneidman, one of the founders of the Los Angeles Suicide Prevention Center, believed that two simple questions — “Where do you hurt?” and “How may I help you?” — could begin to unlock the suicidal impulse.

Shneidman, along with Norman Farberow and Robert Litman, established the center in an abandoned tuberculosis hospital on the grounds of Los Angeles County Hospital in 1958. Staff members offered counseling and support over the phone to the depressed and suicidal. It represented a radical idea in mental health care in America.

Research into suicide — and suicide itself — was largely shunned and stigmatized. In time, the Suicide Prevention Center captured the popular imagination in movies and books and became a national center for studying the enigma of suicide.

Shneidman viewed suicide as a psychological crisis and — as did Albert Camus — as the “one truly serious philosophical problem.”

“Suicide is a complex malaise,” Shneidman said. “Sociologists have shown that suicide rates vary with factors like war and unemployment; psychoanalysts argue that it is rage toward a loved one that is directed inward; psychiatrists see it as a biochemical imbalance. No one approach holds the answer: It’s all that and more …

“You don’t understand psychopathic murder by slicing [Jeffrey] Dahmer’s brain, and you won’t get E=MC2 by slicing Einstein’s brain,” he says. “Unfortunately, it’s in the mind. And the mind is not a structure. It is an ephemeral concept.”

Another excellent remembrance of Shneidman is available on Huffington Post: In “A Good Man, A Good Death,” Dr. Mark Goulston summarizes his “long time mentor and beloved friend['s]” view on what constitutes a good death, as well as providing several additional links to material about Shneidman.

In my opinion, there is no more profound explication of the nature of suicide and, simultaneously, no more practical outline of the principles to consider in effecting its prevention than is found in Shneidman’s “Ten Commonalities of Suicide,” which appear in his classic The Suicidal Mind:

1. The common purpose of suicide is to seek a solution: A suicidal person is seeking a solution to a problem that is “generating intense suffering” within him or her.
2. The common goal of suicide is cessation of consciousness: The anguished mind of a suicidal person interprets the end of consciousness as the only way to end the suffering.
3. The common stimulus of suicide is psychological pain: Shneidman calls it “psychache,” by which he means “intolerable emotion, unbearable pain, unacceptable anguish.”
4. The common stressor in suicide is frustrated psychological needs: A suicidal person feels pushed toward self-destruction by psychological needs that are not being met (for example, the need for achievement, for nurturance or for understanding).
5. The common emotion in suicide is hopelessness-helplessness: A suicidal person feels despondent, utterly unsalvageable.
6. The common cognitive state of suicide is ambivalence: Suicidal people, Shneidman says, “wish to die and they simultaneously wish to be rescued.”
7. The common perceptual state in suicide is constriction: The mind of a suicidal person is constricted in its ability to perceive options, and, in fact, mistakenly sees only two choices-either continue suffering or die.
8. The common action in suicide is escape: Shneidman calls it “the ultimate egression (another word for escape) besides which running away from home, quitting a job, deserting an army, or leaving a spouse … pale in comparison.”
9. The common interpersonal act in suicide is communication of intention: “Many individuals intent on committing suicide … emit clues of intention, signals of distress, whimpers of helplessness, or pleas for intervention.”
10. The common pattern in suicide is consistent with life-long styles of coping: A person’s past tendency for black-and-white thinking, escapism, control, capitulation and the like could serve as a clue to how he or she might deal with a present crisis.

SPNAC readers may download a copy of “10 Commonalities” that is formatted as a handout.

Related SPNAC post: “Edwin Shneidman’s Meditations on Death Are Full of Life“

Please also see Curwen’s 2001 feature story about Shneidman and his work in the Los Angeles Times Magazine, “Psychache.”

[The abridged URL for this post is http://tinyurl.com/PreventionPioneer .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Gathering Shows Power of Community Resilience

Community members affected by the recession form a circle to begin a sharing session at the Glenwood Springs Community Center. (David Frey, Aspen Daily News)

In a May 13 story for the Aspen Daily News, correspondent David Frey reports on a notable example of a community’s resiliency in the face of hard economic times.

They were architects and accountants, construction workers, carpenters and computer repairers, natural gas workers and natural food sellers, reflexologists and real estate agents. But they had one thing in common: The recession has left them looking for ways to make ends meet … They gathered at the Glenwood Springs Community Center to meet with others in similar situations and brainstorm solutions in what was at turns a networking session and a group therapy session.

Tonja LaFrenz, owner of a temp agency in Rifle, partnered with two community members, Nick Isenberg of Glenwood Springs and Wewer Keohane of Carbondale, to make the meeting happen.

LaFrenz said she organized the gathering after clients for her agency dwindled. She was losing business herself, she said, and she had few jobs to offer people who called. When one person called contemplating suicide, followed by another offering his BMW in exchange for a job, she decided she needed to do something to help.

The gathering showed how a community coming together around a common problem–informally and with an open-ended agenda–can help address even the most stressful problems.

Many swapped business cards, but the meeting couldn’t promise jobs. Some participants said they hoped to see the gatherings become monthly. Others planned to set up a Web site to coordinate bartering services for people who couldn’t pay. Others left with something less tangible. “Hope,” one woman said. The woman beside her agreed. “Hope,” she said. So did the man beside her. “Hope,” he said.

[The abridged URL for this post is  http://tinyurl.com/GatheringResilience .]

[Related SPNAC posts:]

• “The Last Word on the Financial Crisis and Suicide Prevention”
• “Town’s Website Reacts to Economy with Mental Health Tips”

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

U.S. Suicide Prevention Oblivious to Working-Age Men

By Franklin Cook, SPNAC Editor

“Men and Mental Health: Get It Off Your Chest,” a study just released by Mind, the leading mental health charity in England and Wales, deserves attention in the United States, where what is known about suicide and men lines up very well with what is known in Great Britain.

Here’s what the study, in which 2,000 men and women were surveyed about their mental health, says about men and suicide. These survey results explain some of the reasons why 75 percent of suicide fatalities are men in England and Wales (79 percent of suicides in the United States are men).

When it comes to risk factors and thoughts of suicide:

• Men are twice as likely as women to have suicidal thoughts when they are worried (seven times more likely for men age 45 to 54).
• Young men (18 to 24) are five times as likely to take recreational drugs when worried as young women, and almost twice as many men overall as women drink alcohol to cope with feeling down.
• Almost twice as many men as women get angry when they are worried.
• Forty-five percent of men think they could fight off feeling down by themselves.

When it comes to getting help:

• Only one-fourth of all men would see their physician if they felt “low” for more than two weeks, and only 14 per cent of men age 35 to 44 would do so.
• Men are half as likely as women to go to a counselor or therapist to talk about their feelings.
• Men are also about half as likely to talk to friends about their problems as women, and only about three out of 10 men are likely to talk to a friend about feeling low (and young men are the most likely to tell a friend to “pull themselves together”).

The Mind report makes several specific recommendations that address the mental health and government institutions in Great Britain, and several more general recommendations that could be translated to U.S. suicide prevention efforts for men:

• Commissioners of health services should identify the need for and plan accordingly for male-specific mental health services.
• The criteria used by health professionals for diagnosing mental health problems should include all indicators of a condition, including the more traditional male symptoms of “acting out.”
• Health professionals should take gender into account when discussing treatment options with men.
• Employers should learn to recognise the symptoms of men’s mental distress and introduce mental well-being policies.
• Core education/training and continuing professional development of health and social services professionals should cover the relationship between gender, sexuality, and mental well-being.
• Race equality and the needs of black and minority ethnic men should be made a priority …
• Commissioners of mental health services and public health professionals should take into account the different needs men can have at different ages and plan services accordingly.

Most importantly, the leadership of the suicide prevention movement in America ought to be asking (and answering) these questions:

• Since four out of five U.S. suicide deaths are by men, what is being done to institute a public health strategy for suicide prevention that specifically targets that obviously high-risk group (including in the areas referenced by the recommendations above)?
• Since nearly two-thirds of all suicides in the United States are by men between the ages of 20 and 64 (precisely during their working years), shouldn’t suicide prevention for those people be one of the highest health-care priorities for employers and the institutions supporting employees throughout the country (such as the Department of Labor and the AFL-CIO, just to name a few)?

These questions are–and have been for a long time–knocking about in the background of  discussions about suicide prevention in the U.S., but developing the strategic answers is on no one’s radar that I know of. Yet there are a number of realities that indicate the need and opportunity for action:

• The National Strategy for Suicide Prevention marked its eighth year in existence on May 1st, and while it still is an excellent blueprint for the public health response to suicide in America, it is now unquestionably overdue for an overhaul.
• The national coordinating body intended to help guide the suicide prevention movement that was called for in the NSSP (which was to be instituted by 2002, in fact) is still not in place (although the Substance Abuse and Mental Health Services Administration, SAMHSA, several years ago indicated it was taking steps to organize such a group under the name “Action Alliance”).
• The lessons being learned from four years of community-level suicide prevention work targeting youth and college students with funding from the Garrett Lee Smith Memorial Act are ripe for translation into programs for suicide prevention across the lifespan.

If suicide prevention is to be effectively based on the public health model, then the highest number of individuals in the population identified as a group that is most affected by the malady ought to be reached through intensive preventative measures. The time for making suicide prevention a priority in the United States among working-age men has come.

[The abridged URL for this post is http://tinyurl.com/ObliviousToMen .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Alcohol Screening Linked to Youth Suicide Prevention

In a May8 Reuters article, reporter Joene Hendry summarizes findings from a University of Connecticut Health Center study that demonstrates “adolescents who drink alcohol while sad or depressed have an increased risk of attempting suicide, whether or not they have previously had suicidal thoughts.”

The findings have implications for screening adolescents for suicide, especially when suicide might be impulsive.

Among adolescents not reporting prior suicidal thoughts, “drinking while ‘down’ was associated with a 3-fold increase in risk,” said [Dr. Elizabeth] Schilling.

Suicide prevention is challenging when youths do not show suicidal ideas before attempting suicide … so screening young people to see if they tend to drink alcohol while depressed may provide “an alternative avenue for identification and early intervention.”

As the study itself points out, “the absence of suicidal thoughts may signify the absence of depression or less severe depressive symptomatology that may evade detection through commonly used screening instruments, which typically include questions about suicidal thoughts and previous suicidal behavior.”

The full text of the study is available from the Journal of Adolescent Health. The study concludes that “the use of alcohol while sad or depressed [is] a marker for suicidal behavior in adolescents who may not engage in planning or ideating prior to an attempt, and hence, may not be detected by current strategies for assessing suicide risk.”

Although problematic use of alcohol among adolescents is readily detectable using current screening approaches … routine screening for adolescent alcohol use by pediatricians and family practitioners is not universally practiced despite the recommendations of the American Academy of Pediatrics, the American Medical Association, and the Society for Adolescent Medicine. Findings from this study should provide further impetus for alcohol and drug screening among pediatricians and family practitioners beyond that motivated by concerns about alcohol and substance use.

[The abridged URL for this post is http://tinyurl.com/AlcoholScreening .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Links to Suicide Grief Stories: May 4, 2009

[Editor's note: "Links to Suicide Grief Stories ..." is a SPNAC series featuring stories of survivors of suicide loss--about the effect their loved one's suicide has had on them and how they are coping with their grief. FJC]

“Those Grieving after a Suicide Forever Wonder What They Could Have Done To Save a Life,” by reporter Tim Chitwood of the Ledger-Inquirer of Columbus, Ga., tells the story of a woman who lost both her husband and oldest son to suicide.

“The effect is would’ve, could’ve, should’ve, I think, which is a normal reaction in probably every death, but especially suicide, because in most cases, the writing’s not on the wall, and you don’t really think that could ever happen to you or your family — even when you’re going through treatment for depression and doing all that you can do to help the individual,” said Debi Dinwiddie-Johnson of the local support group Survivors of Suicide.

“Suicide Creates Lifetime of Hurt for Loved Ones” by reporter Megan Loiselle of the Wausau Daily Herald covers the efforts of survivors in Merrill, Wis., to promote prevention through a billboard campaign that focuses on the aftermath of suicide.

Katarina Miller, 16, of Merrill said a lot of people knew about her father committing suicide in 2007. When she showed up at school the next day, many of her friends gave her hugs.

“People (who take their own lives) think they’re taking the problem away, but they don’t know how many people it affects,” Miller said.

“Dying To Change” by Scott MacDonald of the University of Idaho’s Argonaut begins and ends with the story of freshman Amitti Mackey’s loss of her father to suicide and also informs students about the problem of suicide in Idaho and on campus.

Thinking about the future can be difficult, [Mackey] said. “I don’t get to have my dad walk me down the aisle, or have that first dance.”

“You move forward … It’s not going to be normal like you knew. Just talking about it helps. You can’t keep it all bottled up and compartmentalize it. You won’t get rid of it.”

In a first-person essay, “Suicide: A New Beginning for Those Left Behind,” Michele Cole of Colorado looks back 20 years after her older brother, David, died by suicide and shares how his loss has affected her spiritual growth.

While being ‘left behind’ is never easy, it is a dramatic beginning to what can be a larger than life opportunity to grow in spirit … To learn how to fully grieve without giving into depression and to learn how to honor a life regardless of the mental and emotional anguish they have laid at your feet. The lessons of those left behind from suicide are like no other, and as with every experience in my life, I honor it … David provided many lessons that have helped me find my path–the path that has lead me to being the woman I am today.

“Suicide Prevention: One Family’s Story,” by reporter Sarah Barwacz of WMBD TV in Peoria, Ill., is an interview with Sara Davis and Rachael Myers, who are preparing for Chicago’s Out of the Darkness Walk this summer in memory of Jason Hooker. Rachael, who is Jason’s sister, says in the interview that suicide “changes everything. Your life is never the same.”

[Jason's girlfriend Sara says,] “If we can touch one person’s life and save them from having to go through the tragedy that our families have been through, then it makes it all worthwhile.”

[The abridged URL for this post is http://tinyurl.com/GriefStories01.]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Christian Writers Push Back against Suicide Stigma

[Editor's note: Two recently published articles written by Christian authors give perspectives that push back against the stigma about suicide to which Christianity has historically contributed. The ideas they touch upon reflect a trend over the past century--and increasingly in recent decades--for Christian churches to be more understanding about mental illness and suicide and less judgmental and prescriptive about related behavior.]

In a story in Christianity Today, journalist Christine Scheller writes candidly about her religious faith in relation to the death of her son by suicide.

For nearly two decades, love gave rein to Gabriel, his brother, my husband, and me as we galloped prettily through life. Then we hit a rough patch … Our church experiences alone had left my husband and me limping and our sons jaded … Just about the time I thought we might regain our family stride, Gabriel died by suicide. He was 23 …

Early on, the suicide felt like a cruel cosmic joke. It was as if God, or the Devil, or some Job-like combination thereof, was mocking and toying with us.

The family received comfort from a psychiatrist Scheller had recently met, Aaron Kheriaty of the Psychiatry and Spirituality Forum, who assured them that their son’s death was not their fault and “firmly insisted that the death would never make sense: suicide is inherently an irrational act.”

Kheriaty was a safe person to invite into our moment of horror, unlike some pastors who later described the suicide as an “unwise choice” and simple spiritual failure.

Kheriaty delivered the homily at Gabriel’s funeral, explaining that

“For reasons that are quite beyond our comprehension, God allowed Gabriel to suffer a terrible illness … Gabriel’s death issued from an unsound mind that was afflicted by a devastating disorder.”

In the end, Scheller writes as a survivor who needs “time and space to come to a realistic self-assessment”:

I trust that for me, the crucible will forge a better person, and lead to peace … When I think of all that Gabriel suffered in this life, I do not understand. I find it difficult to trust God or engage him with the intimacy I once enjoyed. And yet every day, I inhale moments of grace. I am immeasurably grateful for the privilege of being Gabriel’s mother.

As Gabriel was walking out the door of this life, I called out after him, “I love you.” Love is as strong as death, wrote Solomon. The love of God is stronger.

The latest column in The Citizen (Fayette County, Georgia) by Pastor Justin Kollmeyer of Prince of Peace Lutheran Church in Fayetteville is titled “Suicide and Heaven.” According to Kollmeyer, not merely “the truth” but “the truth with power and conviction” is that

[Suicide is] wrong. It’s horrible. It’s cruel. It’s regrettable. It’s not the answer. It’s not God’s will. It is never an acceptable solution. It’s an atrocious wounding of all those who love the one making this decision, especially the family …

But I believe there is more to committing suicide than just making one bad and damnable decision for all time …

Kollmeyer first accounts for those who die by suicide because of clinical depression, which he says “is a disease, just as a heart attack is a disease, and cancer is a disease, and diabetes is a disease.”

Health care professionals remind us that suicide is not an inevitable or acceptable outcome of depression. None of us “accepts” suicide as a result of depression, but in hindsight we can see the disease at its most destructive when we see suicide. Death by disease? Unfortunately yes.

Then he goes on to answer the question of suicide being an “unforgivable sin” from a Christian point of view:

Fortunately no! God declares in His word through scripture that He loves His creation, especially His human creation despite the “fallen-ness” and “brokenness” of human sin … God can disagree totally with the decision of one of His dear children, who commits suicide. But at the same time, He keeps His promise to grant salvation and receive sinners into eternal life. Ultimately, we all get into heaven the exact same way. Not earning it, not deserving it, but by trusting in and believing in the sheer grace of God. Can someone who commits suicide go to heaven? Simply, yes. By the grace of God.

Kollmeyer tosses suicide on the pile with all sin (including the Christian concept of “original sin”)–which i contradictory, for one must ask, Is being sick a sin?–but nonetheless, he asserts the belief that Christian doctrine does not condemn those who die by suicide to hell.

[The abridged URL for this post is:  http//tinyurl.com/ChristianStigma .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Essay Offers Clear Insight into Coping with Mental Illness

By Franklin Cook, SPNAC Editor

In 1999, 21 years after my father died by suicide, I experienced the most serious bout of depression I’ve ever had, including frighteningly clear insight into what it’s like to feel grossly suicidal. I lost 25 pounds and woke up daily, usually somewhere between 2 a.m. and 4 a.m., with anxiety that constricted my chest as I watched–in my mind’s eye–depictions of worst-case scenarios unfolding in my life.

I calmed myself by offering what I later came to call “furnace prayers.” I was living with my girlfriend-at-the-time on temporary assignment in an apartment in Oakland, where Broadway meets College Avenue. It was February and very cold every night, and the only source of heat in the apartment was a narrow, vented metal contraption attached to a wall in the living room. The furnace was almost from-floor-to-ceiling tall and lit itself with a flaming whoosh whenever the black knob on the bottom of it was twisted to the right. Each time I awakened, I would get out of bed and go sit cross-legged in front of the furnace to be as meditative as I could be as I suffered the night away. I would always wind up in one version or another of prostrate on the ground, praying that I would not totally freak out (and that my chest would not explode) before it was time for me to shower and get dressed and walk to the Rockridge BART station. That was furnace prayers.

