Suicide: Responding to a growing crisis

COEUR d'ALENE — According to a Centers for Disease Control and Prevention report released Thursday, suicide is on the increase across the nation. Nearly 45,000 Americans killed themselves in 2016. The study of suicide rates in each state from 1999 to 2016 found that suicide rates in rural western counties are among the highest in the nation.

“The highest rates across the time period were seen in parts of Alaska, Arizona, northern California, Colorado, Idaho, Montana, New Mexico, Nevada, North and South Dakota, Oregon, and Wyoming,” said the report.

Significantly, 54 percent of those who took their lives did not have a known mental health condition, said the report.

BITTER STATISTICS

The Suicide Prevention Action Network said that in 2016, Idaho had the eighth-highest suicide rate in the nation. In addition, “Suicide is the second leading cause of death for Idahoans ages 15-34 and for males up to age 44,” said SPAN.

Data for the Coeur d'Alene region's public health district showed that in 2016, the state's northernmost counties had a suicide rate of 16.1 per 100,000 population. That translated into the second-lowest suicide rate of the state's seven regions, with the Lewiston region being the highest at 32.4 per 100,000. When averaged over five years, however, the northernmost region ranked third-highest in the state, with 21.4 suicides per 100,000 population. There were 144 deaths by suicide in Kootenai County from 2012 to 2016, according to SPAN data.

When Kootenai County Sheriff's Office deputies respond to calls involving the potential of suicide, “Our goal is to always preserve life and to help those in need find the resources properly equipped to help them through their situation,” said Det. Dennis Stinebaugh. Suicide-related calls take priority. However, due to a person's remote location or presence in a moving vehicle, locating the person can sometimes be difficult, said Stinebaugh.

When deputies make contact with the person in question, Stinebaugh said, “We do our very best to open a positive dialogue and establish a positive rapport with the person. We then evaluate the seriousness of the allegation, which occasionally have been misunderstandings.”

If the person is in need of help, deputies refer to Idaho Code 66-326, which allows them to temporarily detain the person and deliver them to Kootenai Health, where they can be examined by a health professional. A determination is made within 24 hours of being detained, he added.

So far this year, the sheriff's office has put 33 people in protective custody, according to KCSO records. Last year, 85 people were put into protective custody, up from 45 in 2016.

SCHOOLS STEP UP

The Coeur d'Alene School District has suffered from suicide this year. In just the last two months, a former principal, a former coach, a freshman student and a middle school student all took their own lives.

School officials held many QPR (Question, Persuade, Refer) sessions to help community members steer their loved ones away from self-harm. For the school district to have its own resident QPR instructors, and to multiply the number of QPR sessions held in the district, some health teachers and all 15 nurses will learn how to instruct new QPR trainers, said district lead nurse Nichole Piekarski. One measurable outcome will be that those trainers will themselves train all of the district's 3,421 high school students in QPR before the Christmas break next year, said Piekarski.

The district uses “Cope to Thrive,” an individual-based program, at therapeutic classrooms in Venture High School, Lakes Middle School and Winton Elementary School. District spokesman Scott Maben said the district is looking into adding it as a zero-hour elective at Coeur d'Alene High School and Lake City High School.

Another tool in the school district's toolbox is the “Sources of Strength” program, which teaches students to look at eight distinct areas in their lives from which they can derive comfort and encouragement. By showing them to lean on more than one source, such as family, faith, positive friends, health care, and generosity, students can become more resilient when faced with life's challenges, said Piekarski.

Lakeland School District Superintendent Becky Meyer is passionate about building up resilience to prevent suicide. Students and parents in her school district have taken their lives in the past two years.

“We need to be concerned about people's mental health, effectiveness as a person, health and stability — and not just measure student data,” said Meyer.

Building up resilience skills and long-term thinking is a key to solving the systemic problem of suicide in the community, said Meyer.

Every single staff member, from teachers to bus drivers to custodians, will have completed QPR training by mid-June, Meyer said. The district dedicated its in-service day last October to suicide prevention. Speakers who had lost loved ones, followed by small group breakout sessions, made a big impact, Meyer said. Recently, the district's Life Awareness Community Coalition held its first relay run, which drew more than 300 people for a 15.5-mile run from Timberlake High School to Lakeland High School.

