Talking About Suicide

Because it's not a taboo

New: National Strategy for Suicide Prevention

After what must have been an enormous amount of herding bureaucratic cats, the U.S. surgeon general and the National Action Alliance for Suicide Prevention have released the 2012 National Strategy for Suicide Prevention. It’s rich in information resources and includes a small nod to suicide attempt survivors, and I picked out the most interesting parts on that subject in bold:

“Objective 10.3: Engage suicide attempt survivors in suicide prevention planning, including support services, treatment, community suicide prevention education, and the development of guidelines and protocols for suicide attempt survivor support groups.

“Making a suicide attempt is a risk factor for later death by suicide. Promoting the positive engagement of those who have attempted suicide in their own care is likely crucial in successfully reducing risk for suicide. In addition, these individuals can be powerful agents for challenging prejudice and activating hope for others. Most successful suicide prevention strategies have used multiple components, but one underutilized intervention in suicide prevention has been peer support. Appropriate peer support plays an important role in the treatment of mental and substance use disorders and holds a similar potential for helping those at risk for suicide. Guidelines and protocols are needed to support the development of such services for those who have attempted suicide, as well as technical assistance to assist with the dissemination and implementation of these tools.”

I should add that I’m now on the Action Alliance‘s newly expanded task force for attempt survivors, which spent today talking about how we can use our experiences to reach out to others and generally make sure a suicide attempt or suicidal thinking can be unhooked from such unhelpful responses as secrecy, panic, contempt, disrespect, ignorance and shame. As the new national report puts it, smartly lifting a phrase from another long-fought battle over stigma, “This culture of ‘don’t ask, don’t tell’ can foster rejection, social isolation, and even discrimination if the suicide attempt is known.”

I was happy to hear the term “peer support” several times today, and I was happy to hear from some spirited, open-minded people. I expect to add more resources to this site soon.

The new national report’s sections on attempt survivors can be found on pages 63 and 110. One of the four main goals of the report is to “change the public conversation about suicide,” and another is to make a far better accounting of suicides and suicide attempts. I believe that will improve as stigma decreases and people are more open about accepting and saying for the record that a death is actually suicide, or that an overdose, for example, is actually a suicide attempt. Better numbers will give a better idea of how to track and target suicide as a serious health issue _ and, as the report points out, “not exclusively a mental health issue.”

The report, being focused on prevention, doesn’t get into any discussion of whether suicide is ever a considered, respectable action. Among its suggestions is promoting the goal of “zero suicides,” and it takes reading the smaller print to ease the concern that people who may insist on having control over the end of their lives are going to face stigma anyway. “Part of the zero suicides strategy may be for health systems to conduct a root cause analysis (a structured process used to determine the causes of an event) of suicide attempts and deaths, and to use findings to try to continuously improve service quality by focusing on systems issues rather than individual blame,” the report says. Emphasis mine again, and it’s not meant to be cranky. This national report is aiming at a widespread issue in which every case is deeply individual and never completely understood, and it makes sense that they’re trying for the best results for the largest number of people.

I don’t mean to get too into the weeds here. I’m reading through the report as I write this and am commenting on what looks intriguing. For example, in response to what must be a more vocal protest against forced psychiatric treatment, the report suggests delivering services in the “least restrictive settings,” as well as “non-coercive approaches” to people who fear the consequences of talking about suicide.

And, jumping back a paragraph to “systems issues,” I want to note that the report identifies middle-aged men as a high-risk group for suicide and then says that “there are no resources specific to midlife adult suicide prevention.” That seems like quite a gap, especially in these unhappy economic times and as the number of suicides among military veterans grows.

Take a look at the report _ and the wealth of websites and organizations at the end _ for an idea of how it may affect you.

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