What would you say if I asked you if you have the tools that could prevent a suicide? While I was in the hospital waiting for my triplets to be born, my father died by suicide. I was among the 135 persons impacted by every suicide death. As the survivor of a suicide loss, my focus is now on suicide postvention and strategies to provide support after a suicide. I’ve come to know that postvention is the same as prevention.
September is National Suicide Prevention Month, and I have watched a lot of suicide prevention webinars. The problem of opioids and suicide, I believe, is the most unexpected element throughout the webinars. According to recent studies, a substantial percentage of overdoses are suicides. One out of every five suicide deaths is caused by opioids. In addition, the incidence of opioid overdose is twice as high among veterans as it is among non-veterans.
I was listening to the media during the pandemic as they talked about how suicide is on the rise. Research and webinars on suicide prevention, on the other hand, show that this is not the case. In fact, a research study of 21 nations, including Italy, that was published in the Lancet journal found no increase in suicide rates in 2020. In addition, for the first time in two years, new data from JAMA (Journal of the American Medical Association) reveals a 2% reduction. I recently watched Thomas Joiner’s webinar, Why People Die by Suicide: What the Last 20 Years of Research Has Shown Us. He pointed out that suicide rates are not rising among whites, but among African Americans.
This month, there were a lot of webinars on suicide prevention, and I’d like to point out a few of the ones that stood out to me. First, I listened to a webinar by Eboni Webb, PsyD. Eboni explained how dealing with suicidality in clients with high-crisis DBT and being vulnerable emotionally can be caused by attachment disorders, trauma, and loss. Cortisol overproduction from stress suppresses the immune system and has an effect on neuron death. The webinar mainly dealt with the fight or flight response and the amygdala.
Techniques for Reducing Suicide Intentions
The webinar taught me that we all need to have a better understanding of what happens during the response to stress, emotional dysregulation, and techniques for reducing thoughts of suicide. Eboni gave some ways to increase oxytocin that include focused breathing, laughter, prayer, spending time with a baby, and other distractions without engaging in negative behaviors. Eboni’s webinar, like the others, touched on the fundamentals of safety assessment and developing a safety plan. Eboni’s email address is email@example.com. If you want more information about the Columbia Protocol, go to cssrs.columbia.edu
I also saw a presentation by Kelly Posner Gerstenhaber, PhD, who claims that the Columbia Protocol can minimize suicide, liability, and strain in healthcare and beyond. Because of prejudices and ignorance, people do not receive the life-saving care they deserve. Men are less apt to get treatment, according to Kelly, and up until 2010, pilots were prohibited from flying while taking antidepressant medication, so many pilots either did not disclose or just ignored the signs of depression. Kelly also talked about minimizing the stigma of depression for those in the US army and normalizing screening. You can contact Kelly at Kelly.firstname.lastname@example.org. Visit cssrs.columbia.edu for additional information on the Columbia Protocol.
Kathryn Gordon, PhD’s presentation was full of information about dealing with thoughts of suicide that won’t go away. Kathryn believes that you should guide your patient in developing a safety plan and that they should be aware of the symptoms of a crisis (e.g., unable to sleep, agitation). They also require a purpose in life, a support system of people they can contact for help, and techniques to stay safe (e.g., getting rid of medicines or drugs they could overdose on).
Kathryn also mentioned the importance of knowing how to quickly alleviate painful feelings (e.g., hot tea, hugging, playing or listening to music, art, a hot shower) in order to elicit happy feelings. Numbers for emergency services and crisis centers should be close at hand for your patients. They must also nurture hope and create purpose by linking their activities with their values. Visit kathrynhgordon.com for more information on Kathryn and her work.
My favorite webinar of all that I watched was the one by Stacey Freedental, Phd, LCSW, called Helping the Suicide Person: A Clinical Toolbox. In the webinar she focused on collaborating and connecting with a client that is suicidal, instilling hope and resolving problems. Stacey also explained the difference between challenging and altering suicidal thoughts, along with reinforcing successes (e.g., analyze a recent suicidal situation using new skills). Prepare for a narrative interview by knowing what to say. “Could you explain me how you came to the point where you intended to kill yourself?” for example. Pay attention to psychological pain, “Can you describe your mental suffering?”
Show your patient a grounding technique that incorporates all of their senses. Look for needs that are unmet, like autonomy, the feeling of belonging, and competence. Center on planning for safety. Discuss their motivations for living and go over the list of what they have unfinished and still want to do. Takeaway points are: Focus on the problems that would be solved by killing themselves, work on problem-solving skills, challenge their thoughts of suicide and thoughts that contribute to suicidal thinking, and employ CBT to help fight those thoughts. “Picture yourself getting suicidal in the future,” Stacey says. “What things would you want to say to your future self?”
Clinicians MUST Learn about Suicide Prevention
Taking everything into consideration, I believe that clinicians absolutely must learn about preventing suicide, intervention, and postvention. From my experience as a speaker who talks to professionals about vicarious trauma and compassion fatigue, I know that it is very stressful to work with patients that are suicidal. What is even more stressful, however, is when they decide to take their own life. That’s why all helping professionals must be trained in suicide prevention. Many years ago, I attended a breakout session at an American Association of Suicidology convention led by Ed Shneidman. Two questions he put forth are, “Where do you hurt?” and “How can I help you?” That, I believe, is an excellent place to begin.
Barbara Rubel’s Podcast and Videos on Suicide Awareness
- Interview: https://www.youtube.com/
- Hope4Med Podcast: https://www.youtube.com/
- Elite Healthcare Interview: https://www.youtube.com/
- Healing Place Podcast: https://www.youtube.com/
- Bear Podcast: https://bearpsych.libsyn.com
- Podcast: https://www.voiceamerica.com/
- Videos: https://www.griefworkcenter.com/videos/
Barbara is a leading authority and best-selling author on managing burnout, secondary traumatic stress, compassion fatigue, and vicarious trauma. As a nationally recognized keynote speaker, she motivates audiences to build their resilience and create work-life balance. Her programs help leaders and teams manage workplace chronic stressors and get over burnout at work.
Barbara's newest book, "But I Didn't Say Goodbye: Helping Families After a Suicide", is available now on Amazon - https://amzn.to/2FwS6JI
• Three weeks prior to giving birth to triplets, her father died by suicide. Her story was featured in the Emmy award winning documentary, Fatal Mistakes, Families Shattered by Suicide narrated by Mariette Hartley. Many employees are grieving personal loss. She offers programs for leaders on lost productivity and performance while managing grief at work.
• As a sought-after keynote speaker who has presented to over 500 groups since 1991, including corporations, state and national associations and non-profit organizations, Barbara offers work-life balance strategies for leaders to implement right away. With clarity and humor, her speaking engagements are designed to give audiences powerful and practical strategies of work-life balance, wellbeing, and self-care that can be implemented immediately.
• Barbara is a Board-Certified Expert in Traumatic Stress and Diplomate with the American Academy of Experts in Traumatic Stress. She received a Bachelor of Science in psychology and a Master of Arts degree in community health, with a concentration in thanatology, both from Brooklyn College.