I don’t think I ever would have killed myself (or ever will) even though suicide was in my mind all the time–torturing me, it seemed–and the best I could do was (speaking directly to the force that constantly compelled me to ponder enacting as soon as possible my own death) tell it again and again, “No.” I did not make a plan to kill myself nor come close to doing anything that would lead to my suicide, but when my girlfriend and I went on our day off as tourists to visit the Golden Gate Bridge (which I had never seen up close), I couldn’t get across it. She and I started walking toward the bridge from the parking lot on the Marin County side, and as we walked out to where the bridge’s narrowness and height above the water began to take shape in my visual field, I had to stop and turn around because it felt to me–viscerally–as if I might get sucked over the railing by the destructive force that had been beckoning me for weeks.

The article I’m posting today–Ian Grey’s “The Perfect Prescription: A musician explores the role music has played in treating his mental illness,” from Baltimore City Paper–made me think of that decade-old depressive episode of mine. More precisely, Grey’s memoir made me think of how much I later appreciated the insight I gained into how my father must have felt in the months leading up to his suicide, for “Perfect Prescription” offers the reader an eyewitness view of what it feels like to live with mental illness and, in the end, not only to survive but also to rise above whatever disturbances befall a person as he tries to cope with it.

Grey begins with his initial experience of psychosis …

I was about 14 when I first went crazy. Sitting in the bedroom of my parents’ G.I. Bill house, a bolt of noxious energy exploded around me and the air turned grainy, like reality was suddenly an ugly, 16-mm film. Terrified, I saw the universe beyond my small room as endless and black, occupied only by a malign Presence.

… which was relieved by repeated doses of “Electric Light Orchestra’s ‘Ma-Ma-Ma Belle,’ a silly pop rocker but with an essential difference–a huge, super-distorted guitar,” and before it ends, covers the gamut, from Grey’s experiences in therapy and with medication to his musings and research on the nature of mental illness and the curative powers (at least for him) of music.

Grey concludes with an email he received from Petr Janata, an associate professor at UC Davis’s Center for Mind and Brain:

“Music,” he writes, “is free to impact some evolutionary deep networks (limbic system: anterior cingulate and amygdala), while the cortex can appraise the situation and render it safe, thereby giving it overall positive valence.”

I choose to read this as validation. But it doesn’t explain why music has helped me so much, while failing so spectacularly, so tragically with others … who struggled hard with MI in their own ways and lost, and how totally out there I’ve been at various junctures and still survived. For that, I think [musician Tiffany Lee] Brown has the ultimate answer. It’s no good and it isn’t fair but it sounds about right. “We’re very lucky,” she says.

[The abridged URL for this post is http://tinyurl.com/ClearInsight .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Children’s Deaths Cause Anti-Bullying Outcry

[Editor's note: Several stories linked to in this post include  a brief description of a suicide.] ORIGINAL COMMENTARY — McClatchy-Tribune News Service on Friday published an op-ed by Charles Robbins, executive director of the Trevor Project, and Eliza Byard, executive director of GLSEN (Gay, Lesbian and Straight Education Network), condemning the type of school bullying that has been linked to the recent deaths of two 11-year-old boys by suicide.

Neither Carl [Joseph Walker-Hoover] nor Jaheem [Herrera] identified as gay, yet their peers’ defamatory language and hurtful behaviors broke the barriers of sexual orientation and gender identity. Being taunted as “faggot,” “queer,” or “homo” by classmates is offensive and demeaning to any student -– straight, gay, lesbian, bisexual, transgender, and questioning alike.

The writers point to research showing that homosexuality and intolerance toward sexual orientation are markers for increased risk of suicidal behavior among young people, including references to two studies previously covered by SPNAC:

• A study by the Family Acceptance Project, which “showed that teens who experienced negative feedback were more than eight times as likely to have attempted suicide.”
• A paper from the Suicide Prevention Resource Center (SPRC) reporting on “a variety of studies indicat[ing] that LGB youth are nearly one-and-a-half to three times more likely to have reported suicidal ideation than non-LGB youth. Research from several sources also revealed that LGB youth are nearly one-and-a-half to seven times more likely than non-LGB youth to have reported attempting suicide”

While Robbins’ and Byard’s essay effectively focuses on bullying related to sexual orientation, they make the point that gay-bashing is a major theme in much of the bullying that seems rampant in U.S. schools.

Two of the top three reasons secondary school students said their peers were most often bullied at school were actual or perceived sexual orientation and gender expression, according to a 2005 report by GLSEN and Harris Interactive. In addition, the Trevor Project fields tens of thousands of calls from young people each year, both straight and LGBT-identified, with rejection and harassment by peers being one of the top five issues reported by callers.

In the same GLSEN and Harris report, more than a third of middle and high school students said that bullying, name-calling and harassment is a somewhat or very serious problem at their school. Furthermore, two-thirds of middle school students reported being assaulted or harassed in the previous year and only 41 percent said they felt safe at school.

When they write “Enough is enough,” they are obviously–and poignantly–issuing a call to action for putting a stop to all bullying perpetrated against all children.

It is our hope that in memory of Carl and Jaheem, and in honor of all young people who have completed suicide after enduring constant torment at school, we will be able to work together to promote school environments that celebrate diversity and encourage acceptance of all people. Only then will we be confident that our children are receiving the respect and education they deserve today in order to become the successful and equality-minded leaders of tomorrow.

[The abridged URL for this post is  http://tinyurl.com/ChildrensDeaths .]

[Related SPNAC post: "Father Crusades against Cyberbullying after Son’s Suicide"]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Alert Hotel Owner Helps Stop Group Suicide

[Editor's note: As I've scanned news stories over the past six months for use on SPNAC, I've seen a number of reports describing successful interventions or rescues of people attempting to kill themselves, and I've decided to begin highlighting such stories now and then. FJC]

ORIGINAL STORY — In its online English edition yesterday, South Korea’s Dong-a Ilbo newspaper tells how of an inn owner whose thoughtful actions, combined with state-of-the-art police work, “prevented a group suicide attempted by five young people.

Hongcheon police said yesterday that they received a phone call around 7:25 p.m. Wednesday. The caller was the 50-year-old owner of a pension [hotel] in Seo-myeon, and said she refused to rent a room to five young men and women who looked “suspicious.”

Suspecting a group suicide attempt, police sent text messages to some 1,000 lodging facilities under their jurisdiction, asking them to report if a group of three men and two women sought a room.

The police station established a mass text messaging system last year to prevent crimes.

Less than 15 minutes after the initial call to police, another hotel reported that five people in their 20s had checked in. When police arrived, the five were barbecuing in the front yard of the lodging place, and when questioned, they denied any errant activity, but further questioning made the police increasingly suspicious.

Police asked the five to open the trunk of their car, and found briquettes, a charcoal brazier, and duct tape, items used in a recent series of group suicides in Gangwon Province. The five eventually admitted to police that they did indeed seek to commit group suicide.

Police handed the five over to their families yesterday, saying they conspired to commit suicide together after meeting on an Internet suicide café.

[The rescue of these young people followed the same course of action that has been emphasized generally in SPNAC coverage, as follows: "Suicide is taken seriously. People and helpers work together to reach out to someone who might be in danger. A life is saved." Some will say that statement is an oversimplification, and of course it is, but I would argue that if every community made that simple formula a priority, then we wouldn't--as is now the case--daily overlook thousands and thousands of people who are in danger. For more detailed information, click on the "Need Help?" tab, above.]
[The abridged URL for this post is http://tinyurl.com/AlertOwner .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Finland: 2007 Suicides 1/3 Fewer than in 1990

A woman in Helsinki, Finland attends a 1995 ceremony in memory of suicide victims. (Helsingin Sanomat photo by Jarmo Matilaine)

ORIGINAL REPORT — The Scandinavian newspaper Helsingin Sanomat, in a report yesterday on a recent decrease in suicide in Finland, gives a glimpse of international suicide statistics.

In 2007, 995 deaths in Finland were determined to be suicides. The number has declined by one-third from the record year of 1990, when 1,520 people in Finland took their own lives.

Concerning countries with high suicide rates, the report references a 2005 paper that states “about 60 per cent of the world’s suicides take place in Asia, where it is a major public health problem … [and] one-fifth of all suicides in Asia do not make it into the statistics.”

According to a [2004] article in the medical journal The Lancet, suicides are most common in Lithuania. Kazakhstan is in second place, followed closely by Hungary. They are followed by Latvia, and three Asian countries, Japan, China, and Sri Lanka. Next on the list is Finland … Since then, suicides by men, and especially women have decreased in Finland.

Countries with the lowest rates of suicide include Greece, Israel, and Mexico.

A decrease of one-third in the United States (where more than 30,000 people die by suicide annually) would r esult in 10,000 fewer lives lost , so it would be interesting to learn if Finland’s reduction is a trend or an anomaly and, if it is a trend, whether prevention practices there are duplicable in the U.S. and elsewhere.

[The abridged URL for this post is  http://tinyurl.com/FinlandSuicides .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

A Suicide Prevention Postcard from Crow Creek Nation

[Editor's note: I just wanted to share a picture from my "day job." FJC] The youth suicide prevention project (called Hunkpati Icikte Anaptapi Woecun) of the Crow Creek Nation was the host on Apr. 7-8 of an Applied Suicide Intervention Skills Training workshop at Fort Thompson, S.D. Attending the training were, from left, standing Carla Pickner, Robyn Black Feather, Chris Howe, Kasey Cadwell, Barb Engel, Becky Swanson, Lisha Bairey, Vianna Felicia, Humphrey Long, Jackie Rhode, Michele Howe, Nancy Fleming (ASIST trainer), Jessica Roskens, Leanna Eagleman; kneeling, Jeremiah Nelson, Rich Greenwald, Terry Quilt, Scott Shields, Bernie Long, Franklin Cook (ASIST trainer), Gene Koster. Not pictured: Sam Robertson, Joseph Sheilds Jr., Aggie Clement, Vallie Thompson, Tolly Estes (project director). Project workers from the project were joined by comunity caregivers from Circle of Care, Crow Creek Police, Indian Health Services, and Sanford Mid-Dakota Hospital.

[The abridged URL for this post is  http://tinyurl.com/CrowCreekCard .]

78% of Male Suicides/Attempts Showed Psych Problems at Age 8

ORIGINAL REPORT — According to a report in Science Daily, in a study involving more than 5,000 subjects, a high proportion of men who, by their mid-20s, died by suicide or attempted suicide and were hospitalized had psychiatric problems when assessed at the age of 8, while the same was not true of women.

Andre Sourander, M.D. … and colleagues studied 5,302 Finnish individuals born in 1981. Eight years later, information about psychiatric conditions, school performance and family demographics was gathered from children, parents and teachers. Participants were then tracked through national registers through 2005.

Between ages 8 and 24, 40 participants died, including 24 males and 16 females. Of those, 13 males and two females died from suicide. A total of 54 males and females (1 percent) either completed suicide or made a suicide attempt serious enough to result in hospitalization.

Of the 27 males who either seriously attempted or completed suicide, 78 percent screened positive for psychiatric conditions at age 8, compared with 11 percent of 27 females who had serious or completed suicide attempts.

The study is published in the current issue of Archives of General Psychiatry (abstract).

It also showed a number of other indicators at age 8 associated with suicide and life-threatening attempts in males later in life, namely not living “in a family with two biological parents, [having] psychological problems … reported by a teacher, or [having] conduct, hyperactive or emotional problems.” Again, the same was not true for females.

Interestingly, however, when it comes to depression, the study showed that “depression at age 8 was not associated with suicide attempts for either sex.”

[The abridged URL for this post is  http://tinyurl.com/PsychProblems .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Military, Veteran Stories Focus on Personal Impact of Suicide

At the DOD/VA Suicide Prevention Conference in January, Maj. Gen. Mark Graham, who lost a son to suicide and another to an IED, embraces Christopher Scheuerman, who says his son died of suicide after military supervisors ignored his request for help. (By John Davenport, San Antonio News-Express)

By Franklin Cook, SPNAC Editor

I am a Vietnam-era veteran (U.S. Army field artillery, 1972-1975), my father was a Korea-era veteran (we each remained stateside during the wars that helped shape especially the young adults of our two very different generations), and my grandfather served in France during WWI. I think there is something about being a soldier–even if one never sees combat–that stirs a tribal feeling in a person, and I have always thought of especially young soldiers, in a way, as my brothers and sisters. As I have watched the suicide crisis in the U.S. military unfold during the Iraq War, that feeling of kinship has sometimes touched me deeply.

Perhaps in part because of that feeling, I have posted on SPNAC a good number of items about suicide among the military and veterans. In fact, I believe the concluding paragraph of my most recent posting on the topic, “Culture of Stigma Is a Key Cause of Military, Veteran Suicides,” poses one of the most important–and not satisfactorily answered–questions that needs to be asked about preventing suicide in the military.

Today, I simply want to highlight two recent news reports that do a good job of putting military/veteran suicide in personal terms. I’m not going to quote from the reports or discuss them but simply recommend them to SPNAC readers.

The first, “A General’s Personal Battle,” by reporter Yoshi Dreazen in the Wall Street Journal, tells the story of Gen. Mark Graham and his wife, Carol, who lost their two sons seven months apart, one to suicide and the other to an IED in Iraq. The story artfully interweaves reportage on the facts of the matter with poignant storytelling about a family’s indomitable spirit in the face of tragedy.

The second, “Answering Veterans’ Calls for Help,” by reporter Jon Wilson of KELO TV in Sioux Falls, S.D., uses the story of “Bob,” a Vietnam Veteran who called the VA and got help when he was about to kill himself, as the backdrop for showing how the VA’s response to suicide is being carried out in one city in America. Wilson’s report is a reminder of the power of a well-chosen example when it is shared without frills or sensationalism.

[The abridged URL for this post is  http://tinyurl.com/PersonalImpact .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Two Lives Saved through Facebook, Twitter Communications

By Franklin Cook, SPNAC Editor

The dangerous nature of some Internet communication has become part of the fabric of our society, including when it comes to suicide, as in the recent cases of Megan Meier, a victim of cyberstalking by an adult, and Abraham Briggs, who killed himself with a webcam audience watching.

It is heartening, as a counterpoint, to share two stories from this week’s news in which the Internet served as a medium for preventiing suicide. I want to highlight the phrase “served as a medium,” for the Internet itself is just a tube through which communication flows, and it is what people do with the communication that matters. These two stories are really not so much about the Internet as they are about what people must do to prevent suicide, regardless of the “channel” through which a person thinking about suicide communicates his or her dilemma to us.

The first story, from reporter Patrick Sawer in the London Telegraph, is about a “depressed 16-year-old boy … on the outskirts of Oxford, England … [who] had been chatting to a girl in Maryland, USA, on the social networking website [Facebook] when he told her he was about to kill himself.”

Fearing for his life, the American girl alerted her mother, who then sparked a string of emergency messages between Maryland Police, the White House in Washington, the British Embassy in Washington, Scotland Yard and finally Thames Valley Police.

The story is extraordinary because of the great distance involved, both geographically and coincidentally (not to mention that a host of agencies, several at the highest levels, were constructively involved), but in fact, the girl simply followed steps broadly recommended in suicide prevention training: Take any mention of suicide seriously–treating it as a potential life-or-death matter– and inform a person who can help about the danger.

If everyone did that–and if every agency contacted responded as affirmatively as even the White House and the British Embassy did in this case–thousands of lives would be saved.

Oxfordshire police commander Chief Supt Brendan O’Dowda praised those on both sides of the Atlantic who were involved in the rescue, [saying] “When it did find its way to Thames Valley Police, it would have been quite easy for any number of people to decide there wasn’t enough information. We really didn’t have much to go on. It was just scant information.”

“But due to the tenacity and professionalism of a number of people, we managed to pin down a number of addresses, then went through the painful and laborious process of visiting the addresses to find the lad. It took up time and effort but it was time and effort absolutely well spent.”

The second story is about a rescue initiated after a Twitter communication threatening suicide was sent to actress Demi Moore. According to a report from Selena Hernandez of CBS affiliate KTVT in Dallas-Fort Worth, a man in Frisco, Texas, and a friend of his in Idaho took the action necessary to save a life:

Daniel Morton … said he happened to see the disturbing “tweet” on Demi Moore’s page. “I noticed it looked like a good train of texts, tweets talking about how she wanted to kill herself. Demi responded, ‘I hope this is not a joke.’ At that point I started looking into this woman’s site to see if it was a joke or not.”

He contacted another online Twitter friend, Kim Aiton, In Idaho. Together, the two would combine their resources to help a woman they never met, one who’s name they didn’t even know … Morton said he spent an hour on the phone with the San Jose Police Department, until Aiton found the woman’s real name. “She found the woman’s true identity, gave it to me, I gave it to the police. They pulled it up on the computer — bam they matched the photo to the driver’s license. They knew it was her, so they sent the ‘lights and sirens’ out there to get her.”

San Jose Police found the 48-year-old woman unharmed, some two hours after her initial posting. The department said it was overwhelmed with calls from all over the country — and world — all responding to Moore’s tweet.

Same response, same outcome: Suicide is taken seriously. People and helpers work together to reach out to someone who might be in danger. A life is saved.

Linguist Marshall McLuhan famously wrote “the medium is the message,” which is certainly important to understand if one is studying communications theory. But in the person-to-person interactions that make up our daily lives, especially when someone in pain reaches out for help, the message is the message, and when it comes to suicide, however the is message is conveyed, the human-to-human response ought to be: “Suicide? What can I do to keep you safe? Let’s get the help we need. Let’s all do this together.”

[The abridged URL for this post is  http://tinyurl.com/2LivesSaved .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Economy Spurs Feds To Offer Advice on Health, Coping Skills

The Substance Abuse and Mental Health Services Administration (SAMHSA) has published a web page titled “Getting Through Tough Economic Times,” which, according to an agency news release, “provides practical advice on identifying health concerns, developing coping skills, and finding help.”

The guide … provides individuals and communities with practical steps that can be used to get through these tough periods and achieve restored health and productivity. In particular the guide provides … Important information on identifying the warning signs of depression, suicidal thinking, and other serious mental illnesses … Effective steps to help manage emotional distress, such as through exercise, strengthening connections with family and friends, and developing new job skills … [and] Resources for getting help — such as the National Mental Health Information Center … and the National Suicide Prevention Lifeline [at] 1-800-273-TALK (8255) for those in crisis.

[The abridged URL for this post is  http://tinyurl.com/FedsAdvice .]

