One of the toughest days in my life as a psychiatrist was the day I learned that one of my patients committed suicide.
The news arrived in the middle of a busy workday, with other patients in the clinic waiting to be seen — patients who were still alive, some of them barely clinging on to the hope that they will soon feel better.
So when I heard the news, I knew that the next patient must be seen despite the flood of sadness and shock flowing through the very core of my being. The next patient must be seen because the best way for me to honor the dead from suicide is to try to help those who are living with severe forms of depression, psychosis and other mental illnesses.
I can't discuss many details of my professional experience with suicide but I do know this: Suicide is not a statistic. It is a shockingly permanent and devastating event in the lives of the victims and their loved ones. I also know that suicide is preventable with the right support and treatment.
Because of the stigma and intensely personal pain that a death from suicide can create, suicide is not often discussed in public. It is time to break the silence. Awareness about suicide and suicide prevention can afford every Oregonian the opportunity to save the future of a person who would otherwise be lost.
Know who might be at higher risk — Risk factors for suicide are a combination of inherited vulnerabilities, past life events and current stressors. A family history of suicide among close relatives, the presence of many mental disorders, substance use and a history of military service increase the risk of suicide.
People who have experienced traumatic events in the past, such as abuse, unstable housing and food insecurity, are at higher risk for suicide. People experiencing current stressors, such as job loss, relationship problems and financial difficulties, are at higher risk of suicide. Young people who have had a peer commit suicide are at increased risk for suicide in the time after the peer's suicide.
Although white, older men are still a high-risk group for suicide, suicide rates for some other demographic groups also are high. For example, suicide was the eighth leading cause of death for Native Americans in 2017, while it was the ninth leading cause of death for white non-Hispanics.
• Ask about suicidal thoughts and urges in a calm, caring and nonjudgmental manner — Asking loved ones about suicide does not put ideas into a person's head. Instead, it provides a potentially lifesaving opportunity to ask for help. Many people are too ashamed or afraid to tell anyone. Others may fear the reaction of others if they talk about their dark thoughts. The simple act of asking about suicide may be the only way someone ever gets help.
• Limit access — Because acts of suicide are often impulsive, reducing access to the most lethal and impulsive means of suicide such as firearms and prescription medications for people in crisis has been shown to be effective in the prevention of suicide.
• Aid the suffering person in getting help — If you become aware that someone you know is having thoughts of suicide, encourage that person to reach out for help, either through telephone or texting hot lines, a local mental health clinic or other local resources.
• Advocate at all levels of government — Our mental health care system is overwhelmed and under-resourced. Advocating for effective access to crisis services, preventative mental health treatment and "post-vention" services such as survivor support groups is a key element of the long-term prevention of suicide.
One of the best days of my professional life occurred when a patient told me during our regular psychotherapy and medication management visits that I helped save his life. You can have one of the best days of your life by helping to save a life, too.
Stephanie Maya Lopez is past president of Oregon Psychiatric Physicians Association. She lives in Portland.
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