Suicide Prevention's Perfect Storm

Saturday, June 16, 2018

By Tony Salvatore

For a change, everybody's talking about suicide and suicide prevention. Almost 50,000 people die by suicide every year in the US. Soon suicide will claim more American lives than were lost in more than a decade of combat in Viet Nam. Strangely, not too much talk about that.

So what did it take for suicide to be the topic du jour in the mass media, social media, and around the water cooler? All it took were two very newsworthy suicides involving very well-known people occurring days apart and the release of a report by the Centers for Disease Control and Prevention (CDC) indicating that the US suicide rate has been climbing since 1999 and that it's taking lives in demographics not affected in the past.

Suicides of people of note do unfortunately happen from time to time but not usually in small clusters and the CDC and other federal agencies do release reports on US suicides with some regularity. However, the government reports on suicide are rarely highlighted and the talk about the latest celebrity suicide generally subsides in a few days – as it should. Regrettably, public interest in suicide prevention tends to wane just as fast.

Sadly, most of the attention that suicide prevention's getting will have little lasting effect. To be sure, some people will make donations, some will insert "#suicideprevention" to their social media posts for a bit, others will register for the next suicide prevention awareness event, usually a walk or run, in their town, and those inclined to "do something" will take a suicide prevention training or join a local task force if there's one.

These things may help a little and they are not to be discouraged, but we need to do much more. We need to do something to actually try to prevent suicides or at least keep people from getting the thoughts that sometimes morphs into an intent to die that generates suicide plans that lead to seeking means of self-harm that can then culminate in a potentially fatal suicide attempt. So what do we do?

We need to go after suicide the way we went after cancer starting back in the 1950s. Cancer was not well understood, those it afflicted experienced stigma, and most people did not know what, if anything, could be done about it. The American Cancer Society undertook a long-term public education campaign that changed all that. Yes, people continue to die from cancer but many more are not or are living longer. Cancer was not just talked about when it claimed somebody well-known. The message was everywhere in the media of the day.

So what should the anti-suicide message be? The current message, that suicide's preventable, was put out almost twenty years ago by the Surgeon General and we hear it today. It's important but not enough. It doesn't reach down early enough in the pathway towards suicide when stigma, shame, and like factors have their greatest impact and keep someone, especially a man, from revealing thoughts of suicide even if they believe that suicide is preventable.

The suicide prevention message must be expanded to include another important fact: Thoughts of suicide are normal when someone feels utterly trapped by circumstances believed to be inescapable, when someone feels that he or she is a burden to his or her loved ones who would be better off if he or she were dead, and that those he or she cares about no longer reciprocate that caring. This not to say that dying by suicide is in any way normal.

Suicide prevention is more than talking somebody out of taking her or his life. Hot lines and crisis intervention are essential but too many people never share their risk let alone ask for help. We must get more people to act on the early warning signs of potential suicidal behavior just like most of us do with cancer. Nobody talks about the warning signs of cancer much anymore because we have literally absorbed them. Most of us reflexively seek medical help if a self-examination turns up something that shouldn't be there.

We still have much to learn about suicide but its warning signs are well-documented by research and are as evidenced-based as those of cancer or other serious health problems. Like cancer, suicide may still continue to claim victims. However, even as mortality to certain types of cancer has decreased, we can reduce suicides in some population groups. Now, with suicide prevention having national attention, would be a good time to start.