[Related SPNAC posts:]

• “The Last Word on the Financial Crisis and Suicide Prevention“
• “SPRC Gives Prevention Workers Info on Economy, Suicide“
• “Town’s Website Reacts to Economy with Mental Health Tips“

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

One Policeman’s Suicide Frames Inquiry about National Picture

[Editor's note: The original article includes a brief description of a suicide.] ORIGINAL REPORT — Reporter Brian Kuebler of ABC2 News tells the story of 62-year-old Edward William Eldridge, a 26-year veteran of the Baltimore City Police who recently died by suicide, and his report includes the National P.O.L.I.C.E. Suicide Foundation highlighting police suicide in the United States, which the foundation believes is “a growing and grossly under-reported problem in this country.”

“I believe that suicide among law enforcement officers in the United States is a viable option to them, viable option,” [says Rev. Robert Douglas, executive director of P.O.L.I.C.E., who is himself a former Baltimore City Police Officer.] “The longer we wait and the longer we refuse the face that we have a devastating issue facing us, I call it a cancer, it is a cancer that is growing very fast.”

Although no governmental agency keeps tally, according to Douglas’ foundation, about 400 officers, retired or active, commit suicide every year in this nation. That is an average of one every 17 to 21 hours.

Douglas says for some officers, what they see everyday, the loss of control out of uniform and the stigma of needing help contribute to the suicide rate.

Eldridge’s circumstances illustrate some of the warning signs for suicide that are sometimes exhibited by older men, including police officers:

Eldridge had no wife, no kids … no family. He was a loner. He was meticulous. He kept copious notes on everything, from what he handed out on Halloween each year to what aisle had what in the local grocery store.

[Homicide Detective Randy] Wynn believes it was that kind of organization and control that was challenged when Eldridge became a victim of a home invasion after retirement. Without his badge, playing the victim was an uncomfortable role. Without any friends or family, Wynn believes that crime against him was the beginning of the end.

“We’re as vulnerable as anybody else,” Wynn says.

[Editor's note: A hasty Internet search uncovered only a 2004 article in the American Journal of Psychiatry, which states

Some studies found elevated suicide rates among police officers; others showed an average or low rate of suicide. However, the rates varied widely and were inconsistent and inconclusive, especially because of methodological shortcomings. Most studies have been conducted in limited specific police populations, particularly in the United States.

P.O.L.I.C.E 's assertions that the incidence of police suicide is "growing and grossly under-reported" and that "no governmental agency keeps tally" suggests the need for better data, and SPNAC invites comments by authorities on the subject pointing readers to additional pertinent information.]

[The abridged URL for this post is  http://tinyurl.com/PolicemansSuicide .]

[Related SPNAC posts:]

• “‘Badge of Life’ Works To Counter Police Trauma, Suicide“
• “Problem of Police Suicide Garners Editorial Attention“
• “Cop Pleas with Co-Workers: ‘Talk About It’”

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Teen Depression Screening Is Endorsed, if Therapy Is Available

ORIGINAL REPORT — Medical Writer Lindsey Tanner, reporting for the Associated Press, writes that “an influential government-appointed medical panel is urging doctors to routinely screen all American teens for depression.”

An estimated 6 percent [nearly 2 million] of U.S. teenagers are clinically depressed. Evidence shows that detailed but simple questionnaires can accurately diagnose depression in primary-care settings such as a pediatrician’s office.

The task force said that when followed by treatment, including psychotherapy, screening can help improve symptoms and help kids cope. Because depression can lead to persistent sadness, social isolation, school problems and even suicide, screening to treat it early is crucial, the panel said.

The recommendation from the U.S. Preventive Services Task Force appears in April’s issue of the journal Pediatrics.

Because depression is so common, “you will miss a lot if you only screen high-risk groups,” said Dr. Ned Calonge, task force chairman and chief medical officer for Colorado’s Department of Public Health and Environment.

Calonge stressed that the panel does not want its advice to lead to drug treatment alone, particularly antidepressants that have been linked with increased risks for suicidal thoughts. Routine depression testing should only occur if psychotherapy is also readily available, the panel said. Calonge said screening once yearly likely would be enough.

The recommendation follows the passage of a mental health parity law in the United States, which “is expected to prompt many more adults and children to seek mental health care.”

A separate report, also released Monday in the Pediatrics journal, says primary care doctors including pediatricians and family physicians will need to get more involved in mental health care.

Dr. Alan Axelson, a Pittsburgh psychiatrist who co-authored the second report [said that] because children’s families often get to know their pediatricians, having those doctors offer mental health screening can help make it seem less stigmatizing.

Most pediatricians aren’t trained to do psychotherapy, but they can prescribe depression medication and monitor patients they’ve referred to others for therapy, he said.

[The abridged URL for this post is http://tinyurl.com/TeenScreening .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Town’s Website Reacts to Economy with Mental Health Tips

Wise words about the economy and mental health recently came from the website of a town in eastern Massachusetts, where a humble public servant — Jon Mattleman, Director of the Needham Youth Commission, to be precise — wrote this:

If you are experiencing stress about the economy and/or your finances, below are a few tips that you might want to consider:

If you are in a relationship — Money can be a significant source of stress in relationships. If one partner feels overwhelmed or panics, it is important that the other person provide stability and support so that both don’t spiral downward together.

If you have kids — Be honest with your children as well as age-appropriate in explaining how the financial crunch is impacting the family. Be positive, reassuring, and ask them if they have any fears. Children look to parents for information and guidance, and parents need to model behavior which illustrates that they are coping appropriately also.

If you are retired, single, and/or alone — Clearly this is a time of unprecedented concern for our economy…but the reality is that we have faced difficult times in the past and ultimately triumphed. Make certain to share your feelings with others and keep connected with friends.

Generally speaking, for all people it is important to:

• Try to keep a positive attitude
• Exercise and stay active
• Learn to accept what you cannot control
• Learn relaxation techniques such as deep breathing
• Get plenty of sleep/rest
• Limit or eliminate alcohol/drug use
• Seek out social supports
• Laugh – this is one of the most effective stress reducers
• Get help from friends or a professional if you feel overwhelmed, depressed, or at risk for self injury.

We don’t know if Mr. Mattleman’s composition was entirely original of if he compiled his suggestions from other sources, but we applaud him for sharing them with his constituents … and, now, with all of us.

[The abridged URL for this post is  http://tinyurl.com/TownWebsite .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Culture of Stigma Is a Key Cause of Military, Veteran Suicides

By Franklin Cook, SPNAC Editor

Ever since the Army announced that suicide in its ranks was at an all-time high last year, news outlets have been brimming with coverage about the causes and solutions for the tragedy unfolding among America’s active military and veterans. Several of the latest installments covered testimony before the Senate Armed Services Committee by some of the military’s top brass (SPNAC readers may refer to the transcripts,  or a webcast of the hearing). According to a Stars & Stripes report on the hearing, it “was designed to address plans to deal with the rate of military suicides, which is above the national average.”

Gen. Peter Chiarelli, vice chief of staff for the Army, called the suicide figures for his service “unacceptable” and fixing them “the most difficult and critical mission” of his military career. “The reality is, there is no simple solution. It is going to require a multi-disciplinary approach, and a team effort at every level of command and across all Army components, all services and jurisdictions, as well as partners out of our organization.”

An article on the hearing in Air Force Times summarizes the statistics that are behind the military’s and Veterans Administration’s alarm about suicide:

The Air Force lost 38 airmen to suicide in 2008, a rate of 11.5 suicides per 100,000 airmen. … In 2008, the Army reported 140 confirmed or suspected suicides. That’s 20.2 suicides per 100,000 troops — an all-time high that is nearly twice the national average of 11 suicides per 100,000 … The Navy reported 41 suicides in 2008, a rate of 11.6 per 100,000. The Marine Corps lost 41 Marines last year to confirmed or suspected suicides — up from 25 two years earlier — a rate of 19 per 100,000.

The hearing included testimony from Kathryn Power, director of the Center for Mental Health Services in the Department of Health and Human Services, who shared another potentially troubling indicator with the Senators:

More ominously, 780 callers to a national VA suicide prevention hot line in fiscal 2008 identified themselves as active-duty troops, [she] said. Since Oct. 1, an average of three hotline callers per day have identified themselves as being on active duty, Power said.

Sen. Lindsey Graham, R-S.C., said that indicates many conflicted troops continue to feel a sense of stigma over reporting suicidal thoughts to superiors or military mental health officials.

“When you’ve got this many people feeling they can’t talk to someone within the system, that’s a problem,” Graham said.

Another aspect of the challenge facing those who care for military personnel and veterans was highlighted at the hearing by Brian Altman of the Suicide Prevention Action Network (SPAN USA):

[He] said the services have made improvements on the issue in the last year. But they still need to hire more medical professionals to handle troops suffering from depression — a promise they’ve been making for several years, he said — and to do a better job educating about signs of suicidal thoughts.

“They’ve done a good job with troops … but many times those who commit suicide are not in theater,” he said. “So we would like to see them try and educate spouses and other family members, too, so they can identify the warning signs.”

A recent news release from U.S. Army Forces Command, reprinted in a “Special Report” at the blog Veterans Today, shows how ambitiously Army leadership is responding to suicide (and similar lists of programs are being implemented in the other military branches and in the VA):

On February 15, an Army stand-down began and continues through March 15 … The stand-down teaches peer-to-peer recognition of suicide warning signs and is available to all Army components and Department of the Army civilians … Phase I, an interactive video “Beyond the Front,” allows participants to choose options throughout the film, with the outcome based on their choices … Phase II of the training, also a video, “Shoulder to Shoulder,” reinforces the Army credo of “No Soldier Left Behind” and ties it to helping a Soldier in need …

One of the programs chaplains use is ACE, which stresses the “battle buddy” system. ACE [is] a mnemonic that represents the phrases, “Ask your buddy, Care for your buddy, Escort your buddy” …

[Also,] ASIST (Applied Suicide Intervention Skills Training) program … trains leaders on intervention and working with distressed Soldiers and Families. Army policy requires one ASIST-trained representative in every battalion.

Even with all of the programs coming down the line, Sen. Graham’s observation about stigma is emerging as the key roadblock for troops and small-unit leadership at the operational level. The power of stigma over help-seeking in military culture, in fact, may be the battle upon which winning the war against suicide depends. As Christopher Weaver points out in a post at ProPublica,

It’s a familiar refrain. Since 2003, yearly reports on the Army’s suicide rates have spurred similar news stories and similar reactions by Pentagon officials. Suicide-prevention initiatives — such as the “battle-buddy” program, which relied on ordinary soldiers to keep an eye on each other — have spawned in the wake of the grim statistics, but the numbers have only worsened.

Referring to a Jan. 29 article in the New York Times, Weaver writes,

[It] is absolutely critical to reach out to soldiers and tell them it is not wrong to reach out for help,” [Gen. Peter] Chiarelli told the Times. “We have to change our culture.”

The call for a change in culture also has echoes. A March 2008 report by the Army’s inspector general suggested a new “culture of support for psychological health.” And in April 2005, the Marine Corps Times reported that the Army’s surgeon general, Lt. Gen. Kevin Kiley, told a House Appropriations subcommittee, “That’s still part of our culture: Real men don’t see [mental health counselors]… I would like to see a culture that resets the force mentally.”

If stigma ingrained in military culture is a force that is stopping suicide prevention programs from working effectively, then the vital question to answer is, What is military (and civilian) leadership doing –besides issuing orders, which is a necessary but not sufficient step — to decisively lessen the stigma against help-seeking that is killing so many of those whose sacrifices make our freedom possible?

[The abridged URL for this post is  http://tinyurl.com/StigmaMilitary .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Poet Sylvia Plath’s Son Dies by Suicide in Alaska at Age 47

Sylvia Plath and her son Nicholas

[Editor's note: The stories linked to below include brief descriptions of suicide.]

The well-known depression and suicide of poet Sylvia Plath in 1963 has been grievously followed this week by the suicide of her son Nicholas Hughes, 47, an evolutionary biologist in Alaska.

A statement by Hughes’s sister, Frieda Hughes, is quoted in a story in the [London] TimesOnline,

“It is with profound sorrow that I must announce the death of my brother, Nicholas Hughes, who died by his own hand on Monday 16th March 2009 at his home in Alaska. He had been battling depression for some time.”

The TimesOnline story covers Plath’s legacy, including her literary career, her struggle with mental illness, and her marriage to Ted Hughes, who became England’s Poet Laureate. It also includes an insightful observation from Paul Farmer, who directs Mind, a U.K. mental health charity.

“Suicide is a much more complicated event than simply being a question of genetics, but there is some evidence that if a member of your family has taken their life there can be a higher risk of people doing the same. However, it is often absolutely to do with what’s happening in the here and now rather than any urge that is more deeply rooted.”

There is also a story in the New York Times about Nicholas Hughes and his family.

[The abridged URL for this post is http://tinyurl.com/PlathSonDies .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

SPNAC: APA Principles Are a Guide for Mental Health Advocates

Former Oregon Sen. Gordon Smith, left, talks with Dr. John Wernert, board chairman of the APA Political Action Committee, during Advocacy Day. (Photo for APA by Maureen Keating)

ORIGINAL STORY — In a story for Psychiatric News, reporter Rich Daly explains one of the goals of members of the American Psychiatric Association when they met with members of Congress last month during the APA’s 2009 Advocacy Day.

The enactment of mental health parity and the reduction of the Medicare copay for outpatient mental health services to 20 percent were major accomplishments this past year, and APA leaders are urging Congress and the Obama administration to ensure that psychiatric care is covered on an equal basis with other types of care under any proposals to reform health care.

The article references the APA’s “Principles for Health Care Reform for Psychiatry — Position Statement,” which is an excellent guideline for all mental health advocates to use as we watch over the reshaping of America’s health care system and make sure that creating a sound mental health care system in the nation is a priority. Here are the APA principles:

1. Every American with psychiatric symptoms has the right to a comprehensive evaluation and an accurate diagnosis which leads to an appropriate, individualized plan of treatment.

2. Psychiatric treatment should be based on continuous healing relationships and engagement with the whole person rather than the narrow symptom-focused perspective.

3. Timely access to psychiatric care and continuity of care are the cornerstones for quality, even as a continuum of medical and non-medical services becomes available that would encourage maximum independence and quality of life for psychiatric patients.

4. There must be full parity of psychiatric treatment with the rest of medicine and utilization management must be the same for people with mental illness and well as for other medical illnesses. Payment and utilization should be on the basis of treatment and services and not on diagnosis.

5. Psychiatric care should be patient and family centered, community based, culturally sensitive, readily available for patients of all ages, with particular attention to the specialized needs of children, adolescents, and the elderly. Disparities in the access to care for ethnic and racial minorities must be addressed.

6. Access to psychiatric care should be provided in numerous settings, including private offices, community mental health centers, specialty clinics, and hospitals as well as in the workplace, schools, and correctional facilities. Psychiatric care should be fully integrated with the rest of medicine in primary care settings and in hospitals.

7. Patients deserve to be treated with dignity and respect. When they are clinically able, they are entitled to choose their physician and other providers and make other decisions regarding their care. When they are incapable of doing so, they should receive the treatment they need and when able, they should choose future care.

8. As medical information enters the electronic age, leading to increased efficiency and ease of access to health data on all individuals, the confidentiality of this data must have the highest priority.

9. Patients should receive care in the least restrictive setting possible that encourages maximum
independence and access to a continuum of clinical services.

10. Psychiatric care should be fully integrated with the treatment of substance use disorders.

11. Psychiatric care should have an emphasis on early recognition and treatment as well as prevention. Research into the etiology and prevention of mental illness and into the ongoing development of safe and effective treatment interventions must be supported.

12. Efforts must be intensified to combat and overcome the stigma historically associated with mental illness and its treatments through enhanced public understanding and awareness of mental disorders and the effectiveness of psychiatric treatment.

13. More resources should be devoted to the training for an adequate supply of psychiatrists, especially child psychiatrists, to meet the current and future needs of the population.

* Prepared by the Board AD HOC Work Group on a Mental Health Care System. Approved by the Assembly, November 2008. Approved by the Board of Trustees, December 2008. “Policy documents are approved by the APA Assembly and Board of Trustees … These are … position statements that define APA official policy on specific subjects” (APA Operations Manual).

[The abridged URL for this post is http://tinyurl.com/APA-Principles .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Daring Rescue Saves a Life, but Is There More to the Story?

By Franklin Cook, SPNAC Editor

A story about the rescue a few weeks ago of a potential suicide victim poised to jump from a bridge deserves mention even if there are pros and cons about how the rescue was carried out.

First, the “pro”: A man’s life was saved by a woman who stopped to talk to him as he climbed up onto a railing to ready himself to jump from the West Gate Bridge in Melbourne, Australia. The “con”? The man was wrestled to the ground as the woman was speaking to him . (To be clear, the story has a happy ending, notwithstanding my criticism after the fact.)

Here’s how reporter Kate Rose tells the story in the account she wrote for the Herald Sun:

[Terry Bracks and her husband, Steve,] were returning home … when they saw a large man ’standing on the railings obviously looking as though he was about to throw himself off.’ Mr. Bracks and two other men … pulled him to safety. But it was Mrs. Bracks who was first on the scene and who tried to talk the man down before he was dragged to safety and restrained.

As I said, all’s well that ends well, and it is heartening that the would-be victim credits the Bracks and their co-helpers with saving his life.

“She came right up to me, and put her hand on my upper arm and just spoke to me. The more I think about it, the more I admire her courage,” [he said]. “I was looking down at the water and psyching myself to go, and she I suppose delayed me, and delayed me just long enough … next thing I know I was pinned to the ground … She … saved my life.”

The counterpoints, then, include a concern about Mrs. Bracks’ (and possibly the other rescuers’) safety and a concern about the man being “dragged to safety.”

The man who was rescued points out the following alternative scenario:

“The courage of that woman was just incredible, I mean, I’m a fairly big bloke, I could have just turned around and assaulted her, just smashed her,” [he] said.

And here is the husband’s description of the man’s demeanor:

“She talked to him first and tried to engage him in conversation but he was in a very distressed state and not responding. He was obviously in a very agitated state, and very angry and not himself.”

So my questions are: Might she have engaged the man verbally from a step away (instead of getting close enough to touch him)? And if her talking to him was “holding him back” from jumping, was the physical intervention by Mr. Bracks and the others necessary? Perhaps the answer is “no” she couldn’t have (because he was so starkly in a world of his own that her touch was required to gain his attention) and “yes” it was (because his jumping was so certain and so imminent that nothing else would have stopped it). But I do think, first, that considering one’s safety when engaging a distraught, suicidal person is a legitimate concern and, second, that if verbal engagement is established, it is reasonable to consider allowing it to run its course if possible.

I applaud the Bracks’s success and respect the reality that the outcome in this instance was excellent to the point of seeming miraculous, as far as the story goes. But to go beyond the story, I would suggest that it is the rare case when physical force will “save the day.” The usual circumstance is that a person having thoughts of suicide requires someone to listen to him in a way that allows him to talk about the pain underlying his situation and to offer him the kind of help that will ease that pain.

