The chair of the royal commission into the state’s #mentalhealth system has described as “totally unacceptable” the very high rate of #suicide for lesbian, gay, bisexual, transgender and intersex Victorians.
#LGBTI people have the highest rate of suicidality – which includes suicidal thoughts, plans and attempts – among any population in Australia, but the number of deaths is likely to be even greater because data on sexuality or gender identity is not consistently captured, the commission heard on Wednesday.
Ro Allen, LGBTI Commissioner at the Royal Commission into Mental Health.CREDIT:JUSTIN MCMANUS
Chairperson Penny Armytage told the commission that she was challenged by the #suicide rate for members of this community and “trying to think how we respond better … that’s totally unacceptable and it’s part of our terms of reference around #suicideprevention”.
JamesDonaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.#http://bit.ly/JamesMentalHealthArticle
Current figures show that LGBTI young people between the ages of 16 and 27 are five times more likely to attempt #suicide, transgender people over 18 are nearly 11 times more likely and people with an intersex variation over 16 are nearly six times more likely.
Gender and sexuality commissioner Ro Allen told the hearing that #suicide in the #LGBTI community was often hidden, and not consistently collected in police or coronial data.
“We have very, very bad data collection around this,” Commissioner Allen said. “I remember going to funerals of young #LGBTI people and families didn’t know they were queer; it certainly wasn’t recorded.”
Commissioner Allen said it was not a person’s gender identity, sexuality or intersex identification that was the cause of #mentalhealthillness, but the compounded discrimination they faced in everyday life.
Allen described “minority stress”; the experience of anticipating harassment or assault in everyday situations, and the lasting effect it has on #mentalhealth.
“We don’t wake up in the cot hating ourselves, it comes from somewhere,” they said. “[It comes] from #stigma about how we are labelled and identified, whether it’s through the media or through the recent postal survey which was a tsunami of attacks on our #mentalhealth.”
Suicide rates in the transgender and gender diverse community are higher than in any other group, the commission was told.
Dr Michelle Telfer, the Director of the Royal Children’s Hospital’s gender service said young transgender people faced two periods of highest #suiciderisk: when they come out, and the period between seeking medical care and actually being able to access it.
“In terms of social acceptance of trans identities, we’re still quite a long way behind the acceptance of the #lesbian, #gay and #bisexual communities,” Dr Telfer said.
When the service was originally established at the Royal Children’s Hospital, staff were concerned about the length of time patients were having to wait for access, and the hospital secured state government assistance.
The four-year funding agreement has just expired, but Dr Telfer said she was hopeful to get further funding. Patients are still triaged rapidly, but do have to wait to see a clinician.
The commission also heard there is a severe lack of expert #LGBTI clinicians and counsellors in Victorian rural and outer suburban settings.
Dr Ruth McNair, a GP at Northside Clinic, said she had patients come to the specialist clinic in North Fitzroy from more than 100 kilometres away because they didn’t have local services that understood their needs.
For help or information visit beyondblue.org.au, call Suicide Helpline Victoria on 1300 651 251, or Lifeline on 131 114.
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.#http://bit.ly/JamesMentalHealthArticle
A16-YEAR-OLD BOY, a high school athlete with good grades, told his therapist that he was thinking about taking his own life. That therapist, Dennis Kolsch, got him admitted to an inpatient ward. “He didn’t have a great experience in there, but he was safe,” said Kolsch, a licensed #mentalhealth counselor in Cocoa Beach, Florida. “The family felt comforted knowing that.”
“It’s kind of recognizing we’ve missed a trick in terms of utilizing the assets that are available within people’s communities.”
Teens leaving an inpatient program like this one will have discharge instructions on how to continue care, which usually includes medications and psychotherapy. The boy was discharged to Kolsch’s care, but Kolsch knew that weekly or biweekly therapy sessions were not enough. So he worked on getting the boy into an intensive outpatient program.
In the meantime, his parents were frantic. They didn’t want to let their son out of their sight, and felt they had to recreate the hyper-controlled structure of the hospital setting. It was all-consuming and exhausting. Further, the constant supervision was not helpful for the parent-child dynamic, which had been bumpy before the hospitalization and was now ramping up again. “The mom’s becoming overbearing and the son is withdrawing,” Kolsch said. “And then the mom gets worried because the son is withdrawing.”
