Franklin James Cook

Archive for the ‘Postvention’ Category

Personal Grief Coaching Helps Bereaved People by Phone

In Announcements, Grief, Postvention on January 26, 2014 at 10:01 am


In 2013, Suicide Prevention News & Comment editor and publisher Franklin Cook earned his Certified Professional Coach credentials and combined the principles and practices of Life Coaching with those of peer help for traumatic loss survivors to create an innovative telephone support service called Personal Grief Coaching. Here is what it’s all about:

Franklin Cook mug

Helping people cope with grief after a loved one’s traumatic death is Franklin Cook’s mission in life. His own father died traumatically in 1978, and two decades later, he began working with bereaved people as a newfound vocation. After 15 years as a peer helper, he became a Certified Professional Coach and developed this model for one-on-one telephone support, called Personal Grief Coaching. Franklin believes that each person’s unique experience of loss should be honored and respected, and his coaching sessions provide a safe space for grieving people to tell their story as they wish to tell it.

The guiding principles of Personal Grief Coaching:

  • Grief is a natural human response to a loved one’s death.
  • Each bereaved person’s needs are unique, and people benefit from individualized assistance.
  • Peer support from a person who has recovered from a traumatic death can be very helpful to a bereaved person.
  • Grief involves making meaning from things about life that are confusing and painful (which is also called “relearning the world“).
  • Compassionate dialogue with a peer coach can create a place from where bereaved people can find their own way to healing.

Attempt Survivor Finds Self-Help Support in DBSA

In Mental Illness, Postvention on July 18, 2009 at 7:41 am

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.

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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.

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Related SPNAC posts:

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Tracking Local Suicide Data Helps Support Life Skills Program

In Postvention, Prevention on March 17, 2009 at 12:55 pm
Amanda Miller ("The Oklahoman" photo by David McDaniel)

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.”

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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.

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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.”]

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Post-Hospitalization Psychiatric Support Shown To Be Vital

In Postvention, Research on January 10, 2009 at 4:14 pm

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.”

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Attempt Survivors Help One Another in New Support Group

In Intervention, Postvention on January 4, 2009 at 8:06 pm

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:

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Teen Reports on Attempt, Hospitalization, Recovery

In Intervention, Mental Illness, Postvention on December 26, 2008 at 12:19 pm
Ryan Jones

Ryan Jones

ORIGINAL REPORT — [Editor’s note: The original report includes a brief description of a suicide attempt.] In a video report on 1010 WINS news, reporter Ben Mevorach tells the story of  what happened after a nonfatal suicide attempt a year ago by now-16-year-old Ryan Jones, in  the house where “they live in a picture postcard community in Connecticut.”:

Since then, Ryan has been in and out of a psychiatric hospital three times and doctors continue to try and find the proper medication to help him cope [with bipolar disorder].

He is trapped in a war in his head. Good thoughts versus bad thoughts. Reasons to live versus reasons to die. It is a daily struggle, but what Ryan did next — with his family’s support — is pretty amazing. Rather than hide his depression, anxiety, and suicide attempt from the outside world, he wrote about it for his high school’s independent paper.

In “Dad’s Perspective: An Introduction To Ryan’s Story,” Ryan’s father, 1010 WINS reporter Al Jones, explains,

The National Institute of Mental Health estimates nearly 6 million adults in the United States suffer from bipolar disorder, and of the 3.4 million children diagnosed with depression, one-third are bipolar. My son Ryan is one of them. Initially, I thought it was better to keep it quiet, but my son disagreed. He wrote a three-part series for his school newspaper on one of his three stays in a mental health facility.

Ryan’s first-person narrative is a vivid retelling of his admission to a psychiatric hospital, his state of mind during manic and depressive times, the dilemmas faced by other inpatients with psychiatric disorders, and his struggle with mental stability and suicide. It offers a candid glimpse into the experiences of a teen with bipolar disorder, which some may find disturbing but which tells a real-life story about recovery from mental illness.

“My Days In The Mental Hospital,” by Ryan Jones: Chapter I; Chapter II; Chapter III.

Ryan concludes,

We’re young and for the most part untainted by the world, so don’t let a life slip by that could be preserved. If you’re suicidal and you think you’re going to do something, if you just can’t go on, go to a hospital, see a psychiatrist, talk to people that you can trust … do what you can to stay around … If you die, you lose your life, and all those that love you will lose a bit of theirs. It’s a struggle, but you’re worth it.

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If you or someone you know feels suicidal, please click on NEED HELP?

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Major Local Newspaper Says “No” to Webcam Suicide Story

In Media, Postvention, Prevention on November 30, 2008 at 1:58 pm
Earl Maucker

Earl Maucker

ORIGINAL COLUMN — The editor of the Fort Lauderdale Sun-Sentinel, in an “Ask the Editor” column, gives an extensive reply to a reader, explaining why the Sun-Sentinel did not join the media feeding frenzy that followed the recent suicide of a Florida teen that was broadcast via the Internet (see the previous posts on SPNAC, Publicized Suicide Angers Family, May Harm Others” and “Expert Points To Ambivalence in Suicide Aired on Web“).

