Awareness, connections can save many lives

This is the last in a three-part series on suicide during Mental Health Awareness Month.

By KEITH COUSINS

Staff Writer

People trained in CPR and the Heimlich maneuver are responsible for saving thousands of lives each year.

For Paul Quinnett, clinical psychologist and founder of the QPR Institute, that fact begs another question: Why aren’t individuals similarly trained on assisting someone showing warning signs of suicide?

“This is a leading cause of preventable death and our nation is doing almost nothing about it,” Quinnett said. “What communities need to ask themselves is, ‘What do I do, how do I respond, and how do I get them the care they need?’”

In 2015, Kootenai County’s suicide rate — measured by looking at the total number of suicides per 100,000 residents — was 27.9, putting the county among the highest rates of suicide in the state. Although suicide ideation, attempts, and completion are not unique to any specific demographic, certain groups like teens, elderly, and military veterans are at higher risk.

“Things that can be done for these high-risk populations are not terribly costly,” Quinnett said. “You get connected, you stay connected, and you support each other.”

TEENS

Like many high schools across the nation, Post Falls High is actively engaged in combating student suicide, Principal Chris Sensel said. A primary reason teens are at higher risk for suicide idea and attempts, according to Sensel, is that they are making critical decisions without the necessary life experience needed to guide them through the decision-making process.

“Gener-ally, teens are in a situation where they don’t have a solution. They don’t have the background or experience to know that things will get better,” added Claudia Miewald, director of behavioral health at Kootenai Health. “They don’t want to die; they want to escape from the feelings of pain they are having.”

Staff members at Post Falls High School are trained to recognize the warning signs, a skill Sensel said is less about observing one or two factors and more about seeing a noticeable change in the behavior of the student.

If a change in behavior is noticed, Sensel said, the school immediately contacts the student’s parents so they can be involved in seeking resources and assistance. Outreach to parents, Miewald added, is an important aspect in addressing and preventing teen suicide.

“They need to understand that if they’ve noticed a big change in their teens — like failing grades or lack of interest in things they used to love to do — that’s a sign something is going on and there needs to be a conversation about the behavior,” Miewald said.

THE ELDERLY

In addition to typical risk factors of suicide, Miewald said other considerations come into play with the county’s elderly population. A diagnosis in an elderly person that is physically limiting, chronic, or terminal can lead directly to suicide ideation and attempts, she said.

Other individuals, she added, feel disconnected and devalued after retirement.

“They had a purpose; they had somewhere to go every single day,” Miewald said. “If that isn’t replaced with something, it can lead to feelings of isolation.”

According to Quinnett, if an elderly male’s spouse dies, he is 15 times more likely to kill himself. The most common driver for all suicides, Quinnett added, is untreated depression, which 85 to 90 percent of elderly adults who kill themselves have.

“They feel they are a burden on others,” Quinnett said. “If communities, this is all people across the board, simply increase their rate of connection and create that social connectivity, it’s one of the most promising ways forward for preventing late-age suicides.”

VETERANS

According to data from the Department of Veterans Affairs, approximately 20 veterans a day die by suicide. In 2014, veteran suicide accounted for 18 percent of suicides completed in America.

Veterans make up about 9 percent of the nation’s population.

“PTSD is a contributing factor, so is desensitization to death,” Miewald said. “A lot of veterans have been exposed to more death than the average person and that can be a factor.”

Heidi Lewis, a Kootenai Behavioral Health case manager, told The Press that in their work with the VA, they’ve learned that the high number of roadside bombings in recent conflicts has led to an increase in head trauma.

Head trauma, she added, can lead to mental illness and suicide ideation.

“Here’s the thing: you have to go to the veterans,” Quinnett said. “A lot of them, particularly men, are not going to walk into a clinic. But they will accept help if it’s offered to them.”

COMMUNITY

CONNECTION

At Post Falls High School, Sensel said staff and students are working to combat suicide before kids even start classes. During events for incoming freshmen and their parents, Sensel encourages teens to get involved in after-school activities like clubs and sports.

“They get a better sense of belonging, better grades, and have a larger friend group because of it,” Sensel added. “I can’t emphasize getting involved enough to them. You need that support network.”

Programs like LINK, which trains older students to mentor and assist their younger peers, also go a long way in eliminating the feelings of isolation that can often lead to suicide ideation.

Leonel Hoskinson, another case manager for Kootenai Behavioral Health, said they work with a lot of elderly individuals in the community. Two of the most critical aspects in assisting that group, Hoskinson said, are education and connection to resources.

“We help with care coordination, assessing needs, and reviewing options,” she added. “A huge goal when it comes to this group is figuring out what steps can be taken to get people feeling less isolated.”

More than 75 percent of elderly people who kill themselves, Quinnett said, saw a primary care physician within 30 days of their death. Due to that statistic, Quinnett said, an even greater emphasis must be placed on giving primary care doctors the right tools to recognize and prioritize the warning signs of late-life depression.

As an example of successful outreach to veterans, Quinnett cited an organization in New Mexico that brings a mobile coffee store to communities. Veterans and their families, Quinnett said, are able to go to the coffee shop and have valuable discussions with staff, who are also trained to recognize and help those who are struggling.

“The question communities must ask is, ‘How close are we to each other? Do people in the community have a sense of belonging?’” Quinnett said.

At Quinnett’s QPR Institute, community members and medical professionals throughout the world are trained in a method he developed over the course of a 30-year career at Spokane Mental Health. A foundation of the method is “QPR,” which stands for “Question, Persuade, Ask.”

The training, available online, allows individuals in “gatekeeper” positions — someone in a position to recognize a crisis and the warning signs that someone may be contemplating suicide — to identify and interrupt the crisis before directing that person to the proper care.

“The first thing you have to learn are those warning signs,” Quinnett said. “You need to know how to recognize them in a loved one.”

Common Warning Signs of Suicide

- Talking about wanting to die

- Looking for a way to kill oneself

- Talking about feeling hopeless or having no purpose

- Talking about feeling trapped or in unbearable pain

- Talking about being a burden to others

- Increasing use of alcohol or drugs

- Acting anxious, agitated or recklessly

- Sleeping too little or too much

- Withdrawing or feeling isolated

- Showing rage or talking about seeking revenge

- Displaying extreme mood swings

“The more of these signs a person shows, the greater the risk. Warning signs are associated with suicide, but may not be what causes a suicide.”

What to do if someone you know exhibits warning signs of suicide:

- Do not leave the person alone.

- Remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt.

Getting Help

- If you or someone you know is having thoughts of suicide or exhibiting warning signs:

- Call or text the IDAHO SUICIDE PREVENTION Hotline at 208-398-HELP, or

- Call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255).

- Take the person to an emergency room or seek help from a medical or mental health professional.

- The Northern Idaho Crisis Center is open 24 hours a day, seven days a week. It is located at 2195 Ironwood Court, Suite D, in Coeur d’Alene. The crisis center can be reached at (208)625-4884

Source: The Suicide Prevention Action Network of Idaho