Teens who have been hospitalized for a #suicide attempt or #suicidalideation are at heightened risk of dying by #suicide. A 2007 study, for instance, followed nearly 5,000 young people, from 15 to 24 years old, who sought care at a single hospital for “deliberate self-harm” over a 20-year period. Nearly 3 percent of study subjects died, and more than half of those deaths were likely #suicide — a rate that was 10 times higher than would be predicted for this age group. And the increased risk, research shows, can persist for years.
“We know that transition out of inpatient care is a particularly high-risk time period for #suicide and subsequent #suicide attempts,” said Michele Berk, a clinical researcher at Stanford University.
All of this suggests that where hospitalization provides effective crisis management in such situations, keeping young people safe back at home is a challenge that modern medicine has so far failed to solve. But a group of researchers at the University of Michigan has been working with a simple yet powerful tool that just might help: recruiting three or four familiar adults — not just the young person’s parents — who pledge ongoing support through recovery. The Michigan program trains both family and friends to become dedicated helpers and empathetic listeners — and to encourage their struggling charges to stick to the treatment plan.
The program is unique in both its approach and its results. The intervention is entirely focused on the adult volunteers, not on the child. (The teen’s only role is naming trusted adults.) And in a recent paper reporting a decade-long follow up of teens in the program, those who received the attention of trained adults in their lives were nearly seven times less likely to die than teens who received only standard care. The study was one of the largest #suicideintervention studies ever done, and it is the first clinical trial for #suicideprevention in high-risk teens that found a change in death rates.
“There has never been a study that shows a reduction in actual deaths,” said Dennis Ougrin, a child and adolescent psychiatrist at Maudsley Hospital in London. That’s true regardless of the type of intervention, Ougrin said, whether it’s a medication or psychotherapy or purely social, as this one is. “It’s very exciting.”
This sort of “social prescribing” is too-often the overlooked stepchild of mental health treatment, experts say, even though most psychologists believe that social connectedness is vital to psychological health. And in the context of rising suicide rates in American teens— alongside the failure of most interventions to affect long-term outcomes in high-risk teens — efforts to boost social connectedness are now getting some new attention from mental health professionals.
Of course, King’s results would need to be repeated in future studies to be fully corroborated, and there’s no call to adopt this type of intervention more widely — even by King and her colleagues. (The new paper is a secondary analysis of results measured 10 years after the study. That’s one reason King is cautious about her results.) But given the early signs and taken alongside other social-centric therapeutic approaches being used by researchers at Stanford University and elsewhere, some experts say a potent tool in combating teen #suicide might have been hiding in plain sight.
“It’s kind of recognizing we’ve missed a trick,” said Martin Webber, a professor of social work at the University of York, “in terms of utilizing the assets that are available within people’s communities.”
HISTORICALLY, IT HAS been extremely difficult to show a change in #suicide rates with enough statistical clarity to conclude a true change over chance or coincidence. That’s because actual rates of #suicide are low — even in high-risk groups, such as teens with a history of self-harm and hospitalization. This means that researchers need huge sample sizes to detect a true change.
Adults learn what to do in case of emergency, and how to be a nonjudgmental shoulder for the teen to lean on.
Psychologist Cheryl King and her University of Michigan team enrolled 448 people. About half — 223 — were prescribed coordinated support from friends and family on top of standard care, while 225 received only standard care. (Standard care consisted of psychotherapy and medication.) The combined cohort was large enough to detect a difference in overall death rates, though still insufficient to find a statistically significant difference in deaths attributable specifically to #suicide: There was one known #suicide among the intervention group, versus three in the control group.
But when King analyzed not just confirmed #suicide deaths, but also drug overdose deaths that were not labeled “accidental,” a pattern emerged. There was just one of these in the intervention group, versus eight in the control group — a statistically significant difference. All deaths occurred in adulthood, when subjects were at least 18.
The study made a splash on Twitter with prominent experts in the field. Peter Kramer, who authored the bestselling book “Listening to Prozac,” called the study a must-read. Allen Francis, who chaired the task force that authored the latest diagnostic manual for psychiatric disorders, wrote: “We’ve learned so very much, but still fail miserably in doing the simple things well.”