Editor Earl Maucker’s reply is remarkable not only for its thoughtfulness but also because it tells the story in some detail of a newsroom decision-making process that ends with public safety being taken into account in an extraordinary way:

“It was obvious the story would be interesting, and we wondered if it was the first time someone had live-streamed a suicide,” [said Metro Editor Dana Banker]. “At the same time, we wanted to work out some key questions before publication: Should we reconsider our traditional policies on suicide in this case? How public was this man’s death? How many people saw it?”

Most importantly, she said, she wondered what public value we could bring to our reporting and would that outweigh the risk of encouraging copycat suicides, particularly considering that suicide is the leading cause of death among young people who make up a large share of our web audience?

“With the video not widely viewed, we decided that what we had was a sensational story with limited public value that ran the risk of encouraging a troubled young person to do the same,” Dana said. “We opted not to run the story Thursday afternoon [the afternoon the story was breaking nationally].”

Star Athlete Tells of Comeback from Suicidal Despair

In Mental Illness, Postvention on November 29, 2008 at 10:44 am

stevegurney2ORIGINAL REVIEW — A review in the New Zealand Sunday News shares with readers the story of world-class endurance athlete Steve Gurney “who has spent a lifetime pushing himself to his absolute limits” and in his new book, Lucky Legs: What I’ve Learned About Winning, “has revealed how he battled depression and almost committed suicide.”

In his book … the nine-time Coast to Coast winner has opened up about his biggest challenge overcoming depression and how during his “darkest hour” he almost killed himself.

In an excerpt from Chapter 12,  titled “I’m Not Dead Yet,” Gurney writes:

The depression went on for six months–six months of misery and inability to act. My darkest hour was in the middle of one dark night in February 1995. My house has a flat roof that overhangs a cliff. I found myself standing on the edge of the roof. I could hear the distant noise of traffic and the sea. I looked down at the power lines and I felt like jumping … At that point, death seemed like a realistic solution … But there was a tiny spark that said, “Don’t jump. All you have to do is hang in there. It’s just like a long endurance race, and you’re an expert at that” … I set about finding a way out of the depression …

Student’s Letter Tells of Overcoming Stigma to Get Help

In Postvention, Prevention, Stigma on November 25, 2008 at 12:14 pm

ORIGINAL LETTER — In a letter in The Harbus, Harvard University Business School’s weekly campus publication, a student shares a first-person story of being stricken with depression and getting help after “I almost took my life three times during my first year at HBS.”

I would spend class periods thinking of how to kill myself, and how that was the real answer to all of my problems. I skipped class just because I didn’t want to get out of bed. I went to the bridge two more times. I wasn’t scared anymore. I was ready to die and I didn’t care.

The student also writes about overcoming stigma to get help from the school’s psychiatrist:

I felt like a complete failure for going to see Dr. Kadison. But he helped me realize that I wasn’t. Every year the staff of the Mental Health Services department sees about 140 HBS students. That’s about 1 out of every 11 people … Not to mention the fact that there are many HBS students who go see outside providers without ever going through University Health Services.

Teen Shares Lessons Learned from Nonfatal Attempt

In Postvention, Prevention on November 24, 2008 at 10:23 am
Jordan Burnham

Jordan Burnham

ORIGINAL FEATURE — A feature in the Philadelphia Inquirer tells the story of Jordan Burnham, who survived a suicide attempt and has gone on to visit schools and talk to students about depression and suicide.

“Would you take back that day?” asked one middle school student.

“Yeah,” said Burnham. “It was a horrible decision. I hope no one goes through what I did.”

“I suffered from depression,” said a 15-year-old sophomore. “I’m on pills for it. He really touched me. How he grew from it and learned from it really helped me, and I can grow from it, too.”

Jordan and his parents also speak in-depth about his attempt–and their recovery afterward–in a video provided by the newspaper, and Jordan’s father gives his perspective:

That wasn’t Jordan going out that window. That was Jordan’s body going out that window under the influence of his depression.

There are also a number of pictures of Jordan during his visit to a school in Pottstown, Penn.

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Inquest Opens Window on Chronic Mental lllness, Suicide

In Grief, Intervention, Postvention on November 9, 2008 at 7:14 pm

ORIGINAL STORY — A poignant story in the New Zealand Herald, written by reporter Chris Barton, recounts an inquest into the suicide of a young man who suffered from schizophrenia. In spite of some cultural references that are likely unfamiliar to readers outside of New Zealand as well as the differences between the legal and mental health care systems from one country to another, the story provides a superb look at the real-life experience of a family trying to deal with mental illness and a system of care that is overwhelmed and underfunded.

The two days [of the inquest] are an emotional buffeting: a mother’s anguish and frustration; the shock and response of mental health care staff when a suicide occurs on their watch; a glimpse into the complexities of mental illness; the tragic effects of suicide on a family; plus the enormity of trying to understand why someone decides to take their own life.

And the similarities between the concerns at issue in this tragic case in New Zealand are remarkably similar to concerns often raised in similar cases in the United States:

The question at the centre of the inquest into his death is whether someone as unwell as Shane received the proper level of care. It’s a question that goes to the heart of the recovery-based ideology that guides our mental health services … Whether Shane was given the time and support he needed to get better, or whether a service under strain pushed him back into the community before he was ready.