Our Opinion: To prevent suicide, we need multiple approaches
Last week was National Suicide Prevention Week, but this week is as good a week as any to take stock of the state of mental health and how we treat it — in this county, in this state and in this country.
We reported last month on the expansion of Lines for Life, a nonprofit that operates depression and suicide hotlines out of its Southwest Portland office, into Washington County. Specifically, the group received a grant to begin promoting its Senior Loneliness Line, a help line specifically geared toward older adults, in Beaverton, Tigard and other local communities.
Previously, the line existed only as a partnership with Clackamas County, but as the word got out, operators found that they were receiving calls from residents of Washington County as well — indicating there is demand for a service like that here.
You may also read in our paper today that officials in the Beaverton School District are looking at ways to better address suicidal impulses and ideation among young people in the community. A new state law requires school districts to develop and adopt suicide prevention plans. Since Beaverton is one of the largest school districts in Oregon, if it can come up with effective ways to keep students alive though they're dealing with depression and/or trauma, it could serve as a model for other districts in the state and around the country.
Tigard-Tualatin, Sherwood, Lake Oswego, West Linn-Wilsonville and other local school districts are tasked with developing their own plans. We hope to see school districts freely collaborate and share ideas about how to protect students. Preventing youth suicides should be a priority in every part of the Portland area and the state of Oregon.
Meanwhile, at the national level, there's been a growing chorus of voices calling on our government officials to address the mental health crisis in the United States. This is a noble and worthwhile cause. It's unfortunate that much of it seems to be a political smokescreen thrown up by those who, in the wake of three mass shootings last month alone, don't want to address another key issue: ease of access, including by people with mental illness, criminal records and other "red flags," to semiautomatic firearms.
We welcome a national conversation, though, on mental illness. But that conversation must go beyond paranoid schizophrenia and other acute, reality-warping conditions that are blamed for shooting sprees. It has to include — focus on, even — the causes and effects of common mental health issues, like depression, anxiety and addiction. These are conditions that tens of millions of Americans, including hundreds of thousands of Oregonians, struggle with every day.
There's still a lot that experts don't understand about the human brain. A rising number of children each year are being diagnosed as being on the autism spectrum. While scientists have identified a number of risk factors for autism, it's still unclear exactly what triggers the condition, and why its symptoms vary so widely. So perplexing is the condition that some have blamed vaccines for causing autism, despite there being no scientific evidence linking vaccines — which are widely considered to be safe by medical professionals and regulators — to autism. In the absence of answers, "alternative" theories — and conspiracies — often take root.
That's a problem with mental illness as well as autism. The medical community agrees that depression is caused by an imbalance in brain chemicals. But there is a wide range of reasons why those brain chemicals can get out of whack, and an exact cause — and means of prevention — has yet to be pinpointed.
Anxiety is, if anything, even more mysterious. Experts believe that instead of a single root cause, in many cases, anxiety disorders are the product of multiple factors, which can include other medical conditions, personality traits, outside stimuli, internalized trauma and more. The precise medical trigger hasn't been identified.
With so much uncertainty as to what causes depression and anxiety, it's no surprise there is a wide range of pharmaceutical products, therapeutic approaches and naturopathic treatments intended to address them — and a variable range of reactions and responses. For some patients, an anti-anxiety pill or antidepressant may worsen their condition — even as they change the lives of others for the better.
What we need to accept is that we don't know how to prevent common mental health conditions, and there's no magic wand we can wave to make them all go away. That doesn't mean we should give up on trying to help people who struggle with their mental health and may be at risk of suicide, or that those of us who have mental health conditions should abandon all hope of leading a normal, healthy life. (For that matter, it doesn't mean we should view every person on the autism spectrum as ill, simply for having a brain that works differently from others. Many autistic people do not want or need to be "cured.")
What dealing with the mental health crisis in this country means is a multi-pronged approach. We know people respond differently to different treatments for common mental health issues. In the same way, we need to use multiple tactics to reach people who may be considering suicide, improve their quality of life, and equip them to care for themselves. We need to directly tackle addiction, a problem that has been exacerbated by the overprescription of powerful painkillers and weak regulations that often fail to keep addictive products out of the hands of teenagers. We need to understand and address why certain segments of the population, including teens and veterans, are at greater risk of suicide.
There's important progress happening right here in Washington County — work that will, we hope and believe, literally save lives.
But a true revolution in how we think about and treat mental health requires a mass response. As individuals, we might not have the power to lobby drug companies or write new laws. But we can, and should, be mindful of people we know who are grappling with depression, anxiety, addiction, trauma, isolation, dysphoria and other factors that place them at greater risk of suicide. Being supportive and non-judgmental is often the best thing we can do for a person who is dealing with issues like these. We can also be honest about our own mental health — if not with the world at large, at least with ourselves and our clinicians.
Mental illness isn't a sign of weakness. It's a medical condition like any other, which must be diagnosed and treated.
It's only by seeing things as they are that we can turn the tide against suicide.
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