King started as a faculty psychologist on the adolescent psychiatric inpatient units at the University of Michigan hospital system in 1989. “More than half of the adolescents hospitalized were there because of #suicide risk,” she said. That clinical experience led her to develop the new intervention.
In King’s approach, teens nominate trusted adults — for example, parents, grandparents, aunts, uncles, family friends, teachers, and clergy — to serve as a support team. (Parents have veto power.) The adults then get an hour-long training session and weekly phone calls from King’s intervention specialists to talk about how things are going. They are cautioned to not feel responsible for the teen’s behavior — “We’re not asking them to be #mentalhealthprofessionals,” King said — but they agree to check-in with their teens once a week by phone, a face-to-face meeting, or an outing.
In the training session, which King calls psychoeducation, the adults learn about their teen’s situation — the specific diagnosis, the treatment plan, and the rationale behind them. They learn what to do in case of emergency, and how to be a nonjudgmental shoulder for the teen to lean on. Training sessions are variable and flexible, to satisfy the needs of the people in the room. “It’s kind of an open discussion,” King says.
“A lot of it is answering their questions,” she added.
The education and phone support arm the adults to act as informal caregivers, to stand up and support a child they know and who is at risk. Would this happen without training? It might, King and other experts suggest, but it’s easy to see why it might not. Suicide is scary and upsetting and adolescents can be difficult to talk to. It’s daunting to take responsibility for something like that.
The goal of King’s program, she said, is to make taking on that role less daunting.
As initially conceived, the study did not include deaths as a main outcome measure. That’s because of the numbers problem — #suicide rates so low that it’s practically impossible to show intervention effects. King did what most #suicide researchers do: She measured outcomes thought to be related to #suicidalbehavior. Does a particular intervention reduce thinking about #suicide or self-harm? Does a treatment program help teens function day to day?
Even with these more malleable measures, there are only a handful of randomized controlled trials — considered the gold standard of study design — and very few of them show any impact on #suicide-related behaviors, said Ougrin, who reviewed the scientific literature in 2015. Two otherreviews from the same year pointed to the benefits of involving families and social support.
“We were just trying to get an incremental benefit from a small add-on intervention.”
The family component is critical, said Stanford’s Michele Berk, who was not involved in the King study. “We don’t know yet exactly what factors lead a person at risk to attempt #suicide or die from #suicide at any given time, and we don’t know yet exactly how to help people best through treatment,” Berk said. “Sometimes the most effective thing I think we have is the parents and their ability to create a safe environment around the teen, in terms of restricting access to lethal means, close monitoring of the teen, being the one who can call 911.”
Berk has worked with a psychotherapy intervention called dialectical behavior therapy or DBT. In a 2018 study, she reported significant effects on #suicide attempts and self-harm with the intervention, which also included a dedicated family component. The key thing, Berk said, is being nonjudgmental. “One of the assumptions [in DBT] is that the teen is doing the best they can … So if they’re screaming at you or if they have hurt themselves — we’re not going to judge that,” she said. “We’re going to say, okay, in that moment they were operating at the top of their skill set. And our job is to teach them more skills so they can engage in more effective behavior.”
In addition to adjusting parents’ mindsets, Berk’s intervention helps mitigate the ways that family can be harmful. “Family conflict is a risk factor for #suicide in teens,” she said. “And family cohesion is a protective factor.”
Kolsch, the Florida therapist, agreed that King’s intervention seemed promising. “I think it’s a pretty brilliant approach,” he said. In addition to supporting teens who face so much risk when they go home, he said, it helps reduce the #anxiety and helplessness of the family. (Kolsch’s patient — the boy he had admitted to inpatient care — is now in college and is doing well.
All the participants in the King study received standard psychotherapy and medications, and these mainstays likely contributed to improvements observed in both the intervention and the control groups. “It is difficult to change youths’ trajectories,” she said.
“We were just trying to get an incremental benefit from a small add-on intervention,” she added.
