Watch our Facebook Live discussion with our panel of behavioral health experts below:
Most people who attempt a suicide don’t want to die. They may be in a dark place and may not feel like they have many other options left. But there is hope. There are people to listen – even someone who has been in their situation before. Help is here, available 24 hours a day, 7 days a week, 365 days a year.
"The recent deaths of fashion designer and businesswoman Kate Spade and chef and TV host Anthony Bourdain, have again shown that suicide impacts all – it does not discriminate between race, age, socioeconomic class or other statuses," says Victor Armstrong, vice president of Behavioral Health Services in Charlotte with Atrium Health.
A recent sobering report from the Centers for Disease Control and Prevention substantiated these facts. Deaths by suicide across the United States increased by 25 percent from 1999 through 2016 and in 49 of 50 states. It is the 10th leading cause of death nationally and second-leading cause of death among youth. There are approximately 123 suicides everyday, and for every death, 25 more attempts are made. In North Carolina, about 1,400 people will die by suicide - that’s one life lost about every six hours.
The Sting of Stigma
"Although there has been more public dialogue around suicide in the past decade, the stigma still exists," says Emily Lupsor, a licensed clinical social worker with Atrium Health. James Rachal, MD, chair of the Atrium Health department of psychiatry, reports for those that come through the doors of an Atrium Health facility, they’re able to figure out a plan to best treat them. The problem is that a lot of those people who need the help the most, don’t ask for it.
Dr. Rachal, who lost a loved one to suicide, explains that many feel their families, friends and careers are at risk if they ask for help. Never be afraid to reach out to anyone who you think may be dealing with a mental health issue, Dr. Rachal says. “Ask ‘How can I help?’ ‘What are you doing today?’ Encouraging words can mean something,” Dr. Rachal said. “They may tell you how they really are doing. A lot of times its asking that initial question.”
The language that we use when we discuss suicide also matters, Lupsor says. “When it comes to suicide and mental health, the language we use helps construct reality. ‘Committed suicide’ is a term we’re used to saying but we’re trying to come away from that. It implies criminality or morality and can help further stigmatize the issue.”
Warning Signs and Risk Factors
"No one can predict suicide at a certain time," Sherif Soliman, MD, a forensic psychiatrist with Atrium Health, says. "But professionals do their best to assess a patient’s particular risk. They can perform a suicide risk assessment both in facilities and remotely via telepsychiatry. The biggest risk factor is if a patient has attempted suicide before. But many other risk factors are not as recognizable."
Asking the following questions can help determine if a person may be at risk: Is your loved one feeling more depressed? Withdrawing from normal activities? Feeling isolated? Do they have a history of substance use? Are they eating or sleeping less?
Just like a cardiologist would approach a heart attack victim by looking at risk factors, Dr. Soliman takes a similar approach in helping treat his patients. He looks at risk factors that may be static (fixed) and dynamic (those which may be able to be changed).
Atrium Health has made behavioral health one of its top priorities. Atrium Health has the only psychiatric emergency department in a three-state region; integrated behavioral health into nearly 30 primary care practices including six pediatric practices and opened clinics throughout our footprint. We also provide telepsychiatry services – helping to provide a much-needed service to hospitals and providers for timely situations and in rural areas.
‘Self-Care is the Best Care’
Some of the best methods of breaking stigma, however, don’t require a degree or hospital or doctor’s office. Ricky Witherspoon is a walking, talking stigma fighter. Witherspoon, a certified peer support specialist with Atrium Health, is a suicide survivor. He attempted to die by suicide several years ago. He was battling a mental health issue as well as a drug addiction. He was angry, depressed and “thought about suicide every day.” He attempted to take his own life using substances but woke up in the emergency department several hours later angry that he didn’t succeed. But after getting the appropriate care, he realized that he had a mental illness that needed to be treated – just like any physical disease of the body.
“I had a chemical imbalance. I don’t always have good days, but if I follow my daily maintenance plan for myself, take my medication, be consistent – and with the help and support of my wife and family members, I got past the stigma,” Witherspoon says. “Self-care will provide the best care. I’m still susceptible to making a wrong choice or not taking my medications, but to stay out of the emergency department, I stay compliant with the program for myself.”
Lupsor said that one of the most powerful ways for those who have survived a suicide attempt to recover is to meet someone who has been through it as well – sharing their story and connecting with someone who has walked a mile in their shoes.
The Ripple Effect
When a person dies by suicide, it can have a ripple effect. Not only does the loss impact the person’s family and friends, but first responders, physicians, nurses and other medical staff and many others who may have tried to intervene previously.
“I experienced a loss a few months ago,” said April Schindler, MD, a first-year psychiatric resident. “We go through the same grief process. As physicians, we care very much about our patients and try and instill hope in them in every encounter. It was difficult. But we fight to prevent suicides in all of our patient encounters.”
Suicide loss survivors may also experience feelings of guilt and responsibility that can linger over time. They may ask themselves how they could have missed a sign or symptom or carry the loss with them secretly and suffer internally.
“These are very common feelings,” says Dr. Rachal. “It really does sit with you. It can be an isolating event. You’re carrying that extra burden. It’s important in these times to have someone you can talk to who is non-judgmental.”
Armstrong says that all people grieve differently and not to rush those who may take their time dealing with the feelings of losing a loved one.
Spotting the Signs
In the past decade, many more resources have become available to help spot signs and symptoms of those who may be in a mental health crisis. Atrium Health is a facilitator of the Mental Health First Aid training program among other awareness initiatives.
“Awareness doesn’t take weekends off or stop at 5 p.m.,” Witherspoon says. “But we need to offer encouragement and sometimes ask the blunt questions – ‘Are you feeling suicidal?’ Let’s break the cycle and continue to share the message of hope and freedom.”
Available Resources
Atrium Health has several different suicide and behavioral health resources available to the community including:
Eagle Program: Atrium Health's Eagle Program is a peer support group that treats patients who have experienced their first episode of psychosis or have experienced thoughts of suicide in the past three years. Here, counselors help to give patients and their families all of the tools and resources needed on their road to recovery.
Behavioral Health call center (704-444-2400): Atrium Health provides a crisis intervention help line run by registered nurses and mental health professionals who are willing and able to lend an ear and provide counsel, 24-hours a day, seven days a week. Those clinicians who help answer the phone additionally provide the services and community resources available to help someone navigate their way. Help is only a phone call away.
Mental Health First Aid (MHFA): An evidence-based, eight-hour course, MHFA is a free class that teaches you how to identify, understand and respond to signs of suicide, mental illness and substance use disorders. After taking the class, people report that they have a better understanding of mental illness and feel more empowered to help others. If you are interested in signing up for a course, registration is available here.
Employee Assistance Program (EAP): Most employers provide an Employee Assistance Program that offers professional counselors to address substance and alcohol issues, as well as mental health, marital, financial, and prevention and wellness advice to all company employees.
Substance use outpatient treatment: With substance use heightening suicidal thoughts in those who are susceptible, Atrium Health offers a variety of services to help ease dependence on substances. Resources include: outpatient counseling, substance use assessments, an intensive outpatient program and a medication assistant program, which serves to reduce withdrawal symptoms if a patient is attempting to separate from substances.