I want to emphasize that I am not faulting anyone as far as the story above is concerned–for “Monday morning quarterbacking” is indeed an easy game to play compared to walking up to a person who is facing a life or death situation and trying to help him–but I must say that there is also a concern that extends beyond the story of this man’s rescue, which is embodied in the question “What next?”

What help is available in his community to answer his needs? What resources can be brought to bear to help him (and his family and their circle of support) answer his (and their) own needs themselves? What physical, emotional, psychological, and spritual assistance will there be not only to “save the day” (simply and dramatically, when a person is “on the brink”) but also to help people at risk of suicide live life more healthfully and more effectively day after day both before they might attempt to kill themselves and into the distant future?

[The abridged URL for this post is  http://tinyurl.com/DaringRescue .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Tracking Local Suicide Data Helps Support Life Skills Program

Amanda Miller ("The Oklahoman" photo by David McDaniel)

[Editor's note: The original article includes a brief description of a suicide.] ORIGINAL ARTICLE — Reporter Ron Jackson’s article in the Oklahoman, about the Kiowa Tribe’s Teen Suicide Prevention Program, includes an interview with a program client, Amanda Miller, and a story about the program director, Amy Cozad, who believes, the article says, that “teen suicides are at an ‘epidemic level’ statewide.”

“I use every resource available to me — the state medical examiner’s office, local first-responders, schools, police,” Cozad said. “I try to document the information any way I can. But then there are the attempted suicides, and those are impossible to track.”

In October, the statistics gave way to the reality.

“We had a 19-year-old girl — a Wichita tribal princess — who committed suicide,” Cozad said. “She had attempted suicide 11 times before that. When I got the medical examiner’s report, I just broke down in tears. She had cuts all the way from her wrist to her shoulder.

Cozad’s work also has led her to document likely clusters of suicide in Oklahoma.

In 2007, for example, Cozad logged seven suicides in Anadarko — a Caddo County town of 6,337. Of those, four were people younger than 24.

“I found that number very alarming for a town that size,” Cozad said. “One thing I found early on was it seemed like everyone was trying to chop at the top of the tree and nobody was actually getting at the root of the problem.”

Implementation of the Kiowa Tribe’s Life Skills program was sparked by Cozad’s data, and

Since 2005, more than 200 youngsters have successfully completed the five-month program, which isn’t restricted to American Indian youth.

In the video segment of her interview with the Oklahoman, Miller describes  the mental and emotional struggle that led her to attempt suicide as many as seven or eight times.

“I didn’t care anymore. I didn’t care what happened. I got really depressed.”

Miller and Cozad met last November, and Cozad said that, at the time, Miller “‘was always internalizing everything, all the pain and hurt.’”

“Now she’s coming out more and opening up and talking,” Cozad said. “She’s doing a lot better, although she has a long way to go still.”

Miller said, “In the past, whenever I got sad, I wanted to be alone or stop eating or then I’d start cutting myself because it made me feel better. Now if I feel myself getting sad, I write in my journal. I’m still learning. Talking has helped. Before, I didn’t trust anybody enough to tell them things. I’m learning to trust that people do care.”

[The abridged URL for this post is  http://tinyurl.com/LocalData .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Father Crusades against Cyberbullying after Son’s Suicide

ORIGINAL STORY — Reporter Allison Pries, writing in The Hackensack Record, tells the story of John Halligan’s participation in a New Jersey middle school summit, where “the father of a Vermont teen recounted his son’s suicide and put a face to the problem of cyberbullying.”

“Mr. Halligan’s story brought out the emotional side of bullying,” said Nick Schifano, a Ramsey student council officer. “It shows it doesn’t just hurt one person. It hurts family and friends.”

As young people spend more time instant messaging, texting, e-mailing and using social networking sites, the peer harassment that once occurred in hallways and schoolyards has followed them into cyberspace, experts say.

“It’s so much a part of their life,” said Richard Wiener, the Smith School principal. “So we have to equip them to use the technology in a way that’s going to be productive, not destructive.”

Halligan, after a 23-year career with IBM, is delivering the message about Ryan and cyberbullying full-time.

“The schools need and want this,” he said.

In his presentation, Halligan urged the middle school students not to be the folks who laugh at the teasing of others. “A bully wouldn’t exist if it wasn’t for the power trip he gets from bystanders,” he said.

The message from Halligan, explaining how Ryan’s abuse had forever changed his entire family, was particularly poignant.

“(Bullying) is probably the No. 1 assembly topic,” said Spencer Lambert, an eighth-grader from Ramsey who attended the summit. “But hearing it from a firsthand witness — and the emotion — definitely made a difference.”

Halligan’s outreach includes administering the website ryanpatrickhalligan.org, which “is dedicated to the memory of our son Ryan and for all young people suffering in silence from the pain of bullying and having thoughts of suicide.” One of the final paragraphs from the introductory message on the site’s homepage is a moving summary of cyberbullying’s causes and the sources of its solution:

We have no doubt that bullying and cyberbullying were significant environmental factors that triggered Ryan’s depression. In the final analysis, we feel strongly that Ryan’s middle school was a toxic environment, like so many other middle schools across the country for so many young people. For too long, we have let kids and adults bully others as a right of passage into adulthood inside a school building. We place [accountability] for this tragedy, first and foremost, on ourselves as his parents … but also on Ryan’s school administration, staff and the young people involved. As parents, we failed to hold the school accountable to maintain an emotionally safe environment for our son while he was alive. But accountability and responsibility should be shared by all involved — parents, bullies, bystanders, teachers and school administrators … basically the whole system.

[The abridged URL for this post is http://tinyurl.com/FatherCrusades .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Senate Hearing Looks at Suicide Epidemic among Native Youth

Dana Jetty of the Dakota Nation testifies during a Congressional Hearing. (Senate Indian Affairs Committee photo)

ORIGINAL ARTICLE — Reporter Shelley Bluejay Pierce, writing in Native American Times, distilled the testimony of a recent Senate Committee on Indian Affairs Hearing down to its essence in the voice of Dana Jetty, a 16-year-old high school student and member of Spirit Lake Dakotah Nation in North Dakota, whose sister died of suicide just last November.

“I ask that you support suicide prevention programs in our tribal communities, and I ask that when you have your discussions on the issue of suicide, you remember my sister. She was 14-years-old. She was a beautiful, outgoing teenager with her whole life ahead of her. She was my sister, and she is what suicide looks like in Indian Country.”

The article captures the sense that there is an epidemic of suicide among Native American youth and young adults.

Native youth ages 15-24 have suicide rates more than three times higher than the national average. Across the Great Plains, this rate is even higher.

“Over the past several years in the Rosebud Sioux Tribe alone, we have witnessed dozens of suicides and hundreds of documented suicide attempts. The situation became so bad that in 2007, our Tribal President declared a State of Emergency in order to draw attention and resources to the problem,” explained [Robert] Moore, [Tribal Councilman for the Rosebud Sioux Tribe in South Dakota].

During the Hearing, Sen. Byron Dorgan of North Dakota, who chairs the committee, spoke of the historical context for the situation.

“We need to go back and read the treaties that signed the federal government up for its obligations. Right now, health care rationing takes place on every Indian reservation in America. That is shameful.”

Senate Majority Leader Harry Reid, whose father died of suicide, attended the hearing and reminded everyone of the stigma over suicide.

”It’s important to break the silence about suicide, too often a taboo subject, and to talk openly about it.”

An article in the Albuquerque Journal notes that some funding to address the problem might be forthcoming.

The 2010 budget blueprint unveiled by President Barack Obama on Thursday contained $4 billion for Bureau of Indian Affairs, up $600 million from current year funding. Some of that money could be used on suicide prevention programs, committee members suggested.

SPNAC readers can view a webcast of the complete Senate Hearing, and transcripts of the testimony are also available.

[Editor's note: In my home state of South Dakota, in fact, Native Americans age 15-24 have a suicide rate of 52 per 100,000, while the rate for people in that age group nationwide is about 10 suicides per 100,000. Keeping in mind that approximations are being used, a more meaningful comparison--to bring home the extent of the epidemic in Indian Country--might be to estimate how many 15- to 24-year-olds would be dying by suicide in, for instance, Boston (pop. 600,000) if the suicide rate there were 52/100K: It would be 312 suicides per year among youth and young adults, compared to the approximately 36 annual suicides per year there now (based on Massachusetts's suicide rate for ages 15-24, which is about 6/100K). One wonders if a young person were dying by suicide almost every day in Boston if there wouldn't be more than a Congressional Oversight Hearing and a stray newspaper article or two shedding light on the problem. (Data are for 2001-2005. The data source is WISQARS: Web-based Injury Statistics Query and Reporting System).]

[The abridged URL for this post is  http://tinyurl.com/EpidemicNative .]

[Related SPNAC post: "Youth Suicide among Native Americans Linked to Colonialism" ]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Research Points to PTSD as a “Predictor of Attempted Suicide”

ORIGINAL ARTICLE — Rick Nauert, Senior News Editor for PsychCentral, reports that “new research suggests development of posttraumatic stress disorder (PTSD) may be associated with subsequent attempted suicide in young adults.” According to the abstract of the study, which appears in the current issue of the Archives of General Psychiatry, “posttraumatic stress disorder is an independent predictor of attempted suicide.”

The research involved nearly 1,700 subjects “who had been tracked since entering the first grade in Baltimore public schools” and who were interviewed 15 years later “to assess the occurrence of traumatic experiences, suicide attempts and the development of PTSD.”

Of the participants interviewed, 1,273 (81 percent) had been exposed to a traumatic event and 100 (6 percent, or 8 percent of those exposed to trauma) developed PTSD. Suicide had been attempted by 10 percent of those with PTSD, compared with 2 percent of those who were exposed to trauma but did not develop PTSD and 5 percent of those who had never been exposed to traumatic events.

Further research is needed, the authors write, to learn more about whether “there could be a common pre-existing predisposition to PTSD and suicide attempts that was present before the trauma occurred.” They note, as well, that their findings are in line with “previous research [that] has found that up to 20 percent of suicide attempts in young people are attributable to sexual abuse during childhood.”

“Although we did not focus explicitly on child sexual abuse, our results point to the need to base risk estimates of attempted suicide on data that take into account the psychiatric response to the trauma.”

[The abridged URL for this post is http://tinyurl.com/PTSD-Predictor .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Edwin Shneidman’s Meditations on Death Are Full of Life

Edwin Shneidman is the father of modern American suicidology. (Photo by Liz O. Baylen, Los Angeles Times)

[Special notice: Dr. Shneidman passed away on May 15, 2009. Please see "Suicide Prevention Pioneer Edwin Shneidman Dies at 91."]

By Franklin Cook, SPNAC Editor

I invoke the name of Edwin Shneidman almost every time I speak publicly about suicide–which is quite often–and have saved, in fact, a special place for him in the midst of a particular section of the ASIST (Applied Suicide Intervention Skills Training) workshop I’ve delivered dozens of times in the past three years.

I look out at the workshop participants as I begin to explain the unbearable pain that is experienced by victims of suicide, and I say, “Edwin Shneidman, the father of modern suicidology in America, created a word to describe that kind of pain: He called it psychache.”

And then I refer to Shneidman’s “Ten Commonalities of Suicide” and define psychache as “intolerable psychological pain.” We discuss what it must feel like to be someone who is thinking of suicide, how that sort of pain might make a person feel so desperate for relief or escape that he or she would lose contact with the natural–and powerful–human urge to stay alive and might kill himself or herself.

That oft repeated scene, of me in front of an audience–of ASIST trainees, of survivors of suicide loss attending a support group, or of community coalition members beginning to plan local suicide prevention initiatives–calling Dr. Shneidman “the father of modern suicidology,” came to my mind this morning as I read a wonderful article by Thomas Curwen in yesterday’s Los Angeles Times.

Curwen’s article is a meditation on death, with its subject being one of the world’s foremost experts on the topic.

He lies on the side of the bed, sleepy, unshaven, his hair mussed. He never asked to live to be 90, to see the breadth of his life diminished, the allure of the world fallen further out of reach. He is ready to die.

All his life he has studied this moment — from those who killed themselves and those who tried, from philosophers and colleagues, students and intimates — and its lessons hold no real surprise.

The article is enriched by an illuminating photo-audio essay by photographer Liz O. Baylen, in which Shneidman–in his inimitably straightforward way–shares his view of the nature of death:

There is no spirit or soul. I will be dead, get that through your thick head. I will be dead, and I “live” in my children, in my DNA, in my books, in my reputation: It’s as simple as that.”

Curwen looks back at Shneidman’s early writings on death, beginning with his 1973 book Deaths of Man, which challenged the views of Elisabeth Kubler-Ross:

The end of life isn’t, as she proposed, defined by a succession of stages, one following the other, denial to acceptance, but instead a “nexus of emotions … a hive of affect, in which there is a constant coming and going.”

It was an auspicious moment. “Deaths” was a finalist for a National Book award in science. He was celebrated and feted. But the momentum faltered. Placing mental anguish in a social, cultural or familial context fell out of vogue. Prescribing pills became easier.

While the L.A. Times article is framed by Shneidman’s anticipation of death, it is just as much a meditation on life:

No one has to die, he is fond of saying; it will be done for you. It’s living, however, that takes effort — to weather the sleeplessness and worry, the relinquishing of pride, the dependency upon strangers, the plea for respect and the struggle to remember …

Death is quite simple. Life is more mysterious, and he never tires of its wonderments: How he — a Jew at that — survived the war, how he and a girl from the corn country of Illinois fell in love and married and had four children and such a long and happy life …

The night stretches before him with so many endless hours, and sleep will come, if at all, in the early dawn. Until then, there is some writing he would like to do.

Shneidman’s latest book is A Commonsense Book of Death.

For more on his concept of psychache, see the 2001 L.A. Times article by Curwen titled “Psychache,” in which Shneidman says,

“Suicide is a complex malaise. Sociologists have shown that suicide rates vary with factors like war and unemployment; psychoanalysts argue that it is rage toward a loved one that is directed inward; psychiatrists see it as a biochemical imbalance. No one approach holds the answer: It’s all that and much more …”

“For me, today, the central data to elicit from a potentially suicidal person are not a family history, a spinal tap assay, a demographic accounting or a psychoanalytical session,” he says. Rather, his approach is to listen closely while asking a patient two basic questions: “Where do you hurt?” and “How may I help you?”

[The abridged URL for this post is  http://tinyurl.com/ShneidmanMeditations .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Childhood Abuse Can Alter the Brain and Increase Suicide Risk

ORIGINAL REPORT — According to a Canadian Press report, research shows that “childhood trauma can alter the way genes in the brain work, potentially putting an individual at increased risk for suicide later in life.”

A team of scientists from McGill University analyzed brain tissue from 12 suicide victims who had been abused as children and compared them to the tissue of 12 suicide victims who had not been traumatized and 12 people who died from other causes. They found that the brain tissue from the abused group showed “epigenetic” changes that affect a person’s response to stress, which is known to increase the risk of suicide.

An article about the study is published in the current issue of Nature Neuroscience (see an abstract of the article). In the Canadian Press report, the scientists who completed the research say that “identifying epigenetic changes in abuse victims could one day pave the way for drugs that would reverse the damage.”

“The implications at this stage are you want to identify these people and then probably offer them some sort of intervention,” said [Moshe] Szyf, an epigeneticist in McGill’s department of pharmacology and therapeutics.

Any practical application of the study’s findings is not likely to be available anytime soon, for “researchers would have to find similar epigenetic makings in the DNA of a person’s blood, since brain tissue can only be analyzed after death” and then researchers would have to “find drugs that could reverse the epigenetic changes,” which are both steps not yet accomplished.

Dr. John Strauss, a child psychiatrist at the Centre for Addiction and Mental Health in Toronto, said the McGill study is important because it brings to “psychiatric disorders a way of explaining potential gene-environment interactions.”

The difficulty is translating the method into subjects that are living, he said. “Obviously, if there were some kind of marker that you could check in individuals to see if they are more at risk (for suicide), it might aid identification.”

The findings are also an example of how basic research on brain function might lead to medical or other interventions that would prevent suicide, specifically in the emerging field of epigenetics. For more about epigenitics, see the Public Broadcasting Service feature on Nova or Science magazine’s web page on the topic.

Szyf said the optimistic message from the [McGill] study is that changes in the function of genes transformed by environmental factors are potentially reversible.

“I think what’s nice about the study is we can see marks of early life in the genes of older people,” he said. “And that illustrates the power of epigenetics because it serves as a memory of environmental exposure.”

For instance, it’s known that toxic chemicals like lead, mercury and PCBs can alter the function of a person’s genes and result in disease, including some cancers. “But it seems that social exposures are as toxic and can cause exactly the same kind of changes,” Szyf said. “And we should be aware of the impact a bad social environment can have on our health.”

[The abridged URL for this post is  http://tinyurl.com/AbuseCanAlter .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Author’s Widow Gives Fresh Perspective in “Stories Left To Tell”

Spalding Gray

ORIGINAL INTERVIEW — In an article in the Boston Globe, staff writer Megan Tench interviews Kathleen Russo, survivor of her husband’s suicide in 2004, about the dramatic presentation “Spalding Gray: Stories Left to Tell,” which “is her way of giving his words a new voice.”

With a four-person ensemble and rotating guest speakers … the show draws on both Gray’s acclaimed monologues and his unpublished writings. Audiences will laugh wildly, says Russo, radio producer for an NPR affiliate in the Hamptons – and perhaps they will see a greater humanity and the deep sense of humility that defined her husband’s life.

In the interview, Tench asks Russo, “How have you coped with his suicide?”

Well, there’s no manual. You just get through it somehow in your own way. What helped me most was that I had my children that I had to be responsible for and care for. I had no choice. If it was just Spalding and myself, maybe it would be different. But I had these kids to still raise, so I needed to be as strong as possible.

And then she asks, “Did you see it coming?”

Of course. He was sick for almost three years. One thing your readers need to be absolutely clear on and we do make clear in the show was that he was suffering from brain damage from the car accident. So, yes, he was prone to depression. Yes, he had bouts of depression and episodes. But this was really because he had brain damage.

In the end, Russo gives voice to the experience of many survivors who hope to counter the stigma of suicide:

I think it’s really important to talk about suicide because the more you talk about it, you realize everyone you know has been touched by it. It’s something that should never be swept under the rug like it was when Spalding’s mother committed suicide and no one talked about it. I don’t want my kids to be embarrassed by how their father died.

[The abridged URL for this post is  http://tinyurl.com/AuthorsWidow .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Innovative Home for the Mentally Ill Named for Suicide Victim

ORIGINAL STORY — In a story in the Chicago Tribune, reporter Ted Gregory tells about Joanna’s Lodge in Winfield, Ill., “a place that takes a somewhat unconventional but promising approach to empowering and improving the lives of people with mental illness.”