King says her intervention team had long felt like they were having meaningful impacts on families’ lives, but they didn’t observe measurable changes in any potential predictors of #suicidalbehavior, such as ideation. So how to explain the big effect on death rates? “You know, small effects can have ripple effects,” King said, Perhaps the supporting adults facilitated teens sticking to treatment plans, she suggested, or maybe they helped teens make one or two better behavioral choices.
The University of York’s Martin Webber sees two key elements working together: “There’s the direct effect of social support on that person’s #mentalhealth. We know that from existing studies that has an effect,” Webber said. “But there’s the indirect effect of engaging with treatment which is obviously happening as well.”
Past research has shown that people with more connections, stronger social networks, and more social support will be better off in terms of #mentahealth. And yet, it’s one thing to say people who have more social connections are less likely to die by #suicide — it’s quite another to create and foster those social connections. On that front, Webber noted that the teens in King’s program were able to choose who they wanted supporting them. “We know from relationships that where people are foisted upon them — and this often happens in professional relationships — it kind of nullifies that as a source of support,” he said.
To be sure, the scientific literature on social prescribing remains tiny compared to research on medication and psychotherapy. Several thousands of children at risk of #suicide have participated in various studies of pharmacological and psychological therapies. “We don’t have the evidence base of the social support-type interventions to put alongside those,” Webber said. Also, standardizing social interventions is tricky, he added, especially when compared to the simple act of taking a pill.
“Sometimes the parameters are a bit broader,” Webber said.
“If they’re screaming at you or if they have hurt themselves — we’re not going to judge that.”
At the same time, Webber pointed out that social components are always present. “The role of the family support, the role of friends, the role of people who are not necessarily professionally qualified to deliver any therapy, care, or support” — these things are active ingredients in any person’s treatment. And even in a research study, these social components can contribute to positive effects in both intervention and control groups, though they’ve traditionally been overlooked by researchers seeking to measure the benefits of drug treatment or psychotherapy alone.
According to Berk, #suicide prevention has got to be comprehensive. Rather than just providing psychiatric treatment, she said, there are issues that need to be addressed at the community and social relationship level.
“The more fronts of intervention we have,” Berk said, “the better.”
If you or someone you know are in crisis, please call the #NationalSuicidePreventioLifeline at 1-800-273-TALK (8255), or contact the Crisis Text Line by texting TALK to 741741.
Jill U. Adams is a science journalist who reports on health, psychology, teens, and education. She lives in upstate New York and tweets as @juadams.
A slow down in the economy, job losses, business closures, increasing energy bills: it’s not surprising that relentless negative reporting of economic downturns is impacting people’s emotional health.
#JamesDonaldson notes: Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes. Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use. Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.#http://bit.ly/JamesMentalHealthArticle
Our new research shows that these types of messages can seriously impact people’s #mental well-being. And that when indicators of national economic performance are poor there is typically an associated rise in the #suicide rate.
It’s already well known that #suicide rates increase in times of economic strife and uncertainty. Previous research estimates that the 2007 economic crisis in Europe and North America led to more than 10,000 extra #suicides. And findings from last year show that #suicides increase both in years of significant stock index decline and in the year that follows it.
Austerity measures such as welfare and health spending cuts have also been identified as the cause of “spikes in suicide rates” among certain demographic groups. There is also evidence that a country’s suicide rate is associated with its maturity or stage of economic development (growth) – with increasing male #suicide rates in even the most prosperous developed countries. This suggests that the path taken to increase income over time has negative #mentalhealth effects on countries.
Sentiment and suicide
In our latest study, we used data from the US that took into account the 2007 financial crash and global financial crisis. We explored how such economic factors translate into higher #suicide rates. Departing from earlier studies on this topic we explicitly considered “consumer sentiment” –- this is the emotional way in which people perceive their economic situation to unfold, such as expecting to lose their job. We used the Consumer Sentiment Index to measure people’s perceptions of their financial situation and the economy in general.
We found a strong correlation between the way in which people view their economic situation and the average #suicide rate. So the more negatively people view their prospects, the higher the likelihood of #suicide. The data showed how the average #suicide rate increased significantly in the aftermath of the financial crisis for all sex and age groups – though this effect was found to be stronger for females than males.
