Now that you have felt my heart by way of the introduction you can see where I came from.  It’s not all of what I have experience that has shaped me.  I may share some more of that during the lessons.

I’m not going to attempt to reinvent the wheel so I will be using parts of what I learned in my class on the subject.

Objectives of this class:

By participating in this training you will:

• Have a general understanding of the scope of suicide within the United States
• Know how to identify someone that may be at risk for suicide
• Know what to do when you do identify someone at risk

Statistics of Suicide in the United States             

• More than 48,000 U.S. deaths from suicide per year among the general population
• Suicide is the 10^th leading cause of death in the U.S.
• Every 12.3 minutes someone dies by suicide
• It is estimated that close to one million people make a suicide attempt each year
  • One attempt every 35 seconds
• Gender disparities
  • Women attempt suicide 3 times more often than men
  • Men die by suicide almost 4 times more often than  women

What is the reason for the above statistics in gender disparities?  Women will overdose in most cases and some will realize the consequences and dial 911, whereas men will use lethal force that in most cases when executed there is no time lapse to consider the consequences, such and the use of a gun.

Facts about Veteran suicide

Where I live is near a military base with several others in the eastern part of NC.

• 18% of all deaths by suicide among U.S. adults were Veterans⁴
• Veterans are more likely than the general population to use firearms as a means for suicide⁴
• 25% of Veteran suicides have a history of previous suicide attempts⁵

Common myths vs. realities

Myth – If somebody really wants to die by suicide, they will find a way to do it.

Reality – Making one form of suicide less convenient does not usually lead people to find another method. Some people will, but the overwhelming majority will not.

Death by suicide is preventable:

Lethal Means Reduction

• Limiting access to lethal means reduces suicide

— e.g., Firearms, abundance of analgesic doses  per bottle, etc. 

• How did we figure this out?

— e.g., Coal gas in the UK, placement of lethal items behind counters, fencing off bridges

• 85-90% of people who survive a suicide attempt do not go on to die by suicide later.

Perhaps the greatest evidence we have that death by suicide is preventable is related to lethal means reduction….

• Limiting access to lethal means….

The connection between the availability of lethal means and death by suicide is simultaneously one of the most powerful and most counter-intuitive patterns in the suicide literature. On one hand, reducing access to lethal means is the best empirically supported intervention for suicide prevention. On the other hand, the idea that the suicide rate could decrease by 31% simply by making it mildly inconvenient (e.g., placing lethal items behind a sales counter ) or that it could increase by 20% simply by publicizing a novel method of suicide is paradoxical.

• How did we figure this out?

For those of us unfamiliar with this info, it is best to start with the first well-known example: Kreitman’s (1976) coal gas story. As described in his landmark paper, the United Kingdom experienced a consistent rise in suicide rates for several decades after the end of World War II, when suddenly; they began to decline in 1962. But reductions in the overall rate were attributable to a reduction in only one type of suicide: ingestion of carbon monoxide. Data on the availability of carbon monoxide explained why. Prior to the 1950’s, domestic gas was produced primarily from coal, and the resulting gas available to consumers was 14% carbon monoxide. But manufacturing gas from oil products and then natural gas, rapidly reduced carbon monoxide content to near zero. In the end, the reduction in overall suicides was closely associated with reductions in the availability of gas with carbon monoxide.  In under 10 years, the overall suicide rate in England and Wales dropped by roughly 43%. Decreases in carbon monoxide related suicides were not offset by increases via a different means. This pattern with different lethal means in different counties has been replicated many times (Daigle, 2005).

Another example is found at San Francisco’s Golden Gate Bridge (GGB).  The GGB is widely known as a suicide “hot spot”; it’s estimated that over 1600 people have died there via jumping since its opening in 1937.  Although construction recently began on a safety net, calls for an anti-suicide barrier went unheeded for decades.  Among the reasons often cited for not constructing a barrier was the belief that suicidal individuals “would just go somewhere else” if jumping from the GGB were made more difficult.  In other words, if a person was prevented from making a relatively easy and highly lethal attempt, they would likely simply substitute another site to make an attempt.  A well-known 1978 study tested this assumption by examining outcomes in 515 individuals who were restrained from jumping from the GGB between 1937 and 1978.  Richard Seiden, the study’s author found that over 25 years later, 94% of these individuals were either still alive, or had died of causes other than suicide.  The author concluded that, “…the findings confirm previous observations that suicidal behavior is crisis-oriented and acute in nature.”  