“To me, there’s such a pride in the people who live there,” said Mary Lou Lowry, executive director of NAMI DuPage. Joanna’s Lodge is named for Lowry’s daughter, who committed suicide after a psychotic break in 2003. “They’re always so warm and welcoming. They’re so happy to be there, and when they move on, there’s a huge celebration.”

Joanna’s Lodge was started in 2007 and is the only facility of its kind in Illinois. It follows the Fairweather Lodge model, now being used in 10 states, which “is based on research done in the early 1960s by psychologist George Fairweather.”

Conducting research among people with mental illness at Veterans Administration hospitals across the country, Fairweather found that leadership and problem-solving could be developed in small groups. That work led to the Fairweather Lodge model …

Activity is fundamental to Joanna’s Lodge, a “training campus” where four to eight residents with chronic mental illness receive intensive training in life skills and team building for up to six months and then graduate to a home where they live together in groups of four. During their campus stay, residents learn, among other skills, meal planning, budgeting, medication and stress management, employment and social skills, conflict resolution and problem solving. Lodge residents select a captain, treasurer, secretary and meal captain every week. Every day they hold member council meetings to discuss household issues of the day. By the time they graduate, they also must have a job.

“It empowers them to feel much better about themselves,” said Susan Simonsen, executive director of New Beginnings Community Services, Inc., the organization running Joanna’s Lodge. “Now, they have a purpose. They have a lot of self-esteem. They feel like an active member of society, and they deserve that.”

Esther Onaga of Michigan State University says that the approach instituted through the Fairweather Lodge model causes small groups of residents to become “an intentional community of support.”

[She] said people who graduate from Fairweather lodges return to mental health institutions much less frequently than those discharged from conventional institutions. Lodge graduates also hold jobs, a rarity for residents of more conventional homes, she said. In addition, Fairweather Lodges and the homes affiliated with them cost less to run than conventional homes for the mentally ill.

Those measurable outcomes suggest that investing in the empowerment of the mentally ill pays off. Even more than that, the approach used at Joanna’s Lodge meets basic human needs that often are neglected in other institutional settings.

“So many times people with mental illness have been limited in not being able to follow their dreams,” Lowry said. “So many have forgotten their dreams. We hope this will encourage them to get back their dreams and get back their lives.”

[The abridged URL for this post is  http://tinyurl.com/InnovativeHome .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Juvenile Justice Suicide Report’s Delay Called “Public Disservice”

ORIGINAL REPORT — According to a report by staff writer John Kelley in Youth Today, a national newspaper for professionals in the youth service field, “the author of a recent U.S. Office of Juvenile Justice and Delinquency Prevention report on suicides in juvenile facilities says that, despite the major findings it produced, the agency sat on the report for five years for reasons that have never been disclosed to him.”

Lindsay Hayes, a project director for the NCIA [National Center on Institutions and Alternatives], told Youth Today he handed in the report [titled "Characteristics of Juvenile Suicide in Confinement"]  during the winter of 2004. OJJDP published the study and made it available on its website [on February 9, 2009].

Kelley also posted a companion story on Youth Today’s blog, summarizing the findings of the study, including that

• more than a third of the 110 suicide deaths that occurred between 1995 and 1999 were not known to the supervising or licensing state agency …
• many of the suicides were not known to child advocacy agencies, and nearly a sixth of the deaths were learned about through newspaper articles and conversation despite surveys sent to almost 4,000 public and private juvenile facilities …
• more than two-thirds of private facilities did not respond to survey requests …
• more than 70 percent of the victims were between the ages of 15 and 17 …
• more than half of juveniles who killed themselves in detention did so in the first six days …
• only 35 percent of them had received a mental health assessment at the time of their death … [and]
• only 17 percent of the victims were on suicide watch at the time of their deaths.

The report recommends that juvenile facilities have written suicide prevention policies, and create and maintain effective training programs.

Pro Publica’s A.C. Thompson also reported on the OJJDP study in an article a few days after Youth Today broke the story, suggesting that the department’s delay of the report might have been strategic and questioning the actions of J. Robert Flores, who was chief of DOJ’s juvenile justice office at the time.

Dan Macallair, executive director of the Center on Juvenile and Criminal Justice, a San Francisco nonprofit, said the report would have made headlines had it been released in a timely fashion. “It would have been huge,” [he] said. “It would have led to legislative hearings, newspaper articles … It would have sparked an outcry.”

Over the years, Hayes said, the Justice Department vacillated on the status of the document, saying first that it was fast-tracked for publication and later that it had been rejected and “unapproved.” Last fall, Hayes complained about the delay to [Flores]. “I wrote kind of a nasty letter to Mr. Flores saying I was extremely frustrated that this report didn’t come out — that there are youth dying,” recalled Hayes.

This isn’t the first time controversy has found Flores, who has been the subject of congressional hearings. In June he was questioned by the House Oversight and Government Reform Committee about millions of dollars in grant spending, with then-Chair Henry Waxman (D-CA) describing Flores’ grant-making process as “neither fair nor transparent.” [SPNAC readers can read Flores's statement to the House committee.]

That same month, the Washington Post reported that Flores was the subject of a criminal probe into his “alleged use of government funds for personal travel expenses and his hiring of a politically well-connected contractor who allegedly performed little work in a high-paying job.”

In a column yesterday in the St. Paul Pioneer Press, Ruben Rosario writes that the delay in the report’s release was “a public disservice.”

The findings and recommendations from this unprecedented study could have saved lives while it sat gathering dust.

Rosario goes on to further implicate Flores, quoting “a former high-ranking OJJDP staffer [who] publicly accused Flores of steering OJJDP grant money to programs that had ‘religious, social or political’ connections to the Bush administration.”

One substantial grant was awarded to a juvenile golf foundation whose honorary chairman is George H.W. Bush, even though the program ranked 47th out of 104 grant bidders in an OJJDP funding priority report.

Best Friends, a teen-abstinence program ranked 57th and run by Bush family pal and former drug czar Bill Bennett, was awarded $1.1 million — twice the federal funds it requested.

Flores, who left with the recent change in administration, told ABC News’ Brian Ross that he was free to ignore OJJDP staff recommendations but denied playing favorites.

[The abridged URL for this post is  http://tinyurl.com/ReportDelay .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Actor Launches Nonprofit, Creates Film To Conquer Stigma

ORIGINAL REVIEW — In Joe Pantoliano’s hometown newspaper, the Wilton Bulletin, reporter Paul Schott reviews the actor’s work-in-progress “No Kidding, Me Too!, which shows how diagnosis and treatment can empower those with brain diseases to lead fulfilling lives.”

As well as chronicling Mr. Pantoliano’s own battle with clinical depression, No Kidding, Me Too! prominently features young people who have struggled with depression, drug addiction, and self-injuring. Adolescents and young adults are particularly vulnerable to the harmful repercussions of undiagnosed brain dis-eases, says Mr. Pantoliano. He adds that with the documentary, he wants to teach young people that “it’s cool to talk about your feelings.”

Pantoliano, who directs and narrates the film, has also founded a nonprofit organizaton of the same name, No Kidding, Me Too!, which has as one of its goals “removing the social stigma of brain diseases or mental illness.”

The name of Mr. Pantoliano’s documentary and nonprofit comes from the hope that one day all people with brain diseases will feel comfortable sharing their story and that another person with a mental illness will respond, “No kidding, me too!”

The organization’s homepage features a trailer for the film, a television interview of Pantoliano with NBC’s Brian Williams, and a statement of purpose:

No Kidding, Me Too! is … comprised of entertainment industry members united in an effort to educate Americans about the epidemic related to brain dis-ease in all forms. Through this enlightenment we will teach those suffering from it, and their loved ones who are victims of it, to talk about it openly. The goal is to tear this stigma out of the closet so these people will be surprised to find millions of others like themselves and say, “No Kidding, Me Too!”

[The abridged URL for this post is  http://tinyurl.com/ConquerStigma .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Oratorical Skills Help Teenager Cope with His Father’s Suicide

Brandon Kapelow shares a photo of him and his father (Rachel Shaver, Jackson Hole News & Guide).

[Editor's note: The story referenced includes brief descriptions of several suicide attempts.] Last month, reporter Kelsey Dayton learned she had won first place in feature writing from the Wyoming Press Association for a story last April in the Jackson Hole News and Guide. The story is about teenager Brandon Kapelow, whose …

… journey creating what would be an award-winning original oratory for this year’s high-school speech and debate season started in spring 2002 when Brandon was 8. That was the first time his father tried to kill himself.

The speech Brandon delivered is as helpful as it is courageous, for it reveals not only what it is like for a child to survive his parent’s suicide, but also what it is like for him to live with a parent’s mental illness, including several nonfatal suicide attempts.

Brandon celebrated his ninth birthday while his dad was hospitalized for his second suicide attempt. His father admitted trying to buy a gun to kill himself. In the hospital, he refused to eat, hoping to starve to death.

Brandon began to understand bipolar disorder and how people who loved life could be so sick they tried to end it, when his father made a third attempt. Loren [Kapeolow, Brandon's mother] tracked him to Carbondale, Colo., by intercepting the trademark suicide notes he sent by FedEx. He was in a storage unit, his wrists slit, trying to asphyxiate on carbon monoxide from the running car and barbecue grills he had lit in the small space.

After Stephen’s fourth attempt was thwarted, when he had planned to jump off a building in Indianapolis, it was beginning to seem like routine.

Dayton’s story tells about Brandon’s development as a high school orator, about his yearning to talk about the subject that had shaped his young life, and about the assistance and understanding he received along the way.

His first speech was clinical, full of statistics. Mark Houser, his coach, knew Brandon would have to add emotional gravity to the story to be competitive. But Houser, who coincidentally is a member of Teton County Suicide Prevention and had a friend who killed himself, stepped back. He saw Brandon’s speech wasn’t just about trying to win ribbons.

This was a kid on a journey who needed to go at his own pace.

As Brandon confronted his first competitions in qualifying rounds, he he “worried about using his dad’s story.”

He didn’t want sympathy points. He felt unprepared the first time he presented the speech, at a meet in Rock Springs. He felt exposed when he nodded, “Judge ready?”

[Afterward,] The judges’ comments read: “Excellent grasp of facts and statistics … Good use of personal story without making it a pity party … You have the ability to make a difference concerning suicide because of your insight and because of your excellent communications skills.”

Brandon’s mother watched her son’s progress from the sidelines as he spoke publicly about their family’s tragedy, crediting his oratorical endeavors with helping him with his grief.

Losing a father to suicide is something Brandon probably will never fully recover from, his mother said. Instead, he must learn to cope. Through speech, Brandon was coming to terms with his father’s suicide. His mother knew he was healing or he wouldn’t have decided to talk about it publicly day after day, she said …

Brandon’s no-holds-barred message has an unquantifiable potential to touch lives, Houser [the speech coach] said. Stigma is the biggest issue with suicide, leaving survivors feeling alone and preventing people from getting help, he said. It inspired Houser in his own prevention efforts.

“If there is a teenager that can be so brave, I should try to work through some of my own barriers,” he said.

His presentations are also having an effect on the audiences he has been speaking to.

His speech is not just about how losing a father changes the life of a son. It is a call to action. Be aware. Talk about the taboo. Break the stigma.

In the hallway of Jackson Hole High School, during the national qualifying meet, a girl stopped him … She wanted to thank him. She was depressed. She had seen his piece in Rock Springs. She realized she wasn’t alone … She would be OK now, she said. His speech – his life – had changed hers.

SPNAC readers can also read more about Brandon’s family’s experience in a 2006 News & Guide story in which his mother is quoted extensively. She says, for instance

“Mental illness is a fatal illness, just like cancer.”

“My life is an open book … If I close that book, then it’s like saying I’m not going to help somebody else. … I think that if people don’t talk about it, if we make it taboo, then how are we going to help each other? How are we going to help each other heal?”

[The abridged URL for this story is  http://tinyurl.com/OratoricalTeen .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Study Shows SSRIs Lower Adult Suicide; Teens, SSRIs Debated

ORIGINAL REPORT — A report today in Science Daily briefly summarizes a study by researchers from the World Health Organization and the University of Verona, Italy that is published in the current issue of the Canadian Medical Association Journal, which says that “SSRIs [selective serotonin reuptake inhibitors] in adults significantly reduced the risk of completed or attempted suicide” [SPNAC readers can access the full text of the CMAJ article].

The study, a meta-analysis of 8 large-scale observational studies, was undertaken to explore whether SSRIs reduce or increase the risk of suicide in depressed people.

Previous studies, including a 2007 study by the U.S. Food and Drug Administration (FDA), found the risk of suicide in adults was neutral, elevated in those under 25 and reduced in people older than 65. A subsequent black box warning was added to all antidepressants regarding increased risk of suicidal symptoms in people under 25 years of age.

“While the FDA analysis found a neutral effect of SSRIs (or a promoting effect in adults aged 18-25), we found a strong protective effect associated with SSRI treatment in adults,” [according to] Dr. Corrado Barbui and colleagues.

The WHO/Verona study also concludes that “for studies that used completed suicide as an outcome, exposure to SSRIs was associated with increased risk among adolescents,” and the current issue of CMAJ also features a companion piece [SPNAC readers can access the full text] to the report about the SSRI study, which  focuses on a key issue regarding the FDA’s warning and SSRI use among young people:

Evidence of a possible association between the use of selective serotonin reuptake inhibitors (SSRIs) and suicide in youth presents a vexing problem for clinicians, youth and their families … Do SSRIs carry a greater risk for suicide than no treatment or alternative treatments such as other antidepressants or specific psychotherapies?

The commentary is written by Dr. John Mann of Columbia University and Dr. Robert Gibbons of the University of Illinois, who state “alarmingly, concerns about the risk of suicide in youth have led not only to fewer SSRI prescriptions without substitution of alternative medications or psychotherapies, but also to a decrease in predicted rates of diagnosis of mood disorders.”

With so many uncertainties, large randomized trials are now required … Studies of SSRIs that include suicidal adolescents with major depression are urgently needed to determine the safety and efficacy of these medications.

The FDA’s information on SSRIs includes a medication guide covering antidepressants and suicide that lists the most important information a person should know on the topic:

1. Antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults when the medicine is first started.
2. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Some people may have a particularly high risk of having suicidal thoughts or actions. These include people who have (or have a family history of) bipolar illness also called manic-depressive illness) or suicidal thoughts or actions.
3. [Know] how … [to] watch for and … prevent suicidal thoughts and actions …

The medication guide (SPNAC readers may download a copy) goes on to elaborate on the signs to “watch for” and the action to take if they appear (namely “call a healthcare provider right away”).

[Editor's note: In addition to calling for assistance, one should also not leave the person alone and help keep the person safe from harm (for instance, by removing his or her access to lethal means if it is not dangerous to do so). If you or someone you know feels suicidal, please click on NEED HELP?]

[The abridged URL for this post is  http://tinyurl.com/SSRI-Adult .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Youth Suicide among Native Americans Linked to Colonialism

Doug Cuthand

ORIGINAL COLUMN — A column by freelance writer Doug Cuthand in today’s Saskatchewan Leader-Post makes a strong link between suicide among Native American youth and the impact of colonialism and historical trauma on the indigenous people of North America:

There is no worse indictment on the failure of government policy toward aboriginal peoples in Canada than our appalling rate of suicide. The tragic act of taking one’s life is a reflection of our young people’s lack of hope for the future and pain of the present.

Suicide accounts for one quarter of the injury deaths for First Nations people between the ages of 15 and 25. According to Health Canada, suicide rates for First Nations youth are five to seven times higher than the national average.

We have suicide rates that are among the highest in the world. The rate in Nunavut, for example, is double that of Lithuania, which has the world’s highest suicide rate among countries.

Canada’s situation is similar to that of many Native American communities in the United States. For instance, in South Dakota, the suicide rate for white males 15 to 19 years old is 23 deaths per 100,000 population while the rate for Native American males in the same age group in the state is 103 per 100,000. (Data are for the years 1999-2005. The source is the CDC’s Web-based Injury Statistics Query and Reporting System or WISQARS.)

In his commentary, Cuthand recognizes that “there is no simple answer” to what lies behind this epidemic of suicide.

Living conditions, lack of opportunity, unemployment, and drug and alcohol abuse all contribute to the high rate of suicide among our youth.

Our young people are living through a period of profound change. Our culture is changing rapidly. We are moving from a rural society to an urban one. We are bombarded by information from the world through television. Our young people feel they don’t have a place in this new world.

Also, alcohol and drugs fuel these feelings. Health Canada estimates that about 60 per cent of suicides occurred while the individual was intoxicated.

He makes several fundamental observations that are vital to understanding suicide in Indian Country.

The recent epidemic is not in keeping with our history and culture. In the past, while we may have been poorer than today, the language and family structure was sound. We lived in large extended families. The grandparents either lived with the family or close by. They provided stability and passed the culture along to the younger generation.

The boarding schools broke this bond … Families were torn apart and the strong family support system was weakened badly.

Also, the assumption that aboriginal people are inferior in comparison to European Canadians is internalized and many aboriginal people actually believe they are inferior. This loss of self-esteem is destructive and reduces the ability to deal with life’s challenges.

Today the children and grandchildren of the stolen generations are rebuilding our societies as best as they can. But serious damage has been done and we see jails replacing residential schools, gangs replacing families, and television replacing the teachings of the elders.

Cuthand ends his brief essay with a discussion of possible solutions to the problem of suicide in Native American communities:

Statistics show that the high suicide rate is not evenly distributed across Indian country. Some communities have a higher rate than others and the reasons are associated with cultural factors.

Research has shown that communities where the culture is strong have a lower rate of suicide compared to reserves where the culture has been lost or seriously weakened. Also, when employment rates increase, the suicide rate declines. A strong culture combined with good leadership is a deterrent to youth suicide.

The answer to reducing the high suicide rate doesn’t lie only with the individual, it lies with the community … We must take ownership and address it and put a stop to this senseless loss of life.

[The abridged URL for this post is  http://tinyurl.com/LinkColonialism .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

SPNAC Back after a Brief Pause for Special Task, Special Guests

Carol Graham shares the I.D. tags memorializing her sons, Jeff, left, and Kevin. (Photo by Helen H. Richardson, Denver Post)

By Franklin Cook, SPNAC Editor

Today marks the longest hiatus between new postings on SPNAC (one week) since its launch. Please accept my apologies, but I had training duties to attend to that required my full attention, namely delivering the American Foundation for Suicide Prevention’s Suicide (AFSP) Survivor Support Group Facilitator Training in Denver, Colo., last week, which was co-hosted by the Veteran’s Administration.

