Addressing Suicide Risk in Trying Times

In April, a Global Emotions Report by Gallup showed that people worldwide are sadder, more afraid, and angrier than ever before. This news may not hit you as a surprise. The sense of heaviness in a recent talk about the state of the world is palpable. It seems every day we are struck by dire existential warnings, environmental disasters, mass violence, and painful personal stories. There’s been a lingering question of how this is affecting people’s mental health and how it will continue to do so. For those of us in the field of suicidology, we worry that these effects could be life-threatening.

In the United States, the suicide rate increased by 30 percent from 2000 to 2016. It’s hard to pinpoint a single explanation for this increase. However, there are certain societal stresses that we’ve learned can have an effect. For example, studies have connected financial worries to a rising suicide rate among baby boomers. A 2010 meta-analysis showed a link between debt and suicide, while other research has revealed that even the reporting of economic downturns and hardships are associated with an increase in the suicide rate.

In addition to economic strain, scientists fear that environmental factors will generate an uptick in suicides, as a recent Stanford study discovered a link between increased temperatures and higher suicide rates. Concerns like these are starting to spread, as we become more aware of how certain traumatic events may trigger suicide risk.

One such occurrence took place in March of this year when three different people directly impacted by school shootings died by suicide. Two were students from Marjory Stoneman Douglas High School, and one was the father of a child killed at Sandy Hook Elementary. These are not the first cases in which a shooting was followed by the suicide of someone affected. As a recent Mother Jones article put it, “Researchers haven’t established a direct link between mass shootings and the likelihood of the suicides, but they have found connections between the trauma of those events and the mental health risk factors that can lead to suicide.”

These risk factors include post-traumatic stress disorder and depression. According to the National Center for PTSD, about 28 percent of people who have witnessed a mass shooting in the United States develop post-traumatic stress disorder. Just as the name implies, PTSD is a common response in the wake of tragedy. Recently, it’s been associated with natural and human-made disasters, which are also on the rise.

The question is, could traumatic occurrences such as these lead to an increase in suicide? According to researcher Madelyn Gould, in order for a suicide to occur, the suicidal individual is usually affected by an underlying factor such as a mood disorder, substance abuse, aggression, anxiety, family history, abnormal serotonin metabolism, or adverse childhood events. They may then experience a triggering stress event such as a loss. This can be followed by an acute mood change with the person feeling anxiety, dread, hopelessness, or anger.

If this state is interrupted or inhibited by a potentially life-saving factor such as available support, a slowed down mental state, the presence of others, or the person’s religiosity, then the person is more likely to survive. However, if this mood change is met with facilitating conditions such as the availability of a method weapon, a recent example of suicide, a state of excitation or agitation, or the person being alone, then suicide is more likely to occur. In other words, a stress event may trigger a suicidal state, but there are factors we can address and ways we can react that can reduce a person’s risk of dying by suicide.

While it may feel concerning to look at suicide risk in the context of today’s troubles, the take-home message is not to despair but to prepare. A person’s response to tragedy can be complex. While mental health symptoms and post-traumatic stress disorder tend to increase after certain events such as an earthquake or hurricane, there have been instances when suicide risk decreased in the immediate aftermath of tragedy. This appeared to be the case after Hurricane Katrina and the 1995 Hanshin-Awaji earthquake.

It’s been speculated that in some cases after the initial traumatic impact of a tragedy “emotions improve in a heroic phase, in which [people] are inclined to try to contribute to the disaster response, followed by a honeymoon phase, when community cohesion peaks.” Although it may not eradicate the long-term mental health effects, the idea that cohesion and a sense of support and community helps people heal psychologically is important to consider.

A few years ago in my own hometown of Santa Barbara, my colleagues at The Glendon Association and members of our community came together to form the Santa Barbara Response Network. The volunteer organization mobilizes and responds to crises and traumatic events by showing up on-site, offering Psychological First Aid, and simply being there to provide support and connect people with services they need in the wake of hardship. Since our formation, we’ve responded after devastating wildfires, deadly mudslides, and shocking instances of violence. We have learned first-hand that communities can come together to support and be there for one another, and individuals can absolutely do the same.

When it comes to saving a life from suicide, sometimes all it takes is one person, be it an acquaintance, friend, coworker or family member, to take notice of someone suffering. I highly recommend everyone visit the National Suicide Prevention Lifeline’s #Bethe1to campaign, which teaches people the five simple steps they can take to help someone who may be suicidal. This is part of an effective, coordinated strategy embraced by researchers and experts in the field of suicidology. Learning these steps can make a person more confident to reach out to someone in trouble and can, ultimately, save a life from suicide.

When it comes to any experience of trauma, seeking therapy can be life-saving. It is also important for anyone struggling with suicidal thoughts to be able to access good care. Research demonstrates that when mental health care is more easily accessible and available, it is a suicide preventive. We are fortunate that in recent years a number of respectful, compassionate, patient-oriented treatments have been developed, which are effective in reducing suicidal thoughts and behaviors. To help familiarize therapists with these life-saving practices, I’ve recently developed an online course in partnership with the California Psychological Association that trains mental health professionals in these new approaches towards effective risk assessment, crisis response, and interventions for suicide.

No matter what challenges may come our way, we can all help prevent suicide by reaching out to those affected by tragedy or anyone we notice who is struggling. Now is certainly a time we need to look out for one another, to make efforts to stay in touch and pay attention to those most vulnerable. When it comes to suicide risk, we should spread the truthful message that no matter what contributed to a person’s suicidal thoughts and feelings, help and hope is available. There are countless hope stories of people who were suicidal who have persevered and gone on to lead meaningful lives that they are happy to still have. Most often, these individuals report that it was friends or family they turned to who provided the support they needed that made the difference for them.

Unlike certain forces outside our control, our will to survive can persevere. Suicide is a permanent solution to a temporary problem. The suicidal state is almost always transient and doesn’t last. As painful as it can be in the thick of it, the storm can and will pass.

This is a free hotline available 24 hours a day to anyone in emotional distress or suicidal crisis.

About the Author

Lisa Firestone, Ph.D. Dr. Lisa Firestone is the Director of Research and Education at The Glendon Association. An accomplished and much requested lecturer, Dr. Firestone speaks at national and international conferences in the areas of couple relations, parenting, and suicide and violence prevention. Dr. Firestone has published numerous professional articles, and most recently was the co-author of Sex and Love in Intimate Relationships (APA Books, 2006), Conquer Your Critical Inner Voice (New Harbinger, 2002), Creating a Life of Meaning and Compassion: The Wisdom of Psychotherapy (APA Books, 2003) and The Self Under Siege (Routledge, 2012). Follow Dr. Firestone on Twitter or Google.

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