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David Fox

An ounce of prevention: What we can do to reverse the alarming suicide trends

In this National Suicide Prevention Month of September, learn how you can help, for your call may be what stops a loved one from lethal self-harm
Illustrative. Depression. (iStock)
Illustrative. Depression. (iStock)

Every 11 minutes, a death occurs by suicide in the United States. According to the CDC, suicide is the second leading cause of death for people ages 10 through 14 and 25 through 34. In recent years, staggering increases have been reported across the spectrum of age, ethnicity, social mobility, gender, and marital status. From 2000 to 2018, suicide rates increased by 30 percent. But there is more than just one victim in the case of suicide. The impact on family, friends, and community following this tragic loss is deep and enduring.

Indeed “survivors” among loved ones can be riddled with guilt and frequently dwell on thoughts and feelings that they could have said or done something to stop that fatal decision.

September is Suicide Prevention Month and an important reminder that we, as a society, must address this critical issue and offer preventative and protective measures for families and friends of those who struggle and may pose a risk to themselves.

An individual suffering from depression is 20 times more likely to die by suicide than someone without the disorder. When an individual has a pre-existing mental health disorder, it is important that family members be educated as to whether that condition is one that presents a potential risk for self-harm. Not every disorder or specific case is linked to suicidal urges or ideas, but a mature family member can inquire from a skilled professional on how to communicate and how to detect signs associated with escalating distress or encroaching mood changes. Together they can devise avenues for notifying the treating professional when evidence of deterioration or other worrisome signs may emerge. Psychoeducation of this type can be a key to staying attentive and alert, and for preventive, protective intervention.

Job stress, work overload, and burnout are other factors that have been associated with some who engage in lethal self-harm. Here, as well, family members should obtain guidance on how to help facilitate greater self-awareness, self-expression, and identification of pressures that may impinge on the mood and clarity of the one in danger. When those close to the one suffering can validate the reality of external stresses and their role in triggering internal distress, this can help to reduce feelings of despair, failure, and hopelessness. It can help normalize the sense of turmoil and turbulence and can be an antidote for some who have contemplated suicide.

Seeking specialized professional help for those with addictive behaviors which can correlate to suicidality, such as drug or alcohol abuse, can be the most valuable ounce of prevention. While some choose to avoid seeking help due to social stigmas, that is certainly not a strong enough argument to deny potentially saving a loved one’s life.

Impaired relationships, divorce and separation, and social isolation are also things to consider. We are living in a post-COVID world where isolation and reduced contact with others have led to depression and anxiety. At the same time, we live in a technologically-saturated yet often interpersonally starved work and school environment. Reaching out, expressing interest in another’s wellbeing, sharing gratitude, and even greeting others might be another facet of reducing the intense loneliness associated with resignation to perceived stress and misery, and contemplating death. Family and friends can step up to provide the functional relationships which may be missing among those who feel socially alienated.

Shame is a two-way street. The shame of feeling unable to cope can underlie thoughts of giving up on life. Yet the shame of being a survivor of someone who ended their life can precipitate their own withdrawal and isolation. Supportive family members must be made aware of the importance of destigmatizing the need to engage in professional help. Ensuring that all members of the inner circle obtain guidance on how to reinforce the recommended treatment guidelines may be a key to breaking through the shame barrier which can obstruct recovery. Those survivors who look back and know that they took steps to facilitate help are less likely to experience their own high degree of shame. Those who display acceptance, encouragement, respect, and empathy may lessen the feelings of shame in the despondent family member.

So often, in the retrospective history-taking of those who committed suicide, signs of earlier trauma surface, or were apparent early on. Treatment of trauma is a complicated process, and the effects on cognitive, affective, and physical dimensions of personal functioning when one is or has been a victim of trauma, specifically unprocessed and untreated trauma, can fester for years. Trauma within the family must be addressed by drawing on all the therapeutic, medical, legal, and psychoeducational resources needed to intervene, and problem solve. Loved ones can take prospective measures by encouraging struggling individuals to seek support and resources from skilled mental health professionals, trusted mentors, competently trained clergy, and stable friends.

The difficult news is that there are some individuals who seem driven to suicidal ideas, planning, and self-harm. At times they may be beyond the caring reach of the most skilled professionals and surrounding loved ones. But the inquiry of the caring family as to the frequency of those thoughts, the concreteness and realism of that plan, and the presence of prior self-harm may be the only prospective data available, and the call for help by loved ones may be the only option. A measure of prevention may offer a ray of hope for reversing these tragic trends and diminishing the prevalence of painful statistics.

About the Author
Rabbi Dr. Dovid Fox is the director of interventions & community education for Chai Lifeline's crisis intervention services.
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