Our findings suggest that consumer sentiment plays a significantly greater role in explaining variations in the #suicide rate compared to traditional indicators such as income and employment figures. So it would make sense that constant negative announcements – such as high unemployment, rapidly rising prices, and increasing business failures – can have an impact on mental well-being. Ultimately, these relentless messages depress consumer sentiment and raises #suicide rates.
Our statistical work, however, also shows that a 10% increase in the Consumer Sentiment Index reduces #suicide rates by 1%. So the results show that a more positive outlook on personal finance and the economy in general can actually reduce #suicide rates.
Reporting the facts
We also tested the impact of increased spending in #mentalhealth provision in the US and found no evidence to suggest it lowers #suicide rates. This is likely due to other public spending categories, such as in education and employment, being even more important to #mental well-being than state level #mentalhealth spending.
Clearly, it is incumbent on news media to report honestly and frankly on the state of the economy. Yet rarely is consumer sentiment explicitly recognised as contributing to potentially serious #mentalhealthissues.
So in the same way that many media outlets aim for sensitive coverage of terrorism, gun crime and natural disasters to avoid unwanted panic, responsible media communication of issues relating to the economy should also be considered. This could offer balanced reporting that is mindful of #mentalhealth and well-being.
Rarely is it reported in economic news coverage, for example, that downturns are always followed by upturns. Cyclical patterns in economic performance are perfectly normal and to be expected. And in this sense, they can be good times to exploit training and education opportunities in advance of the next upturn.
#JamesDonaldson notes: Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes. Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use. Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.#http://bit.ly/JamesMentalHealthArticle
Greg Abbott, the governor of Texas, said Saturday’s #massshooting by a gunman who opened fire in an El Paso mall was a hate crime.
Twenty-five years ago, I was part of Maryland’s progressive gun violence prevention movement. My then-spouse had been shot in the head during a robbery in Baltimore. His high-profile shooting helped to harness the energy of an emerging group of people distressed by the rising number of gun-related murders, accidents and #suicides.
Back then, we felt certain handgun violence could be prevented by reasonable gun control laws. We looked to Canada and European countries as places where life was valued above gun sales. Surely, we thought, common sense would prevail. We advocated for the elimination of straw gun purchases and the use of gun safety locks. We held hope in the emerging technology of fingerprint scanning that would limit the use of a handgun to its registered owner.
A law enforcement officer stands guard outside the Walmart
We were hopeful even as parents lost children through guns — young men killed on the streets of Baltimore, children accidentally killed by handguns “hidden” in dresser drawers and teens who killed themselves with guns. My colleagues and I were on the front line of phone calls from parents whose children were yet to be buried; we were called on to request the return of bloody clothes held as evidence by law enforcement. Over time, political might won over bullet-ridden bodies, and America’s stomach for gun violence prevention waned — as did our hope for a less violent society.
Thirty killed in two mass shootings this weekend. Two hundred murdered in Baltimore this year. Sixty-five gun #suicides per day in America.
Are we now angry enough to change the uniquely American tragedy of gun violence?
Today, nearly two-thirds of gun deaths are #suicide. Accessibility of guns is contributing to #suicide among teens, veterans, law enforcement and older people — representing nearly every part of our society. #Suicide is private and quiet. #Massshootings are public and horrific. In cities such as Baltimore, gun violence is unrelenting. Children receive trauma care and practice school lock downs.
On the local news this weekend, a pediatrician discussed how parents engage in age-appropriate discussions with their children about mass shootings. He advised that, much like fire safety plans, families should develop a communication plan in the event of a public shooting.
Cathe Hill cries during a vigil for victims of Saturday’s mass shooting in El Paso. “There’s no such thing as a stranger here in El Paso,” Hill said of the effect the shooting had on the community.
Our lives have changed to adjust to the ramped-up reality of guns in our country. In recent years, I have witnessed armed guards at the sacred places of Ebenezer Baptist Church in Atlanta and the National Cathedral in Washington, D.C. Is this from an abundance of caution or a statement about the reality of the world we live in? Either way, it is painfully uncomfortable to accept this as a way of life in a country founded on the principles of liberty and justice.