I facilitated the training with Joanne Harpel, AFSP’s Director of Survivor Initiatives. It was the second of two such events (the other was in New York last fall), through which AFSP and the VA have explored providing resources focused on strengthening grief support services for survivors of suicide loss.

More than 25 people attended the training in Denver–most of them survivors of a loved one’s suicide who are either now facilitating a support group or who wish to start one–representing 10 states and including veterans, family members of veterans, and caregivers who, whether or not they themselves have lost a loved one to suicide, are interested in contributing their efforts to the cause.

On Day One of the two-day workshop, we have a working dinner, and last week, we enjoyed a first in the history of the facilitator training when we were joined by two very special guests, Gen. Mark Graham and his wife, Carol, who both delivered brief personal remarks and then spent half an hour answering questions and fielding comments from the workshop participants to give us a better idea of the specific needs of soldiers, veterans, and their families when it comes to surviving the loss of a loved one to suicide.

Gen. Graham is the Commander of Fort Carson, Colo., and Mrs. Graham is a board member for the Suicide Prevention Action Network, SPAN USA. They are the survivors of one son’s suicide and, seven months later, of their other son’s combat death in Iraq. To learn more about the Grahams, here is a Denver Post story about them, and here is recent interview with Gen. Graham from KOAA TV in Colorado Springs.

[The abridged URL for this post is  http://tinyurl.com/SpecialGuests .]

[Related SPNAC post: "National Youth Prevention Workers Praised by Survivor Leaders"]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Two Random Acts of Speaking Out Are Brought Together

By Franklin Cook, SPNAC Editor

Separate items published over the weekend in two different newspapers–one in California and the other in New Jersey–coincidentally brought together the voices of two people who have lost a loved one to suicide. From opposite sides of the continent, each of them was speaking out against stigma .

The first voice comes to us courtesy of Brian Hamilton, sports editor of the Nevada County Union in Grass Valley, Calif., who last week “watched one of the most courageous performances I have ever seen on a basketball floor.”

It came at halftime, with no ball nor hoop necessary. As he grabbed hold of the microphone and [a] thousand or so basketball fans were sitting in absolute solemn silence, Mike Bratton began to tell a story no parent should ever have to share.

“My son … committed suicide,” he said. “And that’s something that’s so often covered up and hidden because of the embarrassment. My son committed suicide, you know, so did I do something wrong? It’s just had that stigma.”

“It’s an every moment, in-your-face, life-lasting reality. It’s something that never goes away, the aftermath and devastating effects of suicide. But it has to be talked about. People have to know. We don’t want it to be glorified, what my son did, but people have to know.”

The second voice comes to us directly from Augusta Santos, in an op-ed piece at MyCentralJersey.com, the website of the Home News Tribune and the Courier News. Augusta suggests that “it’s time for this six-letter word (stigma) to be removed from the Webster’s Dictionary — in order for it to stop having so much power and control in people’s lives.”

I believe and know that until families, communities, and society accept … emotional disorders the same way they accept their physical illness, this six-letter word called stigma will not go away.

Augusta’s husband, John, died of suicide in 2004, and she thinks stigma played a part in his death, so she wrote to her hometown newspaper this weekend to suggest that people do more to make stigma “go away.”

As I lived with John, a man with a heart of gold, who struggled with deep depression, I experienced first-hand what this horrible and debilitating illness can do to the human body …

Never did I imagine that there is an organization called the National Alliance for Mental Illness (NAMI) whose mission is to improve the quality of life of individuals who suffer from a serious mental illness and provide moral support for their families. I believe that health professionals, who have patients suffering with emotional disorders, should go that extra mile to inform the patient and their families of these important organizations.

I’m pretty sure Mike Bratton and Augusta Santos don’t know each other, and it is purely happenstance that what they said recently about stigma got put together here, but the synchronicity of their voices–speaking out bravely against the stigma they and their loved ones have faced–made me wonder how powerful a message we might send to our society about stigma if we all put our voices together.

[The abridged URL for this post is  http://tinyurl.com/SpeakingOut .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Columnist Depicts Survivor Experience (almost) Accurately

By Franklin Cook, SPNAC Editor

ORIGINAL COLUMN –  Author Lisa Earle McLeod’s “Forget Perfect” column this week will strike a chord with people everywhere who have lost a loved one to suicide:

A friend of mine just got the news that another man in her neighborhood killed himself …

Another man who decided that his family would be better off without him.

Another man who will never walk his daughter down the aisle or be the best man at his son’s wedding.

Another man whose wife will forever wonder what she could have done differently.

I don’t know what happened in each of the circumstances. But I do know that when someone is depressed they lose perspective and often fail to see the true consequences of their actions.

She writes directly to people who might be having thoughts of suicide as if she herself knows what a family member goes through after a loved one kills himself:

If you’re starting to think that things would be better if you weren’t around, let me fill you in on the aftermath of a suicide.

Your kids will spend the rest of their lives wondering why they weren’t enough to make you happy.

They’ll go to bed every single night knowing that their mom or dad would rather be dead than be with them.

They’ll look back over happy moments you spent together and wonder if you were just faking it, because surely if you really loved them you never would have chosen to leave.

They’ll struggle with relationships for the rest of their life, because they’ll never feel confident that someone will ever love them enough to stick around.

With each new person they meet, at work, or in church, or at school, they’ll wonder, should I tell? Do they already know? What will they think of me when they find out?

Of course, your spouse will have to plan a funeral, sort out the mess of your finances, and manage every aspect of the household alone. But that will be nothing compared to the grief they face as the surviving parent trying to keep it together for kids whose lives will never be the same again.

Some people will even suggest to your spouse that he or she should have gotten you some help. It will hurt to hear, but it’s nothing that they haven’t thought a million times themselves.

And, if your parents are still alive, they will suffer the worst grief a human can bear, and they will forever feel like they failed.

I take issue with some of the images she draws in those passages, for example:

• Describing children survivors (whether they are young children or adult children of parents who die by suicide) as “knowing” their parent didn’t love them is both misleading and unhelpful. The actual experience of the vast majority of survivors would be much better described by words such as “wondering” or “questioning” not “knowing,” for in fact it is the doubt, confusion, and fear about one’s relationship with the deceased that are most commonly troubling to survivors. And, more importantly, almost without exception, people who die by suicide love their families (even if they lose contact with that love as a resource for their own decision-making and behavior).
• Using absolute terms such as “never feel confident” and “forever feel like they failed” also oversimplifies the emotional outcome of suicide. It is sadly true that, early in the grief process, one’s confidence can be crippled and one’s sense of failure can be overwhelming–and that suicide grief can be strenuous and complicated for a relatively long time. But most people who lose a loved one to suicide do indeed recover from the debilitating aftermath of the death. Survivors don’t “get it over it,” but they generally do find ways to begin living their lives again with confidence in the love they receive from others and with the understanding that their loved one’s death was not a failure on their part.

Those few blemishes in what McLeod writes are not merely nitpicking, for writing (and speaking) accurately about suicide is vital. In her zeal to say something useful to men who might be desperate enough to kill themselves, she lost sight in a few instances of what she might also be saying to survivors. Even so, her errors shouldn’t detract from the otherwise excellent observations she makes in her column about the aftermath of suicide from the perspective of the survivors left behind.

[The abridged URL for this post is  http://tinyurl.com/ColumnistDepicts .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

The Last Word on the Financial Crisis and Suicide Prevention

By Franklin Cook, SPNAC Editor

Other than the Nov. 24, 2008, post “SPRC Gives Prevention Workers Info on Economy, Suicide,” I have intentionally avoided coverage of suicide and the financial crisis because I fear that the present–and rather intense–media focus on the “connection” between the two might contribute to suicide contagion. The Nov. 24 post introduced a user-friendly SPRC document that helps explain “the relationship between the economy, unemployment, and suicide” and is organized into “talking points [that] summarize what is known about these complex relationships.”

For essential information on preventing contagion in a community, see the U.S. Centers for Disease Control and Prevention’s document “CDC Recommendations for a Community Plan for the Prevention and Containment of Suicide Clusters.”

Those recommendations are succinctly summarized–from the perspective of schools but also covering an entire community’s response–in a presentation by Frank Zenere of the National Emergency Assistance Team of the National Association of School Psychologists, titled “Tragic Connections: Identification And Assessment Of Youth Suicide Contagion.”

A seminal document on the relationship between media coverage and suicide is “Reporting on Suicide: Recommendations for the Media.” (This is an excellent resource, but it is a bit dated, mainly because it lacks references to online media)

Those recommendations are summarized in a publication from the Suicide Prevention Resource Center (SPRC): “At-a-Glance: Safe Reporting on Suicide.”

The three largest nonprofit organizations focusing on suicide prevention in the United States have all weighed in with authoritative (based on science and facts) statements about suicide and the economy. Here they are:

• Statement by the American Association of Suicidology (AAS)
• Statement by the American Foundation for Suicide Prevention (AFSP)
• A list of “things you can do to help” from the Suicide Prevention Action Network (SPAN USA), available on its homepage (below the fold under the heading “Listen and Act to Prevent Suicide During the Economic Crisis”)

Some of the best recent media pieces about suicide and the economic downturn (in my opinion … others can suggest additional candidates in “Comments,” below) are the International Herald Tribune’s “Economic collapse brings out resilience in most, experts say,” USA Today’s “Economy prompts more calls to suicide hotlines,”  the Toronto Star’s “The myth of post-crash pavement suicides,” the Montreal Gazette’s “Economic crisis takes toll on mental health” (which even mentions protective factors), and a column by David Lazarus in the Los Angeles Times’ “Social services see recession’s toll.” (Please note that these articles are not referenced because they adhere strictly to the media guidelines–very little media coverage does that, especially when it comes to brief descriptions of method–but rather because they come close to following the recommendations and they cover their subject both artfully and helpfully.)

And the last word is this, from today’s editorial in McCook Daily Gazette, a small-town newspaper in Nebraska:

“Am I my brother’s keeper?” While Cain and God both knew the answer — Cain had already killed his brother Abel — not all of us have answered the question for ourselves.

As economic conditions deteriorate, more and more of us are needing help from our friends and neighbors — and more and more of us are being called upon to provide that help.

We don’t know all of the details of the tragic deaths of a California family of seven, but it appears to be a murder-suicide involving a man worried about his job at a medical center … In a completely different situation, a 93-year-old World War II veteran in Michigan apparently died of hypothermia after the city limited his electricity for unpaid utility bills …

As we read about thousands of jobs disappearing each week, we can be sure variations of the two tragedies recounted above will be repeated all too often.

Certainly the elderly man would have been saved, had someone known the heat in his home was completely shut off. Not all of the details are known in the death of the California family, but intervention of some type at the right time could surely have made a difference.

Whatever the situation, it behooves all of us to keep tabs on our friends and neighbors to make sure they’re coping with the challenges life throws at them.

Even more important is the need for those of us who encounter tough times, whatever the cause, to not hesitate to seek help when we need it.

[The abridged URL for this post is http://tinyurl.com/LastWord-Economy .]

[Editor's note: Please share this story widely and, if you are so inclined, whenever you read something online about the connection between suicide and the financial crisis, please see if there is a "comments" section associated with it and post a comment, referring to the URL http://tinyurl.com/LastWord-Economy .]

[Related SPNAC post:] “SPRC Gives Prevention Workers Info on Economy, Suicide“

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Attempt Survivor Speaks Out with Art after His Brother’s Suicide

ORIGINAL STORY — Reporter Andy Parks, writing for the Northern Rivers Echo in Lismore, Australia, tells the story of Mic Eales, who survived two suicide attempts before his brother Bryan took his life seven years ago.

Bryan’s death was a catalyst for a positive change in Mic’s life. He started harnessing his experiences and creating works of art that deal with the issue of suicide … At the moment he is collecting coffee cups. Mic’s aim is to collect 2101 coffee cups (the latest figure from the Australian Bureau of Statistics for Australians who committed suicide in a year) for a piece he is planning to create.

“It’s about the conversations we don’t have. We have pleasant conversations when we are having coffee, but we don’t go there… If somebody has experienced suicide, we don’t talk about it, we closet it. So I want to be able to open it up to say ‘these are the conversations we need to have.’”

Mic’s creative and provocative way of bringing attention to suicide includes a piece called “Too Few Ladders,” which is based on “‘Snakes and Ladders’ … an ancient Hindu game … used to teach children about the ups and downs of life.”

Mic said most people who had seen Too Few Ladders came up to him and talked about a friend or a cousin who had suicided.

“Everybody knows somebody,” he said.

He still struggles at times with suicidal thoughts, and he deals with them by focusing on his family, meditating, and using “the 12-step program for addicts [adapted] for his own situation.”

Another factor in his survival has been an ongoing correspondence with the daughter of a friend who committed suicide.

“(I tried) to explain to her the pain that somebody goes through: When you get into that dark place, you don’t think about the family. You actually think they are going to be better off without you. They’re weird, twisted thoughts, but they are very real and very logical (at the time). That’s the part you have to fight. You have to be able to look at those thoughts for what they are.”

Pictured is one of Mic's artworks that combines the pages of a phone book (representing how people often hear of a loved one's suicide) and writings, pictures, and images from throughout his own life (representing all that his loved ones would have to remember him by if he had died by suicide), along with an element of "Too Few Ladders."

[The abridged URL for this post is http://tinyurl.com/SpeaksArt .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Two Communities Highlight ASIST Suicide “First Aid” Training

Tom Gangel of Steamboat Mental Health delivers ASIST. (Photo by John F. Russell, Steamboat Pilot & Today)

Two recent newspaper articles offer a good look at the two-day Applied Suicide Intervention Skills Training (ASIST) as it is being implemented in different communities.

Reporter Sandra Jontz writes about a recent ASIST workshop led by Navy chaplains in Naples, Italy, in an article in Stars and Stripes.

“The training is helping me get over the fear of helping someone, of interfering,” [said Donna Lunsford, a] 54-year-old spouse of a DOD civilian employee … “You can’t help anybody if you don’t ask [about suicide].”

Newly ASIST-trained caregivers join a growing community network of people trained not only to be more aware of suicide risk in another person but who also have the skills to intervene and help keep the person safe.

“The ASIST program provides everyday people with the perspective and skills to empower them to provide effective care for others,” said Chaplain Jason Hefner, the lead ASIST instructor for the Navy’s region, which encompasses Europe, Africa and Southwest Asia.

“You might be aware of someone thinking of suicide. What do you do with that information? That’s what people in the field really struggle with,” [said Dr. (Lt. Cmdr.) Robert Zalewski-Zaragoza, a psychiatrist and head of the mental health department for Naval Hospital Naples].

Education reporter Zach Fridell covers a recent training in Steamboat Springs, Colo., in a story about ASIST in the Steamboat Pilot and Today.

The nine participants, including several school-based mentors … said they hope they never have to use the skills presented by [Tom] Gangel and Sandy Beran, of the Northwest Colorado Visiting Nurse Asso­ciation. But unfortunately, the time likely will come when they need to talk to a suicidal person. Survey results of the nationwide ASIST program show that six months later, 64 percent of participants used the training in their lives.

The intervention model learned through ASIST applies a systematic approach to interacting with a person at risk of suicide..

There are several difficult steps along the way, [Rangel] said, including broaching the topic of suicide with a depressed person and getting past the question, “Are you thinking of committing suicide?” After that question is asked, Beran said, the helpers must also “spend time listening to things that are so negative,” often a difficult task.

The workshop features half a day of one-on-one simulation of  the model to help people practice the skills they are learning:

Caroline Beard and Megan Rea, school-based mentors with Partners, sat across from each other. Beard played a single mother with three children. Her eldest son had been in a car accident and was in a coma. The bills are piling up. On a break from her fictional job as a waitress, she told Rea she was contemplating suicide.

Rea gently questioned Beard about whom she could talk to and how she was coping. She established a rapport with Beard and gradually talked her away from her depression.

Derek Kratzer, another Partners mentor, said finding the patience to complete the process can be difficult, especially in stressful situations.

“I’d say (the hardest part) is me not trying to move too quickly through the conversation with them but taking the time to have them tell their story, for them to explain their depression and reasons they do have to live,” he said.

According to LivingWorks, the developer of ASIST and safeTALK, a companion training that teaches suicide alertness to the public, the ASIST workshop has been delivered to 750,000 caregivers worldwide in the past 25 years. LivingWorks trainings promote the concept of suicide-safer communities, which are explained in its core beliefs about suicide and its prevention.

[The abridged URL for this page is  http://tinyurl.com/Suicide1stAid .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Hospice Chaplain Ponders Lessons Learned from Survivors

ORIGINAL COLUMN — Ted Swann, a chaplain for Burke Hospice & Palliative Care of Valdese, N.C., writes in a column for the Morganton News Herald, “In my opinion, death by suicide is the most complicated grief to deal with.”

There are no goodbyes … Once, I facilitated a support group for suicide survivors … [in which] the group of six widows ITAL taught me. I was a good listener. Once they felt safe with one another they shared deep feelings, frustrations, anger and disappointments.

Swann says he learned several important lessons from listening to the members of that support group:

People don’t want to talk about suicide. It’s a different grief … There are at least these three reasons we don’t talk about it: The stigma — What do you feel when people whisper behind your back? … If you don’t know what to say, just be there for your friend. He/she is hurting and is an unfortunate victim … It’s too painful — It’s a sudden, violent death. There’s no gentle way to die by suicide … It is excruciatingly painful, but communication is vital … Theological beliefs — Many Christian churches, and individual members of them, are divided on this question. Personally, I want to look at all of a person’s life, not just the last 60 seconds. I accept the belief that the God of grace encompasses all of life.

Swann also makes several observations about the “feelings of anger, guilt and shame” that the support group members shared with one another.

Wrongly, we think, someone is responsible. This is more common with a suicide death than with other illnesses. This is an important quotation: “The other day I heard the father of a boy who had committed suicide say, ‘Everyone has a skeleton in their closet. But the person who kills themselves leaves their skeleton in another’s closet.”

Each loved one wracks their mind and tears the heart questioning, “What could I have done to prevent this?”

In the end, he shares his opinion:

The suicide survivors, wounded healers, are the best therapists for each other. Together they work through feelings of shame and guilt.

And he offers some excellent advice:

A good rule to follow: As we meet people each day, let our kindness and caring be intentional. After all, we don’t know what just happened in their lives. “In response to all He has done for us let us outdo each other in being helpful and kind to each other and in doing good” (Living Bible — Hebrews 10:24).

Isn’t it time we talked? I have a friend who is a whittler. The finest I’ve known. He and I made a covenant that if the time comes, we will say to each other, “Isn’t it time we talked?”

[The abridged URL for  http://tinyurl.com/ChaplainPonders .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Devotion to Basketball Is Teen’s Way of Coping with Grief

Darren VanGennip, with his brother, sister, and grandparents (photo by Fred Lynch, S.E. Missourian).

