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Suicide prevention requires direct, open discussion, behavior observation

A community forum on suicide prevention featured as much audience participation as panel discussion as attendees and experts shared views and advice on recognizing and helping vulnerable youth, adults and veterans.

The forum, “Let’s Talk…A Community Forum on Suicide and its Prevention,” on March 30 was sponsored by the St. Peters Health & Wellness Advisory Committee, a group of community volunteers that advises the city’s Board of Aldermen and city officials.

Members of a three-member panel that led the discussion said suicide attempts, particularly by young people, continue to rise.  And suicide is a major issue for young veterans who are trying to reenter civilian life.

Heather Davidson, director of youth services for SSM Behavioral Health Services, said about 30 young people between the ages of 15 to 24 die of suicide each year in the St. Louis area.

According to the Centers for Disease Control and Prevention [CDC], there were 41,149 suicides in 2013 in the United States. About 1.3 million adults age 18 and older attempted suicide in 2015, with suicide the second leading cause of death among persons aged 13 to 34.

The CDC statistics are about two years behind, according to Davidson.  “They’re going up – we’re seeing much of that on the youth side, and also on the adult side,” Davidson said.

Molly Dwyer-Simonsen, team leader of outpatient behavioral health programs at SSM Behavioral Health Services, said five years ago suicide was the tenth leading cause of death.  “Now, it’s eighth,” Dwyer-Simonsen said. “That kind of puts things into perspective that it’s jumped up that much in less than five years.  It was more prevalent than we’re aware of.”

Davidson, Dwyer-Simonsen, and Wendell W. Webb, national senior commandant for the Marine Corps League, discussed the need to recognize and treat depression and recognize signs of suicidal tendencies.  They also advised being direct and open about talking about suicide and taking immediate action such as seeking help from medical professionals and agencies that specialize in crisis intervention and suicide prevention.

Most of all, they advised not being judgmental but listening to what someone says. “They don’t want us to fix it, they just want someone to listen,” Dwyer-Simonsen said. “And listening is a very trained and learned skill.” Opening a dialog with family members also helps with opening up with friends and others, she said.

Dwyer-Simonsen said genetics can play a role in some forms of depression as can drug and alcohol abuse. Having an experience with someone who committed suicide, the news media, and use of the Internet can increase risk factors.   “It makes it [suicide] more plausible and somehow more acceptable to actually think about that and go through with it,” she said.

Davidson said economic issues and cyber-bullying through the Internet also can create depression and anxiety.  She said medical professionals also are seeing higher numbers of gay and lesbian young people.

Webb, who works with Marines and other veterans, said veterans organizations have actually seen a drop in suicides locally, largely because agencies and organizations are providing direct treatment and engaging veterans.

Often the issues behind suicide may not stem from combat in, say, Afghanistan, but arise when veterans come home.  “When he or she comes home, they’ve lost purpose,” Webb said.  Because of changes at home while they are in the military they feel they often don’t fit in anymore, he said.

Unrecognized and untreated depression often leads toward suicide, the panelists said. Some of the feelings and thoughts suicide-prone people experience include an inability to stop pain, talking about wanting to die or harm themselves, talking about being a burden on others, not thinking clearly, not sleeping or eating, lack of attention from others, and extreme mood swings, they said.

Dwyer-Simonsen said parents, friends and acquaintances of depressed people have to be direct and ask questions and not be as worried about offending someone. They also advised calling in medical professionals and agencies that specialize in crisis intervention and suicide prevention.

Being alert to changes in behavior and appearance and other “tell-tale signs” is also a critical factor in helping someone.  For example, if someone starts to sees a veteran with all their “stuff folded and neat you need to start worrying,” Webb said.

“We need to start to observe,” Dwyer-Simonsen said.  “When we notice something, we need to get connected and care about one another and be okay with being a little obtrusive,” she said.

Webb said veterans sometimes don’t answer telephone calls or emails but they often will text.  He said it’s important to keep in touch with them, stay connected and listen to what they say.

But much of the advice and comment from the hour-and-a-half panel discussion came from the audience, which included former teachers, parents and people who said they suffered from depression.

Observing changes in behavior and appearance, particularly among young people, could be indicators of issues with depression, a former teacher said.  One audience member, like Webb, said people contemplating harming themselves often don’t tell anyone or even answer the telephone so it’s important to observe behavior.

Another audience member lamented the lack of “adequate holding procedures” for patients who need more long-term care.  Physicians often opt for increasing medication rather than other care, they said.

Former teachers said as far back as the 1980s there were resources and programs dedicated to helping young people. Those resources and programs have disappeared.  Insurance companies now often dictate care because they provide only enough dollars for a limited stay at treatment facilities, they said.

The increasing use of controlled substances, including heroin and painkillers, have also contributed to the suicide issue. One former teacher complained that an emphasis on sports among students may be robbing young people of needed rest.

While panelists emphasized the need for open and direct communication, they also said parents and families also have to set limits and expectations for their children to abide by.

Attendees and panelists agreed that the “stigma” of suicide needs to be overcome with people being more willing to talk about it openly. Other changes also would help. Webb said discharge papers that state that a veteran is “unemployable” need to be changed.  A veteran who is 30 to 35 years old has no future and cannot get a job with that on their record, he said.

Dwyer-Simonsen said attendees can become advocates for suicide prevention, particularly by asking lawmakers who control budgets to provide funding for programs to help.

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