The culture of gun violence cannot continue. In the past 25 years, we have shifted our cultural norms about drunk driving, seat belt use and bike helmets. With each issue, Americans changed their attitudes and practices for the sake of common-sense safety. The same can be accomplished with guns in America. We must act to protect the lives of those we love.
Here are some steps to move the needle:
1. Do not keep guns unlocked or unsecured in your home. Your children and teenagers will find them. They can easily inflict harm on themselves and others. Ask friends and relatives to do the same. To learn more about suicide, visit the #AmericanFoundationforSuicidePrevention at www.afsp.org.
2. Advocate for the availability of #mentalhealth resources at schools and other local places. Learn more from the non-profit #MentalHealthAmerica, www.mentalhealthamerica.net.
3. Work to ensure gun violence prevention is a top priority for your elected officials. Learn about state gun laws at www.everytownresearch.org.
“We cannot let those killed in El Paso, Texas, and Dayton, Ohio, die in vain,” the president tweeted Monday. “Likewise for those so seriously wounded. We can never forget them, and those many who came before them.”
He neglected to say: And the many who will come after — if we don’t act. Now.
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.#http://bit.ly/JamesMentalHealthArticle
Author: Brittany Falkers
PORTLAND, Ore. — #Mentalhealth crisis incidents are not necessarily increasing in Portland, but they are not slowing down either, according to Portland Police.
“Our ECIT officers are called upon every day. Sometimes it’s not as drastic, sometimes it’s not as public, but they are truly out there making a difference every day,” said Sgt. Brad Yakots with Portland police.
The ECIT, or Enhanced Crisis Intervention Team, in Portland includes 70 officers with specialized training to gain rapport and work with someone in a #mentalhealthcrisis. Every officer in the bureau receives at least 40 hours of mental health crisis training, but these officers get 40 additional hours as well as refresher training throughout the year, according to Yakots.
They were there last Friday when police shut down parts of Interstate 84 for about eight hours. A man stood on the Northeast 12th Avenue overpass, preparing to jump into traffic the below, according to police.
Then, Sunday morning, police shut down the Steel Bridge downtown for over three hours. There, a woman suffering from a #mentalhealthcondition and was throwing objects onto the pavement.
“There’s a person, there’s a human being, there’s a loved one up there,” Yakots said. “That’s why we take the time to build that rapport to get them down safely.”
In both incidents police were able to safely bring these people back to the ground without injuries.
It caused a traffic nightmare for many, frustrating commuters trying to get around town. Portland police do work with transportation partners to ease the traffic impact, but when a life is on the line the way police respond cannot be rushed.
“By and large it’s patience, it’s building that rapport, talking slow, letting the person digest what the officer is telling them,” Yakots said. “And then, we’re very, very successful in getting that person back over the railing.”
Police got the people involved in both incidents to a hospital to be evaluated. But tackling mental health issues starts with the community, before it gets to the point of crisis.
“We know that there’s hope. We know that there’s recovery and we know that interventions can save lives,” Deborah Zwetchkenbaum with Lines for Life said.
Lines for Life is a local nonprofit dedicated to preventing substance abuse and #suicide. Zwetchkenbaum works with their crisis intervention line and says being part of the solution starts with being aware and listening to those around you.
“When we can slow down enough to really just give that person a chance to tell their story, to let that pain out and – even if we can’t change anything about their circumstance,” she said. “If we can really hear them and acknowledge their feelings and let them know we see them – I see you, I hear you, I care. That message can save lives.”
#TheNationalSuicidePreventionLifeline can be reached at 800-273-8255. The Crisis Text Line provides free, 24/7 crisis support by text. Text 741741 to be connected to a trained counselor.
Help is available for community members struggling from a #mentalhealth crisis or suicidal thoughts. Suicide is preventable.
The Multnomah County Mental Health Call Center is available 24 hours a day at 503-988-4888.
If you or someone you know needs help with #suicidal thoughts or is otherwise in an immediate #mentalhealth crisis, please visit Cascadia or call 503-963-2575. Cascadia Behavioral Healthcare has an urgent walk-in clinic, open from 7 a.m. to 10:30 p.m., 7 days a week. Payment is not necessary.