In addition, the district has formed a memorandum of understanding with Heritage Health to get mental health therapists in the schools. The service is there for students and families who need multiple sessions to work through a mental or emotional health issue, said Meyer. Students need parental consent to see the therapists, she said.

The Coeur d'Alene School District is beginning similar discussions with Heritage Health. Piekarski said more than 100 people sought counseling within a 24-hour period last week after a student took his life. Cumulatively, hundreds of students and staff have used the service during the 2017-18 school year, she said.

The Post Falls School District “will have suicide awareness and prevention training for all school personnel prior to the start of school,” said Dena Naccarato, assistant superintendent for secondary schools.

As described by Columbia University professor Kelly Posner in a Feb. 7 USA Today opinion piece, screening people for suicide is another way communities can work to prevent suicide. According to Posner, the U.S. Marine Corps has equipped support personnel with such a screening tool since 2014, which contributed to a 3.5 percent decrease in suicide since then. She also pointed to results by outpatient provider Centerstone in Tennessee, which in just 20 months saw a drop from 3.1 suicides per 10,000 population to 1.1 suicides per 10,000.

Piekarski and director of secondary education Trina Caudle are forming an interdisciplinary team this summer to evaluate the many screening tools available. The team will select one tool and establish protocol for follow-up by early October, Piekarski said.

FAITH and HOPE

Pastor Tim Remington of The Altar, a church in Coeur d'Alene, has a lot of experience dealing with people who have attempted suicide. The Good Samaritan program, which helps addicts get clean and get back on their feet, draws many people into his congregation. Up to 25 percent of his congregants say they have attempted suicide, he said. The common theme in their drive to self-destruction is a lack of hope, said Remington.

Providing hope comes in concrete form. One step is to shift their focus away from their present pain to a form of constructive activity. Another key is to have somebody to lean on in the dark times, he said.

“Normally, if you provide them with something to do for a period of time and somebody to walk with them, it'll save their lives,” said the pastor.

Remington said that by showing people God has a purpose for them that is bigger than their pain, they can make it through rocky stretches because their hope is not limited by the here and now. A common long-term goal is the healing of broken family relationships, he said. The thread that ties it all together is the hope of eternal life.

“The hope is Jesus,” said Remington.

Katherine Hoyer, spokesperson for Panhandle Health District, said public perception of suicide needs to change.

“Just like we wouldn't allow our friends or family to drive drunk, we want to encourage people to step in and help someone who may be depressed by ‘taking away the keys,'” she said. “That means locking up the lethal means they have available to them like firearms or opioids. We hope to reduce stigma around mental health and raise awareness of the resources available. It's OK to step in and ask someone if they need help and it's OK to ask for help yourself.”

Remington said there's something else society does today that is not helpful with regards to suicide prevention. Years ago, he said, the community would mourn and regret the suicidal person's act of self-murder. Today everyone utters a cliché: they're in a better place now.

“For the past 20 years, there has been a watering down of truth. We can't determine where a person is,” he said. “We don't know their hearts. We don't know what happened right before they died.

“All you hear is ‘They're in a better place.' What do you tell another 700 students in a high school going through a tragedy when that particular person has committed suicide? We have to tell them the truth. The truth is we don't know. What that person did was wrong. It hurt so many people. It's a tragedy. It's not good. Nobody's in a better place because of that. There is no better place for someone who commits suicide. We have to stop promoting that if you kill yourself, then you'll be in a better place.”

By perpetuating the misleading cliché, society facilitates more people attempting to take their lives, said Remington.

“We have to stop any type of theology that says anybody would be in a better place by destroying themselves and everybody around them,” he said.

Among the resources available for those contemplating suicide, said Hoyer, are:

• The North Idaho Crisis Center, which is open 24 hours a day to anyone and is completely free

• The Rock Your Role help lines 208-398-HELP (call or text)

• Free QPR trainings

• St. Vincent de Paul and the Mental Health Referral & Community Resource Guide from the Crisis Intervention Team of Idaho

• North Idaho's SPAN chapter holds suicide prevention training, awareness campaigns, media education and other activities. SPAN will hold its 10th annual SPAN 5K walk on Sept. 22.