Franklin James Cook

Archive for the ‘Intervention’ Category

One Man’s Death Offers Insight into Humanity and Suicide

In Grief, Intervention, Opinion, Prevention on February 19, 2010 at 12:38 pm
Powell and Market Feb 16 2010 Man who jumped

For information about this photo, please see the note below.

By Franklin Cook, SPNAC Editor

The circumstances surrounding a suicide earlier this week in San Francisco — a man jumped to his death from a building on a busy street corner as a large crowd watched — are so disturbing that I am reluctant to write about it, but I hope to extract something helpful out of the situation.

Let me begin by saying that my own description, calling it “a sucide earlier this week” and “the situation” obscures the most centrally important, viscerally real fact about it, which is that a living, breathing human being died — that a life as unique and special as your life or my life are to us right now was irrevocably extinguished. In the blink of an eye, an actual person was tranformed from an “is” into a “was,” into a man who now can be referred to only in the past tense.

But, for those closest to him, their love for him is not in the past tense.

Here is an audio recording of a news interview I did with Don Grant of KOTA Radio in January 2008 after a teenage boy died by suicide in my hometown in a scene that was very public. In the interview, I say,

When something makes front page news … when the public is very aware of a suicide death, it turns a private matter into a public matter. So I think the first thing I would say to the community is, please remember that this is a very private matter … In many ways, it is a death like any other death, and we don’t want to bring attention to a family’s private suffering … The first thing I would like the community to understand is that this suicide affected a very precious human being … He has a family and friends and loved ones who deserve our respect and our compassion and our understanding and our support. We really need to … understand that, in our hearts, the most important people in this moment are those who have lost their dear loved one. That young man just a few days ago was a very vibrant human being: We should not make judgments about him. He had the same things to be happy over or to be sad over that we have. Suicide sometimes strikes a family, and we should be very understanding of that.

Another thing about last week’s tragedy in San Francisco that merits comment is the crowd’s reaction to — or perhaps I should say participation in — the suicide. Some news coverage (and lots of social network communication) depicted people who urged the man to jump or who laughed about his death. Besides the numerous seemingly obvious and perhaps futile comments that one might make (that such behavior is barbaric, that the media-entertainment machinery has so desensitized us that we are numb to each other’s pain, etc.), I would like to assert this: It might have gone differently, had those near at hand at the time he died acted differently.

This is not merely wishful thinking on my part nor simply my desire to blame someone for something that is terribly upsetting to me. Rather, I am claiming that a very straightforward, common-sense, practical behavior might have saved a man’s life.

What if one inspired, compassionate person in the crowd had yelled — not at the man threatening to jump but at the rest of the crowd — “Chant with me! Please don’t jump. Please don’t jump. Please don’t jump”? I can imagine something like that happening: “Chant with me! Everyone chant with me! Please don’t jump. Please don’t jump.” I can imagine a few dozen people taking up the chant in unison, “Please don’t jump! Please don’t jump! Please don’t jump!” Then a few hundred people joining in, “Please don’t jump! Please don’t jump! Please don’t jump!”

Can’t you, too, imagine that happening, ? If you were there, wouldn’t you have joined in the chanting? “Please don’t jump!”

There is no way to know whether that would have prevented the man from jumping, but, as the photographer says in the quote below, “he stood [on the ledge] for 50 minutes or so,” and, according to other news coverage, “witnesses reported seeing the man start to jump twice and then stop himself at the last second, before he finally made the jump.” So there were unquestionably real moments when his ambivalence between wanting to die and wanting to live might have allowed him to step back from the abyss.

The noisy scene at Powell and Market on Tuesday suggests that ideas such as these — that people facing a suicide crisis ought to be compassionately cared for as unique human beings and that there are effective ways we can intervene to help save a life during a suicide crisis — are so fundamental that perhaps we’ve taken them for granted.