• 90% of people who survive a suicide attempt do not attempt again.

We think this is because suicidal crises often emerge & resolve quickly.

Myth –  Asking about suicide may lead to someone taking his or her life.

Reality – Asking about suicide does not create suicidal thoughts. The act of asking the question simply gives the person permission to talk about his or her thoughts or feelings.

Myth – There are talkers and there are doers.

Reality – Most people who die by suicide have communicated some intent. Someone who talks about suicide provides others with an opportunity to intervene before suicidal behaviors occur.   Another words they are giving clues that they want to be talked out of it no matter which side of the coin you look at.

                Almost everyone who dies by suicide or attempts suicide has given some clue or warning. Suicide threats should never be ignored. No matter how casually or jokingly said, statements like, “You’ll be sorry when I’m dead,” or “I can’t see any way out” may indicate serious suicidal feelings.

Myth –  If somebody really wants to die by suicide, there is nothing you can do about it.

Reality – Most suicidal ideas are associated with treatable disorders. Helping someone connect with treatment can save a life. The acute risk for suicide is often time-limited. If you can help the person survive the immediate crisis and overcome the strong intent to die by suicide, you have gone a long way toward promoting a positive outcome.

Myth – He/she really wouldn’t die by suicide because…

• he just made plans for a vacation
  • she has young children at home
  • he made a verbal or written promise
  • she knows how dearly her family loves her

Reality – The intent to die can override any rational thinking. Someone experiencing suicidal ideation or intent must be taken seriously and referred to a clinical provider who can further evaluate their condition and provide treatment as appropriate.

Let’s use this acronym I was taught to use in pursuit of helping people that are troubled.

S.A.V.E.               

S.A.V.E.                will help you act with care and compassion if you encounter a person who is in suicidal crisis.

The acronym “S.A.V.E.” helps one remember the important steps involved in suicide prevention:

• Signs of suicidal thinking should be recognized
  • Ask the most important question of all
  • Validate the persons experience
  • Encourage treatment and Expedite getting help

This last point is of the utmost importance to me.  Listen and learn.  Don’t be hasty to act.  Look at the situations surrounding people you suspect to be suicidal.  They might not actually be.  Be sure you read the signs properly.  Risk signs might include:

1.            Depression

2.            Withdrawal from friends and family.

3.            Self-harm such as cutting, pulling out hair

4.            Saying things like “You’ll be sorry when I’m dead,” or “I can’t see any way out”. 

These are things that can indicate serious suicidal feelings.

To conclude Lesson 2 we must realize there are multiple ways for people to attempt suicide.  It doesn’t really lay at the feet of any given method.  Guns, carbon monoxide, drug overdose, hanging and any other idea dreamed up can and will be used. 

I would like to insert here a method used in a suicide that occurred with a neighbor of mine back in the 70’s.  This husband and wife were not next door at the time of the incident.  The wife moved in next to me post suicide with her two daughters. 

The husband of my neighbor sent his wife to the hardware store to buy rope.  She was clueless as to the nature of his need for the rope.  She brought the rope home and he took it and went to the garage.  Later she found him hanging in their garage deceased.  It was a tragic ending.  The method was pre-planned by the husband and she told me she had no idea of his inclination.  The result was a life of depression for this woman that was so crippling she was unable to function as a normal person should because she blamed herself as being complicit in his suicide.  Her husband’s death left her as nothing more than a troubled woman that also died early from the grief she carried.  Suicide not only ends in the tragic ending of the life of the person, but it also affects the family and friends at all levels.  We will delve into this aspect as we continue.