Information about the Portland Police Bureau’s Behavioral Health Unit (BHU) and additional resources can be found here.
By Aaron Hunt, MS (Graduate Intern, APA Health Disparities Office) and David J. Robles, BA (Graduate Intern, SAMHSA Office of Behavioral Health Equity)
From 2001 to 2015, the #suicide risk for #Black #boys between the ages of 5 and 11 was two to three times higher than that of #White boys, according to a new research letter in JAMA Pediatrics (Bridge, 2018). This concerning trend continues through adolescence as reported by the Nationwide Youth Risk Behavior Survey (Kann et al., 2017). The rates of attempted #suicide, including attempts that resulted in an injury, poisoning, or overdose, are 1.2x higher among #Black #males compared to White males.
These persistent trends are enrooted in life expectancy disparities that Black boys face. The APA Working Group on Health Disparities in Boys and Men recently released a new report on Health Disparities in Racial/Ethnic and Sexual Minority Boys and Men, which includes a review of research which may help to explain this increase in #suicide in Black boys.
JamesDonaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.#http://bit.ly/JamesMentalHealthArticle
Recent national conversations on suicide have gone past the usual “reach out if you need help” messages to encouraging friends and family to reach out to individuals that they think might be suicidal or struggling with depression. This is undoubtedly important, but to do this, people need to know what depression looks like. According to the APA report, even professional health care providers have trouble detecting depression among racial/ethnic minority patients. Men from these groups are diagnosed with #depression less often than non-Hispanic white males, and #depression may also present itself differently in males as irritability, anger, and discouragement rather than hopelessness and helplessness.
The unique way that depression presents itself in males combined with the underdiagnoses of men of color with depression may intersect to cause further disparities for Black boys. The APA report discusses how Black boys are more likely to be viewed as older, less innocent, and more culpable than others—biased beliefs that may lead to harsher interventions in school starting as early as pre-kindergarten. In fact, Black boys are over three times more likely to be suspended from school than White students. These disparities combined with a lack of awareness about what #depression looks like in men and boys of color may lead to social reprimand, school suspensions, and expulsion rather than to the #mentalhealth care that they need.
Young men of color are also more likely to be caught up in the school-to-prison pipeline as a result of these experiences. Black male high school students are also more likely to miss school due to feeling unsafe in their classroom environment or community, get in a physical fight in or outside the school setting, be a victim of sexual violence, and be a victim of physical dating violence (Kann et al., 2017). These risk factors remove what might otherwise be protective factors found in school or close social relationships.
There is clearly a need among national conversations of #suicide for understanding how the role of masculinity, beliefs and social norms intersect to explain the disparities in health and well-being. As science advances there is a growing body of literature, but also a growing number of questions. Now is the time to leverage the tools and opportunities to make a difference and possibly save a life.
Although Black boys may face unique challenges, most racial/ethnic minority boys and men, as well as their families and communities, are resilient and seek positive growth and health. Having a greater sense of control over social and political forces, culturally responsive interventions, healthy cultural identities, and less rigid notions of masculinity show promise for helping racial/ethnic minority males become more resilient to depressive symptoms. Specifically, helping adolescents learn to display self-control over their emotions, talk with parents or friends, seek help, and have positive relationships with adults can help to build resiliency.
What can we do to reduce #depression-related health disparities in boys and men of color?
Teachers should take continuing education courses on cultural bias and depression in Black boys to help address the problems they face in a school setting.
Clinicians need to stay up to date on best practices in working with racial/ethnic minority boys and men to make sure that they are not missing signs of #mentalillness.
Researchers should continue to study health disparities in boys and men of color as well as how resilience can be formed at a young age and strengthened through the life-course.
Community members should consider how to create protective factors for vulnerable boys in their communities (e.g. mentoring opportunities, after-school programs)
Policymakers should consider legislation, regulator, and administrative actions for vulnerable boys, and seek to remove systemic structures that marginalize boys and men of color (e.g. disparities in school discipline, school-to-prison pipeline).
Everyone can work together to eliminate the persistent exposure to implicit biases and microaggressions in settings where boys and men of color live, learn, work, play, and seek healthcare.