[Editor’s note: There is an inherent contradiction in my words “this is a very private matter” and in my decision to publish the photo that accompanies this post. In addition, publishing the photo is arguably an infraction of the suicide prevention field’s media guidelines, which advise against sensationalizing suicide. My decision to publish the photograph was not made lightly nor without considering those matters, but the point that the man who died was “a living, breathing human being” possessing “a life as unique and special as your life or my life are to us right now” is brought home more powerfully than it could be in any other way by including the picture with the story. The photographer who posted the photo online said of the man pictured that he wanted “to show him alive [while] he is standing there … He stood for 50 minutes or so, and I watched him look around as if he was waiting for some positive message for help … So by remembering this image, next time you see someone … thinking about taking their own life, then please talk to them. Let them know you are [there] for them and ask them what do they need. Show them love even if it is a stranger.” FJC]

[The abridged URL for this post is http://bit.ly/onemansdeath .]

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Palo Alto Volunteers Act Boldly against Teen Suicides

In Intervention, Prevention on December 2, 2009 at 10:54 am
101202_PaloAlto-TrainTracks

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 .]

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Malpractice Advice Generates Suicide Intervention Checklist

In Intervention on November 7, 2009 at 12:23 pm
DrResnick

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 .]

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A Life Saved Connects the Dots on Data from Hotline Study

In Intervention, Research on November 3, 2009 at 10:00 pm

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 .]

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Lifeline Offers Veterans Help through Online Chat

In Hotlines, Intervention on September 11, 2009 at 5:45 am

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 http://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 .]

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Readers Respond to Story of National Guardsman’s Suicide

In Intervention, Prevention on August 9, 2009 at 11:34 am
NYT-SoldierGraphic

(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

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Feds Give Funds to Hotlines to Help with Economy Calls

In Intervention, Prevention on August 6, 2009 at 9:38 am

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

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

In Hotlines, Intervention, Prevention on August 4, 2009 at 10:10 pm

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 http://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 .]

Cop Handles Crisis with Listening, Not Lethal Force

In Intervention on July 16, 2009 at 8:38 pm
CD09HERO_KG_0281.jpg

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

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CSAT Manual on Suicide in Alcohol/Drug Treatment Is Free

In Intervention, Postvention, Prevention on July 14, 2009 at 4:39 pm

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:

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Compassion, Courage Mark Story of Woman’s Rescue

In Intervention on June 25, 2009 at 11:10 pm

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 .]

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

In Intervention on June 4, 2009 at 8:28 am

[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 .]

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Alert Hotel Owner Helps Stop Group Suicide

In Intervention on April 24, 2009 at 10:16 am

[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 .]

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A Suicide Prevention Postcard from Crow Creek Nation

In Intervention, Prevention, SPNAC Stuff on April 13, 2009 at 12:14 pm

The Hunkpati Icikte Anaptapi Woecun youth suicide prevention program 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, Nancy Fleming, ; and, kneeling, ASIST trainer, Franklin Cook, ASIST trainer . Youth suicide prevention workers from HIAW were joined by their partners from the Bureau of Indian Affairs Police, Sanford Mid-Dakota Hospital, Indian Health Services, and a number of community caregivers serving Crow Creek's youth.

[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 .]

Two Lives Saved through Facebook, Twitter Communications

In Intervention, Media, Prevention on April 5, 2009 at 9:53 am

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 .]

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Daring Rescue Saves a Life, but Is There More to the Story?

In Intervention, Prevention on March 18, 2009 at 6:33 am

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 .]

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Two Communities Highlight ASIST Suicide “First Aid” Training

In Intervention, Prevention on January 27, 2009 at 5:09 pm
asist-dude1

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.

suicidesafer-lw-1According 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 .]

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EMS Chief Turns Master’s Studies into Suicide Response Training

In Grief, Intervention, Postvention on January 20, 2009 at 8:27 pm

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 .]

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Psychiatrists’ Book on Patient Safety Says Communication Is Key

In Intervention, Postvention, Prevention on January 18, 2009 at 10:49 am

apa-patientsafety-suicidecover1ORIGINAL REPORTPsychiatric 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 .]

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Crisis Line Worker Says Honesty Is the Best Intervention

In Grief, Hotlines, Intervention on January 11, 2009 at 8:42 am
Michelle Dougan-Sullivan (Photo by Jill Nance, <em>The News &  Advance</em>)

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 .]

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