ORIGINAL STORY — A feature by reporter Christopher Smith in the Southeast Missourian tells the story of high school senior Darren VanGennip, who has counted on his love of basketball to help him cope with “his mother’s death from lung and bone cancer, his father’s suicide, and the deployment of both his brother and sister to Iraq.”

On some days when he did not have school, he would play basketball from 10 a.m. until dark, pretending he was going against legends like Michael Jordan and “Pistol Pete” Maravich.

His mother died in 1999 when Darren was 8, and his father died two years later. Both were in their early 40s.

“After that, everything just felt different to me,” Darren said. “Everything just seemed kind of slower to me. For a while I’d wake up and I’d be so upset that I wouldn’t want to do anything. But I started playing basketball and that kind of took my mind off it. So that got me on track.”

“I was as sad as you could be,” [said Darren's grandmother, Wilma VanGennip]. “I remember (Darren) saying, ‘Grandma, are you ever not going to be sad anymore?’ And I thought, ‘If that kid can live with it, then I can, too.’ And he brought me out of it.”

When his brother and sister were deployed to Iraq for a year’s tour of duty with the National Guard in 2004, “basketball took on even more importance for Darren.”

“It was a pretty tough time for me because I really look up to my brother and sister, and not being able to talk to them for months at a time kind of made things difficult,” he said. “I’d just play ball, and I guess that’s where I fell in love with the game.”

His acceptance of what happened began to develop with “the realization that his parents were not coming back.” In Darren’ own youthful and wise words:

“It’s been tough. It was real tough at first. … Life goes on. You’ve still got to live your life and that’s all you can say, really.”

SPNAC readers can watch a short video of Darren on YouTube, in which he says of his parents,

“I wish that they could see me play [basketball]. They never got to see me play any sports, so … they had no idea. I … keep a good attitude. I’m just thankful for the memories I still have of them.”

[The abridged URL for this post is  http://tinyurl.com/BasketballWay .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

All Recruiters To “Stand Down” One Day in Wake of Investigation

Army recruiter Nils “Aron” Andersson--who served two combat tours in Iraq--died by suicide in 2007.

ORIGINAL REPORT — A report yesterday by Catherine Abbott of the Army’s Office of Public Affairs details the conclusions from “a two and a half month investigation into the suicides of four Soldiers assigned to the Houston Recruiting Battalion … between January 2005 and September 2008.”

The investigation concluded that there was no single cause for these deaths. Relevant factors included the command climate, stress, personal matters, and medical problems …

As a result of the findings, Secretary of the Army directed a USAREC command-wide “stand down” day focused on leadership training, suicide prevention [and] resiliency training and recruiter wellness … The Army is also reviewing recruiter screening and selection processes, the provisions of care for Soldiers who need mental health care, Army-wide suicide prevention training, and access to care and peer support networks for geographically dispersed Soldiers.

In an article in the Houston Chronicle yesterday, the Associated Press reports that

Brig. Gen. Dell Turner, who conducted the investigation, … said the one-day stand-down is a significant action. “It’s rarely implemented, and typically only after some significant event. It’s a day for the unit to stop what it’s doing on the mission side and review policies and practices.”

In a separate AP story late today in the Chronicle, it is being reported that U.S. Sen. John Cornyn of Texas, who was instrumental in initiating the original investigation “on Thursday called for a congressional hearing on suicides among Army recruiters, saying a recent group of deaths in an East Texas battalion show the strain on an all-volunteer force fighting two wars.”

“As you might imagine, corners might have been cut — and they were — given the exigency of recruiting for war,” Cornyn said in a conference call with reporters. “The concern is that this is not isolated to a single battalion.”

For the Cornyn story, AP reporter Michelle Roberts also spoke to “Charlotte Porter, the mother of recruiter Sgt. Nils “Aron” Andersson”:

“There’s so much pain still,” she said. “It’s not only the Army that’s going to have to take a stand. Other people are going to have to take a stand. These young men fought for our rights to speak out. When they come home, we have to find a way to listen.”

For more in-depth coverage of yesterday’s breaking news, see the article by Chronicle staff writer Lisa Wise.

[The abridged URL for this post is  http://tinyurl.com/Recruiters1Day .]

[Related SPNAC posts:]

• “Recruiters’ Stress, Army’s Response Are Issues in Investigation“
• “Single Battalion’s 4 Recruiter Suicides Result in Army Probe“

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

“Prayers for Bobby” Shines Spotlight on Suicide of Gay Youth

Sigourney Weaver and Ryan Kelley embrace in their roles as mother and son.

Staff writer David Wiegand, in his review in the San Francisco Chronicle, gives the upcoming TV movie Prayers for Bobby, starring Sigourney Weaver, a bit of criticism for “awkward dialogue and merely adequate direction,” but in the end, he praises the film for the emotional weight of its acting and its message.

If “Prayers for Bobby,” airing Saturday [9 p.m. ET/PT] and based on the book by the late Leroy Aarons, is a tearjerker, it’s not only because it’s a Lifetime original film, and that’s what the network does, but because the true story of Bobby Griffith is tragic.

The film is about a gay teenager whose mother (Mary Griffith, played by Weaver) is a fundamentalist Christian who tries to “cure” him, which contributes to the young man’s suicide. The tragedy results in the mother coming to a new understanding about homosexuality, including speaking out about her experience. For more information about the movie, see the Internet Movie Database plot summary.

In a Boston Herald review, Mark Perigard writes that Weaver gives “one heartrending performance as a mother who realizes her rejection of her gay son led to his suicide.”

In the hands of a lesser actress, Mary would come off as an unhinged religious fanatic. As Weaver captures her, she’s a devoted parent confronted by something alien and frightening to her core beliefs … Weaver’s work should be remembered come Emmy time.

SPNAC readers may view a trailer of Prayers for Bobby, and MyLifetime’s page about the movie includes additional video, photos, interviews, and background material.

[UPDATE 01/22/2009] CBS’s Early Show today featured a TV interview by Maggie Rodriguez with Sigourney Weaver, in which the actress talks about meeting the real-life Mary:

“I have to say that I never felt judgmental of Mary. She meant the best for her son. That’s what’s so frightening … As far as she was concerned, this was a choice. And I think she didn’t understand that this was part of who Bobby was. She thought he was choosing a life, and she readily admits that she was incredibly ignorant.”

Also in today’s news, TV writer Chuck Barney of the  Contra Costa Times interviews Mary in “the Walnut Creek home [Bobby] left behind.”

Mary, 74, is sitting in the kitchen of a ranch-style home that is packed with cherished knickknacks, family photos, angel figurines and grade-school artwork provided by her grandchildren.

“I didn’t listen to my conscience. I was entrenched,” Mary recalls. “But I don’t live with the guilt anymore because I realized I was truly ignorant. It wasn’t something I did out of malice. So I can forgive myself for that.”

Following Bobby’s death, Mary, believing she was to blame, began an extraordinary journey of redemption and transformation. She became a highly visible spokeswoman for the Diablo Valley chapter of Parents, Families & Friends of Lesbians and Gays [PFLAG]. She also appeared frequently on television talk shows, campaigning for public school counseling to support gay teenagers.

[The abridged URL for this post is  http://tinyurl.com/ShinesSpotlight .]

[Related SPNAC post: "Trevor Project Honors Actress for Inspiring LGBTQ Youth" ]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

EMS Chief Turns Master’s Studies into Suicide Response Training

ORIGINAL COLUMN — In her regular op-ed column in the Denver Post, writer (and former Littleton mayor) Susan Thornton highlights recent studies by Wayne Zygowicz, EMS chief for Littleton Fire Rescue, in which he found a lack of training for emergency medical personnel on responding to the scene of a suicide.

Zygowicz surveyed 190 firefighters and police officers in Littleton, and 125 firefighters in 31 other states. All of the Littleton firefighters who responded said they had been on a suicide call, and 97 percent had responded when the suicidal person died. Sixty-three percent said the experience left them with changes in their sleeping or eating habits and emotions, and almost all remembered details of the suicide long afterward. In addition, one-third had felt personally threatened while on a suicide call.

Survey results for police and firefighters in other states were similar. Nationally, only 3 percent of fire departments reported providing training in dealing with suicide.

Zygowicz did his research while studying for a master’s degree, and he “developed a training program that helps first responders know what to do when they encounter a suicidal person.”

“Talk to the person in the ambulance on the way to the hospital. Show compassion,” he urged firefighters in a recent training session. It may ease the person’s anxiety and begin the healing process. First responders should recognize suicidal warning signs. “Ask if they have access to lethal means at home,” he said.

He also created protocols for his own unit’s firefighters when they respond to a suicide fatality, including “suggested phrases EMS can use to avoid re-traumatizing grieving family members.”

“Families say they remember forever what first responders say and do at the time of a suicide,” he said.

[The abridged URL for this post is http://tinyurl.com/SuicideResponse .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Prevention Advocate One-on-One with Obama on Train Ride

Matt Kuntz, center, chats with Barack Obama and Joe Biden during their pre-Inauguration Day train trip. (Photo by Alex Brandon, Associated Press)

ORIGINAL ARTICLE — Staff writer Jodi Rave reports in the Missoulian that last Saturday, Matt Kuntz–a survivor of suicide loss from Montana–”was the only guest invited to join President-elect Barack Obama on the caboose deck as the Whistle Stop Tour slowly rolled out of Philadelphia, en route to Washington, D.C.”

“It was just the president-elect, his wife and myself,” said Kuntz, one of 16 “everyday Americans” invited as guests on the train. “It was amazing.”

“As I prepare to leave for Washington … know that I will not be traveling alone,” said Obama [during a speech before departing]. “I will be taking with me some of the men and women I met along the way, Americans from every corner of this country, whose hopes and heartaches were the core of our cause, whose dreams and struggles have become my own … Theirs are the voices I will carry with me every day in the White House. Theirs are the stories I will be thinking of when we deliver the changes you elected me to make … ”

Hopefully, the President-elect will ambitiously promote the cause for which Kuntz has been an advocate in his home state, and as he does, the new President also will transform the lessons being learned about soldiers and PTSD into an opportunity to take the lead on making suicide prevention a national priority.

Kuntz … began dedicating his time and effort to helping the mentally ill after his stepbrother, Chris Dana, committed suicide upon returning from the war in Iraq with the Montana National Guard. In response, Kuntz, now executive director of Montana’s National Alliance on Mental Illness, led the state in creating a program to monitor National Guard soldiers for signs of PTSD … Obama met Kuntz and other veterans when he was campaigning in Montana before last June’s primary. As president, Obama has promised to expand NAMI’s mental health program for soldiers nationwide.

[The abridged URL for this post is http://tinyurl.com/WithObama .]

[Related SPNAC post: "Montana Advocate Will Be Obama’s Guest at Inauguration" ]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

MLK Day Inspire’s Blogger’s Dream for Better Mental Health Care

ORIGINAL POST — On Huffington Post today, blogger Therese Borchard shares her vision for mental health care in “On MLK Day: I, Too, Have a Dream,” in which she says, “I dream that one day depression won’t destroy so many marriages and families, that better and faster treatment will work in favor of every form of intimacy.”

Borchard is author of her own blog, “Beyond Blue,” which is hosted by Beliefnet.com, but even as her writing often reflects a religious point of view, she comes down firmly on the side of science in her views about mental illness.

I have a dream that … a neurological perspective coupled with a biochemical approach to mental illness will develop targeted treatments: new medication and better response to particular medications … I have a dream that spiritual leaders might preach compassion to persons with mental illness, not indict them for not praying hard enough, or in the right way, or often enough …

And Borchard, who herself lives with bipolar disorder, writes passionately about suicide:

I have a dream that suicide won’t take more lives than traffic accidents, lung disease, or AIDS, that together we can do better to reduce the 30,000 suicides that happen annually in the United States, and that communities will lovingly embrace those friends and families of persons who ran out of hope, instead of simply ignoring the tragedy or attaching fault where none should be.

Borchard moderates a depression support group on Beliefnet.com, and her memoir is due out later this year from Center Street publishing company.

[The abridged URL for this post is  http://tinyurl.com/DreamCare .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Psychiatrists’ Book on Patient Safety Says Communication Is Key

ORIGINAL REPORT — Psychiatric News announces the American Psychiatric Association’s publication of “a 33-page handbook that addresses ways to develop and integrate systems to reduce or prevent six critical events: suicide, aggression, falls, elopement, medical comorbidities, and drug or medication errors” [emphasis added].

Like the rest of the patient-safety movement, ["SAFE MD: Practical Applications and Approaches to Safe Psychiatric Practice"] emphasizes a shift away from blaming medical professionals for mistakes and toward creating systems that produce safe practices, wrote the editors. “The likelihood that an individual will commit an error is far greater in systems that are poorly organized and that have weak procedures and regulations,” they said. “A good staff member cannot combat a bad system.”

This systemic approach to safety garnered attention following a 1999 report by the Institute of Medicine, To Err Is Human, that concluded

“The majority of medical … errors are caused by faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent them … Thus, mistakes can best be prevented by designing the health system at all levels to make it safer–to make it harder for people to do something wrong and easier for them to do it right.”

In the Psychiatric News report, Dr. Lucian Leape of the Harvard School of Public Health says that

the systemic approach has produced progress since the IOM report came out. “There’s been a tremendous increase in activity, concern, and action and a real improvement in safety. The most important new development is the movement away from procedural guidance to teamwork and relationships.”

Dr. Alfred Herzog, one of the handbook’s editors, says that in psychiatry “‘the human interaction is critical’” because safety protocols for medical practices, such as surgery, that are centered around procedures differ from safety practices for psychiatry, which is centered around what he describes as “‘a cognitive-awareness process.’”

“The psychiatrist must ask, ‘What information do I need, and what steps do I take to assure safety with this patient?’”

If one thread runs through the [handbook], it is communication. Psychiatrists need to communicate closely and continuously with other members of the treating team, as well as with patients and their families.

[Editor's note: SPNAC readers may download an excerpt from the new handbook, containing only the chapter on suicide. Any caregiver who is a psychiatrist or who desires to work collaboratively with psychiatrists should  also see the APA Practice Guideline "Assessment and Treatment of Patients With Suicidal Behaviors."]

[The abridged URL for this post is  http://tinyurl.com/PsychCommunication .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Chicago Group Is a Model for Local Mental Health Advocacy

ORIGINAL REPORT — Staff writer Megan Cottrell reports in the Chi Town Daily News on “members of the group Coalition to Save our Mental Health Centers” who recently “were shocked to find out that North River [Mental Health Center] is set to close its doors at the end of the month.

“It’s absolutely appalling to find out that the center is closing,” says Linda Forbes, pastor of Sauganash Community Church. “Where are the families going to go that need care?”

North River is just one of five centers around the city that will be closed this year by the Chicago Department of Public Health. The department will consolidate these centers into the seven remaining centers that are spread across the city on Feb. 1.

City officials explain that the restructuring is linked to reductions in funding, “most notably a $1.2 million cut from the state,” arguing that the seven remaining centers will be able to provide more efficient, more effective services than the current 12 centers for which “resources have been spread very thin.”

“Right now we have a patchwork situation that makes no sense,” [says Dr. Terry Mason, head of the Department of Public Health]. “What we’re doing will result in care that is consistent and complete.”

“We will not drop any of our patients,” says Tim Hadac, spokesperson for the Department of Public Health. “All patients are being welcomed at the remaining CDPH clinics, if they choose.”

But, of course, accessibility and efficiency often work against one another.

Organizers in North River’s surrounding community say asking the center’s 450 severely mentally ill patients to travel across the city for services is nearly impossible.

“It’s gonna take us three hours at least,” says Lourdes Adrianzen, a patient at North River who lives in Kilbourn Park. “I have to take the bus to the red line. It would take me an hour and a half just to get there.”

In the face of the budget cuts that could be forthcoming in communities everywhere, the care of the mentally ill is going to have to be considered not only in terms of short-term costs but also in terms of a community’s priorities.

“We seem to be involved in more glamorous battles these days, and we forget about those people who need our help,” says [Alderman William Banks].

“How can Chicago afford to have the 2016 Olympics if we cannot afford to help the needy and the mentally ill?” [Forbes] says. “How can we dare to present ours as a first-rate city and give third- or fifth-rate care to the citizens?”

And the Chi Town article closes with an essential point that is ultimately of vital interest across Americal:

Department of Public Health officials say the issue of mental health funding isn’t a problem at the city level — it’s a battle that’s been waging for years on the national stage, for more federal funding.

“For decades, mental health care has long been neglected in our nation’s capital–treated like a poor and unwanted cousin,” says Mason [of the Department of Public Health]. “I am hopeful that with a new President and a new Congress firmly committed to fully-funded health care reform, in 2009 we will at long last see movement in the right direction.”

Chicago’s Coalition to Save our Mental Health Centers is noteworthy because it provides a model for local advocacy; for instance, the coalition’s website is an effective springboard for community action, and its resources include tools such as a locally produced video that superbly tells the story of the group’s efforts.

[The abridged URL for this post is  http://tinyurl.com/AdvocacyModel .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Blogger Issues Call to Action for “Mental Health New Deal”

ORIGINAL POST — Michael Sigman–Chairman of the Board of the Wright Institute of Los Angeles, a postgraduate clinical training institute that provides psychotherapy to economically disadvantaged people–started the New Year with a piece on Huffington Post titled “Time for a Mental Health New Deal.”

America’s economic health is inextricably intertwined with its citizens’ psychological well-being. The very language we use to describe our financial plight — insanity, depression, panic, insecurity, trauma … To give short shrift to mental health programs would geometrically compound the insanity; over and above the humanitarian cost, the financial losses in productivity and from increased crime rates are incalculable.

Sigman recommends a decisive, grassroots response to people’s mental-health-care needs in America:

“We’ve got to organize and lobby hard for a mental health ‘New Deal,’ in which the Feds immediately restore funds for decimated state and local treatment programs, and then create a national mental health safety net so no one falls through the cracks … Let’s take a page from Obama’s grass roots Presidential campaign. Start or join a group at the local level to lobby the president-elect and incoming HHS Secretary Tom Daschle. Bombard your legislators with emails and phone calls. If you’re not an activist, become one. If you can give even a few dollars, donate to a mental health-oriented charity or non-profit.

Yes, these proposals will cost more money and mean more borrowing. But if we don’t act now, the tragic fallout will reverberate throughout society for decades.

By callling for action to promote a Mental Health New Deal, Sigman has highlighted the need to build political will for the next phase of mental-health-care reform now that mental health parity legislation has passed Congress. The importance of building political was clearly articulated when the national suicide prevention movement began to gain traction in 2001 with the publication of the National Strategy for Suicide Prevention, which states

For any preventive action to go forward, three ingredients are necessary: a knowledge base, the public support for change, and a social strategy to accomplish change. [Emphasis added.]

