“Our suicide prevention efforts do take place within a broad public health context,” he says. “Ideally, we’d like to be able to prevent people from becoming suicidal in the first place.”
A program called the Good Behavior Game, which was awarded $11 million over five years by SAMHSA and is designed to identify early behavioral health problems is one initiative McKeon points to as having an impact on catching people upstream. It’s used in 22 economically disadvantaged school systems across the country and has been cited as effective by the Institute of Medicine. The Garrett Lee Smith Memorial Act is used to fund youth suicide prevention programs as well and has been described as successful at raising awareness by peer-reviewed journals like Suicide and Life-Threatening Behavior.
“A lot of the work we do is aimed at identifying youth who are at most serious risk right now,” he says. “We are dealing with a lot of high-risk situations among very vulnerable people, but there’s also solid scientific basis for early interventions.”
LifeNet, 11:14 a.m.
It took a little less than an hour for Santiago to get her first call on the National Suicide Prevention Lifeline, and it’s in Spanish.
The male caller has contacted the center six times since 7 a.m. He tells Santiago he’s depressed, anxious. He’s hearing things that aren’t there and can’t connect with his psychiatrist. He says he feels like he’s going to die. Actually, he says he already feels dead. This isn’t unusual. This is the kind of thing Santiago and the rest of the operators deal with every day.
Call center operators go through about 100 hours of training before they take their first solo call and are trained to use minimally invasive approaches. EMS is rarely called because it can be very traumatic. Sometimes callers will harm themselves while on the phone, but the operators are trained to know the signs of a real suicide attempt.
“There are people who will cut themselves to try and cope with pain,” says Gloria Jetter, a 29-year-old clinical supervisor. Some will truly attempt to take their own lives while on the phone, but this often shows the deep ambivalence of those who are suicidal. They want their pain to end, but part of them wants to live. That’s the part of them calling people like Jetter.
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The caller that stands out for Jetter came about a year ago. A middle-aged male dialed the suicide prevention lifeline incredibly distraught. He felt like he was a burden on his family and thought everyone would be better off if he were dead. “He was drinking heavily,” she says. “And it turned out he was actually driving a truck, and he had called because he was just so horrified at his own thoughts, which was that he had a gun with him in the car and he was going to go shoot himself where someone wouldn’t find out.”
Jetter was able to talk the man into pulling his vehicle to the side of the road. He left the gun in the truck and walked toward a hospital as Jetter stayed on the phone with him for the mile-and-a-half walk. The man was just one of many older men she and her colleagues started hearing from as the recession hit.
A Midlife Crisis
The most stunning statistics to come from the CDC report released in May concern the shockingly high suicide rates for older males. The rates for men aged 50 to 59 increased by almost 50 percent from 1999 to 2010, and LifeNet’s crisis counselors began observing a change in their callers when Wall Street crashed and the Great Recession began to take hold.
While rates went up in cities across the country, it hit rural areas even harder. Wyoming has the highest rates of any state. Park County, home to Yellowstone National Park, had 12 suicides per 30,000 people in 2012. Compare that with the national average, which is closer to 12 suicides per 100,000 people. The woman in charge of coordinating the state’s efforts to prevent suicide is Terresa Humphries-Wadsworth, who has been trying to bring the rate down by targeting those most at-risk.
“In Wyoming, we have a tough-it-out kind of mentality,” she says. “Locally, they call it ‘Cowboy Up’ – being very independent, solving problems for yourself.”