For information on how to promote the behavioral health of boys and men of color and how to use prevention research to guide practice:
Look out for an upcoming blog post related to the health disparities in sexual minority men and boys sections of the APA report.
References:
Bridge, J.A., Horowitz, L.M., Fontanella, C.A., Sheftall, A.H., Greenhouse, J.B., Kelleher, K.J., Campo, J.V. (2018). Age-related racial disparity in suicide rates among U.S. youths between 2001 and 2015. JAMA Pediatrics.
Kann, L., McManus, T., Harris, W.A., Shanklin, S.L., Flint, K.H., Queen, B., Lowry, R., Chyen, D., Whittle, L., Thornton, J., Lim, C., Bradford, D., Yamakawa, Y., Leon, M., Brener, N., Ethier, K. (2017). Youth Risk Behavior Surveillance—United States. MMWR Surveillance Summary, 65, 1-174.
Biographies:
Aaron Hunt, M.S. is a summer graduate intern in the APA Health Disparities Office and a rising second-year Ph.D. Clinical Psychology student at George Mason University. While broadly interested in the intersection of clinical psychology with health, community, and social equity, Aaron has specific research interests in HIV, stigma, bias, disclosure, and social disparities. In addition to full-time graduate studies, Aaron is also an adjunct professor at a local community college and a proud member of the APA’s Health Equity Ambassadors program.
David J. Robles, B.A. is a summer graduate intern at the Substance Abuse and Mental Health Services Administration (SAMHSA) in the Office of Behavioral Health Equity (OBHE) and a second-year M.A. Psychology student at California State University, Los Angeles. David is broadly interested in studying the psychosocial processes underlying HIV, substance use disorders and psychiatric diagnosis among underserved communities and related behavioral health disparities. David’s graduate work is supported in part through a RISE NIH M.S.-to-Ph.D. Graduate Fellowship. David is also the Vice President for the MORE Programs Student Advisory Committee, a Campus Representative for the APA’s Society for Health Psychology and was recently selected as a Sally Casanova Pre-Doctoral Scholar.
Lawmakers and medical professionals need to help curb the #suicide risk for older adults living in long-term care, a new study shows. File Photo by C Levers/Shutterstock
JamesDonaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.#http://bit.ly/JamesMentalHealthArticle
June 17 (UPI) — Lawmakers and medical professionals need to help curb the #suicide risk for older adults living in long-term care, a new study shows.
The research, published Monday in JAMA Network Open, highlights the importance of providing emotional well-being and other #mentahealth care services to adults over age 55 who live in, or are thinking of moving into, nursing homes and assisted-living facilities.
“There are things we can do to promote the emotional health and psychosocial well-being of people who are living in long-term care facilities or are transitioning into them and their family members,” Briana Mezuk, a researcher at University of Michigan’s School of Public Health and study lead author, said in a news release.
For the study, the researchers used a computer algorithm to examine data from police and medical examiner reports on 47,759 #suicide deaths of people over age 55. The data was collected between 2003 and 2015.RELATED Deaths from drug ODs, suicide soaring among millennials, report shows
Through that time, more than 1,000 of those #suicide deaths occurred in long-term care settings. Among that group, 428 adults committed #suicide while living in long-term facilities and 449 were transitioning into or out of long-term care, researchers say.
Beyond patients, 160 adult caregivers helping elderly family members in long-term care or during recovery from a hospitalization, also took their own lives. The study suggests these relatives may have felt stress or fear from the financial burden of providing long-term care.
“We need to be supporting interventions to promote the emotional #health of people in their 60s or 70s, 80s and 90s, even if they also happen to have diabetes or they happen to have mobility problems,” Mezuk said. “#Suicide is a very extreme outcome; it is the tip of the iceberg.”RELATED Epilepsy drug linked to increased suicide risk in young people
Adults between age 45 and 54 make up 20.2 percent of the suicides in the United States, but rates for people over age 85 come a close second at 20.1 percent, according to the #AmericanFoundationforSuicidePrevention.
“We have a diverse set of tools and techniques for promoting emotional #health of older adults and thus reducing #suicide risk; they aren’t being implemented to their fullest degree,” Mezuk said. “Our analysis helps illustrate the importance of addressing this gap.”