SPNAC readers can refer to the Suicide Prevention Action Network’s (SPAN USA) Legislative and Media Action Center to learn how they can help build the political will to advance suicide prevention in America and in their home state.

[The  abridged URL for this post is  http://tinyurl.com/MH-NewDeal .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Crisis Line Worker Says Honesty Is the Best Intervention

Michelle Dougan-Sullivan (Photo by Jill Nance, The News & Advance)

ORIGINAL STORY — In a recent story in the Lynchburg News & Advance,  reporter Casey Gillis profiles a volunteer at the Crisis Line of Central Virginia, Michelle Dougan-Sullivan, whose 16-year-old son died of suicide two years ago.

“It’s a positive way to focus my grief and focus my energy,” she says. “Whenever I come into the office, I bring his picture with me. That kind of helps to keep me focused and remember why I’m here.”

She began her career as a volunteer at the crisis center more than a year ago and, after “32 classroom hours and 20 mentoring hours” of training, was working the phones, including answering calls from people considering suicide.

“If you are open and honest with a person in crisis and actually ask that person straight out, ‘Are you thinking about suicide?’ they will be honest with you,” she says. “That just basically takes a weight off their shoulders and opens a door.”

“The majority of the people who call the suicide hotline or are thinking about suicide, they don’t want to die,” she adds. “They just need somebody to talk to. They just need reassurance (that) they’re worth the conversation, they do matter.”

The Crisis Line of Central Virginia offers a variety of community services in addition to answering calls for the Lifeline (1-800-273-TALK), including Teen Talk for adolescents, Chatterline for younger children, the Sexual Assault Response Program, a  food program called Helping Our People Eat (HOPE), and TeleCare to help people who are homebound. All of the programs combined receive 2,000 calls a month.

Executive Director Joyce Sachs says that for some … people, Crisis Line and its volunteers are “like a lifeline. We’ll tell them to call three times a day for 10 minutes.

[The abridged URL for this post is  http://tinyurl.com/BestIntervention .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Post-Hospitalization Psychiatric Support Shown To Be Vital

ORIGINAL ABSTRACT — According to the abstract of a study being published this month in the Journal of Affective Disorders,

The first 12 weeks after psychiatric hospitalization are the highest risk period for suicide, and health systems with limited resources should focus their suicide prevention efforts there.

The online health information resource Modern Medicine briefly describes the study:

Marcia Valenstein, M.D., of the Department of Veterans Affairs Medical Center in Ann Arbor, Mich., and colleagues conducted a study of 887,859 Veteran Affairs patients who were treated for depression from April 1999 to September 2004 … Within the first 12 weeks of psychiatric hospitalization, there were 568 suicides per 100,000 person-years, versus 210/100,000 after new antidepressants treatment, 193/100,000 after other starts and 154/100,000 after changes to dosage …

“Health systems with limited resources may need to first focus on the highest-risk treatment periods which follow psychiatric hospitalization,” the authors write. “If resources permit, health systems might also consider providing closer monitoring in the first 12 weeks immediately following antidepressant starts, across all adult age-groups.”

UPDATE 01/12/09: Today’s Washington Post includes the entire background article on the study, by HealthDay reporter Steven Reinberg, which quotes Simon Rego, associate director of psychology training at Montefiore Medical Center and an assistant professor at Albert Einstein College of Medicine in New York City:

The study highlights the importance of moving some of the responsibility traditionally placed on clinicians to the entire mental health care system in order to shift the focus of prevention efforts from individual patients to entire at-risk populations, [Rego said].

“In terms of suicide prevention, the results indicate that there are readily identifiable high-risk periods following specific events, such as being discharged from an inpatient psychiatric stay or starting a new antidepressant medication, and contrary to previously held notions, that these risk periods are not just for younger patients,” Rego said … “the best use of our mental health resources would be to target efforts at frequent reassessment of suicide risk, offering of support, and establishing a connection to outpatient services during the entire 12-week period after discharge from a psychiatric hospitalization.”

[The abridged URL for this post is  http://tinyurl.com/PostHospitalization .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Montana Advocate Will Be Obama’s Guest at Inauguration

ORIGINAL STORY — Reporter Jennifer McKee writes in the Billings Gazette that a Helena, Mont., mental health advocate will be attending Barack Obama’s inauguration as the new U.S. president’s guest.

[Matt Kuntz], who dedicated himself to helping the mentally ill after his stepbrother committed suicide upon returning home from combat, has been picked to be one of 18 ‘everyday Americans’ to celebrate inauguration with President-elect Barack Obama. [They] … will take the train with Obama to Baltimore for a speech, then head off to Delaware to pick up Vice President-elect Joe Biden and his family for a final jaunt to Washington, D.C.

Kuntz, who is now head of the Montana office of the National Alliance on Mental Illness,

was working as a lawyer in Helena in spring 2007 when his step-brother Chris Dana, a Montana National Guard soldier, committed suicide after suffering from post-traumatic stress disorder following his tour of duty in Iraq.

That tragedy compelled Kuntz and Dana’s parents to begin working for better screening for returning soldiers. Eventually … the Montana National Guard adopted a screening program that leads the country when it comes to making sure returning soldiers don’t fall through the cracks.

Kuntz, a former Army officer himself, met Obama briefly this fall during a campaign stop in Billings.

Kuntz said he was impressed then that Obama seemed to really care about the issue of mental-health help for returning soldiers. Obama told Kuntz he wanted to take the Montana Guard’s program nationwide.

“The president-elect realizes that Montana is really leading the country on this issue,” Kuntz said. “This was done entirely by the people of Montana. They demanded better treatment.”

A brief news story from a local television station can be viewed here.

[The abridged URL for this post is  http://tinyurl.com/MontanaAdvocate .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

National Youth Prevention Workers Praised by Survivor Leaders

Sen. Gordon and Sharon Smith (Photo by Ross William Hamilton, The Oregonian)

By Franklin Cook, SPNAC Editor

There has been a brief hiatus in fresh news posts on SPNAC because, all this week, I’ve been in Phoenix, Arizona, attending a conference of the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) grantees who are delivering youth suicide prevention programs funded under the Garrett Lee Smith Memorial Act.

In opening remarks on Monday, Richard McKeon of SAMHSA outlined the theme of the conference, saying “we ourselves, all of us here today, constitute a community of hope,” noting that the GLSMA grants represent “the first time the United States has ever made funding widely available for youth suicide prevention.”

Since GLSMA was signed into law on Oct. 21, 2004, the bill named after the son of Sen. Gordon Smith and his wife Sharon–who died by suicide one day shy of his 22nd birthday in 2003–has been responsible for projects administered by 42 states, 19 tribes or tribal organizations, and 70 colleges or universities. Through those projects, more than 150,000 people have been trained in youth suicide prevention activities.

In a video message on Wednesday morning, Sharon Smith told the conference attendees that “Garrett suffered from what was likely bipolar disorder” and “could not comprehend an end to his darkness.”

“Garrett’s story, unfortunately, is not unique,” she said.

After his son died, Gordon Smith related, “I almost threw in the towel and gave up on everything, even the U.S. Senate,” adding that he is now grateful that he “soldiered on … with a heavy heart.”

“As a result of the Garrett Lee Smith Memorial Act, families across America are finding help,” he said, praising the grantees “for helping young people who, like Garrett, have a mental illness.”

“You are doing the work of angels, and I thank you.”

SPNAC readers can access a copy of Sen. Smith’s remarks about GLSMA that were delivered to the U.S. Senate last September 10, on World Suicide Prevention Day.

The conference on Wednesday was also addressed by Maj. Gen. Mark Graham, who lost a son to suicide in 2003 and, seven months later, lost his other son in combat in Iraq.

“Both my sons died fighting different battles,” Graham says in a television news interview he shared with conference attendees.

To the grantees, he said, speaking of himself and his wife Carol, “We really wish we weren’t qualified to be here,” adding that the loss of their sons “has left us feeling empty and truly hopeless at times.”

“Even after five years,” he said, “I still wake up thinking maybe this was a bad dream or some other family’s story, not ours.”

General Graham recounted how he had reached the end of his will to go on as an Army officer, but then he and his wife–even in the midst of a moment of despair–saw how they might be of service to others. Like the Smiths, the Grahams have “soldiered on” and are now advocates for the cause of suicide prevention, and they dedicate their lives to supporting others who are grieving from losses both to suicide and to combat.

“An amazing phenomenon has occurred,” he said. “Little by little, we could feel ourselves growing stronger … the more we realized that they really weren’t gone at all … [that] they were in our hearts, and we carried them with us everywhere we would go.”

SPNAC readers can access a Denver Post report that includes interviews with Gen. Graham and his wife.

[The abridged URL for this post is http://tinyurl.com/WorkersPraised .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Attempt Survivors Help One Another in New Support Group

ORIGINAL ARTICLE — Reporter Christine Moyer, writing for the Beacon News (Aurora, Illinois), profiles the Suicide Attempters group in Batavia, a place where “people who are alive even though they had hoped to die … get the proper help and support to overcome their depression and despair.”

Stephanie Weber, director of Suicide Prevention Services in Batavia, created the group in May and serves as its clinician. For Weber, whose mother killed herself after one unsuccessful attempt, the group is very close to her heart.

“No doctor, no hospital ever put information in my hands, saying the second attempt is usually fatal,” Weber said.

The Beacon News article paints a picture of a 47-year-old woman who attends the Suicide Attempters group, whose “depression started around 11 years ago when her father died of pancreatic cancer.”

Lisa, then a practicing nurse, cared for him until his body gave out. About a year later she overdosed on her depression medicine.

It was her first suicide attempt. The four or five attempts that followed — Lisa can’t remember exactly how many — each involved overdosing on pills, some purchased over the counter, others that were prescribed.

Now Lisa, who before her most recent attempt last summer was, in fact, the facilitator of the support group, “attends … as an attempter … not as a facilitator.”

She’s still passionate about the attempters group, which relies on people who have tried to kill themselves to lead the discussions.

“When you tell (the facilitators) you’re just so depressed, you’re fed up with everything, you don’t feel there’s a reason to live, you know they’ve been there,” she said.

Weber’s first try at starting a support group for attempt survivors was 20 years, but at that time, it did not get established, so she kept up hope and then

… recently, people began sharing their stories of failed suicide attempts with Weber. They were young men, middle-aged women and people well into their 50s. Each time, Weber asked if they would reach out to others. And many of them agreed, she said.

Now the group meets the first Wednesday of every month. The meetings are still small, but Weber is optimistic about their impact.

Dr. David Leader, chairman of the department of psychiatry at Dreyer Medical Clinic and Provena Mercy Medical Center in Aurora, Illinois,

considers the attempters group an integral form of intervention [because] it enables fellow survivors and clinicians to assure the attempters that while their feelings are legitimate, there are other tools they can use to cope with them.

The key, Leader said, is getting people to realize they have options that are better than killing themselves. It’s not about giving them false hope, he stressed, but giving them real tools.

There are several basic booklets designed by the National Suicide Prevention Lifeline for use in emergency departments that are publicly available for free:

• “After an attempt: A guide for taking care of yourself after your treatment in the emergency department”
• “After an attempt: A guide for taking care of your family member after treatment in the emergency department”
• “After an attempt: A guide for medical providers in the emergency department taking care of suicide attempt survivors

[The abridged URL for this post is  http://tinyurl.com/HelpOneAnother .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Several Mental Health Champions Missing from 111th Congress

ORIGINAL REPORT — In the edition of Psychiatric News published online today, reporter Rich Daly highlights the loss of mental health champions in the 111th Congress, noting that “the departure of several of Capitol Hill’s strongest mental health advocates will be felt by APA [American Psychiatric Association] and other like-minded advocates when the new Congress convenes later this month.”

Several longstanding mental health advocates retired at the end of the 110th Congress, including Rep. Jim Ramstad (R-Minn.), and Sen. Pete Domenici (R-N.M.), while Sen. Gordon Smith (R-Ore.) lost his bid for reelection … In 2007 Ramstad and Rep. Patrick Kennedy (D-R.I.) embarked on a nationwide tour to highlight the importance of mental health insurance parity that used a series of field hearings to galvanize support for legislative action … Domenici’s accomplishments include extensive leadership on mental health parity, as well as legislation to fund more mental health services for public school children … Smith is most known for sponsoring the Garrett Lee Smith Memorial Act, to create screening programs to identify and help youth at risk for suicide.

Smith and his wife Sharon’s son Garrett–who is memorialized through the legislation Sen. Smith sponsored–died by suicide in 2003 when he was 21 years old. The Smiths have provided leadership through avenues such as Sharon Smith’s service on the board of directors of the Suicide Prevention Action Network (SPAN USA), and they have gained the respect and admiration of the national suicide prevention community. It is widely hoped among suicide prevention proponents and survivors of suicide loss that their influence will continue to be seen and felt even though they no longer represent Oregon in the U.S. Senate.

The report in the Psychiatric News also points to some of the strong proponents of mental health care who remain in Congress, including

[Rep. Patrick] Kennedy and his father, Sen. Edward Kennedy (D-Mass.) … [who] has … dropped his chairmanship of the powerful Judiciary Committee to focus full time on health care reform … Continued support also is expected from … Rep. Chris Van Hollen (D-Md.), chair of the Democratic Congressional Campaign Committee; Rep. Steny Hoyer (D-Md.) the House majority leader; and Sen. Harry Reid (D-Nev.), the Senate majority leader. Reid, who lost his father to suicide, and the other Democratic leaders were supportive of a mental health parity law and a law to end Medicare’s discriminatory copayments for outpatient mental health care.

And several new members of Congress are expected to add their energies to advancing the cause of improved mental health care in America:

Rep. Paul Tonko (D-N.Y.), a former New York State Assembly member who was a sponsor of New York’s mental health parity law, “Timothy’s Law,” enacted in December 2006.

Rep. Jon Adler (D-N.J.), supported several issues of concern to APA and other mental health advocates as a state senator including a state mental health parity bill, youth suicide prevention programs, and postpartum depression awareness campaigns.

[The abridged URL for this post is  http://tinyurl.com/MHChampions .]

[Related SPNAC post: "Suicide Prevention Champion Not Re-elected To Senate" ]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Recruiters’ Stress, Army’s Response Are Issues in Investigation

ORIGINAL REPORT — [Editor's note: The original report includes brief descriptions of several suicides.] NPR’s “Morning Edition” today added an in-depth report to the coverage of a series of suicides that are being investigated in a U.S. Army recruitment battalion in Houston, Texas (see http://tinyurl.com/RecruiterSuicides).

NPR reporter John McChesney interviews several survivors, including the father of  Aron Andersson, who died by suicide in March 2007.  Bob Andersson had told his son’s chain of command about his suicidal thinking five months before Aron Andersson killed himself.

“I don’t know if that was the right thing to do, but I called a major and told him [Aron's] girlfriend had said he threatened to commit suicide, and she told me he was going through night terrors and a bunch of other things.”

Andersson says his son had trouble delivering the required two recruits a month, especially after his experience in Iraq.

“How could you be over there and see some of the things he saw and dealt with, and try to hire people to go over there and do that?” he says.

The report highlights the pressures under which Army recruiters work:

“I believe that short of being shot at — you know, risking your life — that recruiting is the toughest job in the Army,” says James Larsen, a retired senior policy analyst for the Army Recruiting Command.

Whether or not recruiters have the highest stress level, there’s little doubt they are under extraordinary pressure to sell the Army to a small number of reluctant consumers. Add to that the marital stress brought on by 12- to 14-hour workdays, the isolation of being stationed in small towns far from a base — and in the Houston battalion’s case, alleged abusive treatment of those who didn’t produce their quota — and you have a potentially toxic cocktail.

Texas Sen. John Cornyn called for the investigation that is under way into the deaths, and he has indicated that his concerns go beyond the particulars of the suicides in question.

“I hope we’ll hold [Senate] hearings.”

One of the questions the senator wants answered is whether it is wise to order combat veterans to take recruiting jobs. Most of them don’t volunteer …

[And] Cornyn is concerned about another matter.

“Part of this that was troubling was the suggestion that there was pressure being put down the chain of command to keep this quiet,” he says.

The “Morning Edition” report provides links to the Houston Chronicle’s coverage of the issue, including

• May 18, 2008: “A Soldier’s Tragic Tale”
• Sept. 26, 2008: “Houston Soldiers’ Suicides Prompt Scrutiny”
• Oct. 4, 2008: “Widow Pleads For Recruiting Overhaul”
• Oct. 10, 2008: “Cornyn Seeking Probe Into Army Recruiter Suicides”

[The abridged URL for this post is  http://tinyurl.com/RecruiterStess .]

[Related SPNAC post: "Single Battalion’s 4 Recruiter Suicides Result in Army Probe" ]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).

Survivor of 3 Suicides Gets Training, Starts Support Group

ORIGINAL STORY — Reporter John Bulger tells the story, in the Dec. 20 edition of the Idaho State Journal, of a Fort Hall woman whose brother died of suicide in 1991 and who then lost two sons to suicide, in 1996 and in 2006, both when they were 31 years old.

[Margaret] Brown again bottomed out after the latest death, but unlike the time following [her first son's] death, she sought help. She first found a support organization online. She began attending Creekside Home Health and Hospice’s grief group … The process was gradual. Brown attended the weekly group meeting for six or seven months before she felt secure enough to speak about her sons’ deaths …

“It takes a lot of courage to go to a grief group,” Brown said, but noted the payoff has been extraordinary. “They have helped me immensely.”

Brown went on to form a support group specifically for survivors of a loved one’s suicide, after attending the American Foundation for Suicide Prevention’s Suicide Survivor Support Group Facilitator Training.

Brown attended the training seminar in San Diego this summer … When she told of her loss of three family members, a collective gasp arose from the crowd. Brown worried that she had violated some etiquette. She was assured she had not stepped over any line, that the reaction came from the enormity of her loss … Instructors at the seminar told her that her lack of a degree had no bearing on her ability to be a capable mentor for a bereavement group.

“‘You’ve lived it,’ they told me,” Brown said. “‘You don’t need a Ph.D.’”

As time has passed, Brown told the State Journal, she has seen her surviving son struggle with his grief by beginning to talk about it and her husband struggle with his grief in other ways.

One of the things Brown has learned is that she is not alone. The other is that survivors of suicide have many burdens to bear, and that it is OK to lay that great weight down.

“You have guilt. You have shame. You feel like you’ve let them down.”

Brown does not push her husband to talk about Chuck and Steve. One thing she has learned is that everyone reacts to grief in their own way.

“Everybody has their own journey,” she said. “I respect that.”

[The abridged URL for this post is  http://tinyurl.com/StartsSupport .]

SPNAC readers can take part in a discussion about this story by clicking below on the red COMMENT box. Please see the subscription page to have the weekly SPNAC newsletter sent to you by email (subscriptions are voluntary and private).