On Suicide


This first blog entry is going to be brief.   Others will vary in length, but all will be interesting. To hook your interest, here are a few things you need to know about me and my plans.

First, I’m a writer, a clinical psychologist, a suicidologist, and fly fisherman.  If you were wondering…,  a “suicidologist” is someone who studies suicide and how to prevent it.  This blog is going to be about suicide, not fishing.

I’m also part-time professor at the University of Washington School of Medicine in Department of Psychiatry and Behavioral sciences, and I’ve trained thousands of doctors, psychologists, social workers, nurses, and counselors in suicide prevention for more than 40 years.   I’m also an older gent with two main missions: prevent the next suicide, and catch a few trout along the way.

I realize that only you (the reader) can help me prevent the next suicide.  I cannot do it alone.  Preventing  suicide is up to all of us, and no one is exempt from this duty to our fellow human beings.   This is why my tag line, “Preventing suicide…, it’s what people do” is intended to bring us all to the same place; learning to help each not die before we really have to. 

We are not alone.  Thousands of people are now working around the globe to prevent suicide, and yet your help is critical. Where I see good things happening I will note and praise them, and I will encourage you to do the same.

 If you return to this blog, you will learn why preventing suicide is actually a new social movement; a broad, collective, humanitarian effort to expand our circle of empathy to include people we have too often stigmatized, avoided, and punished.  If we can do this, we can save lives.

Just sharing this blog will help make a difference.  And, I will personally teach you some simple “how-to” steps you can take to make what may be a life-saving difference in the lives of those you know, love, and care about.

As a value check, consider that the purpose of our lives is not see how well we can live, but if others live at all because of us.  In my view, nothing is more noble or rewarding than preventing someone suffering from a mental illness – a disease of the brain – from ending his or her own life.  I know, I’ve done it.

My first book was entitled “When Self-Help Fails, A Guide to Counseling Services.” I wrote that book 20 years ago, and I wish I was still not writing about the same subject.

But I am.  And I have to. 

Why?  Because roughly 10,000 of the people who die by suicide in America each year are in active care with a health professional at the time they die.

As reported and recommended by the CDC, “Providers need to closely monitor and continually assess the risk for suicide among persons who are receiving mental health services, especially if they have other acute stressors and are using alcohol or other substances.” (full report @ http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6106a1.htm).

If experts agree suicide is preventable, then why do people continue to die when they are actively receiving treatment?  Over the course of this blog, I will offer my explanations  and opinions, and will – where at all possible – translate breaking research and science into information you can use today.

I will attempt to answer questions about suicide from what I’ve learned from 40  years of mental health work as a clinical director of a large service where we saw 10,000 patients a year,  as a private practitioner who specialized in helping suicidal patients, and as a trainer and mentor to thousands of students, interns, medical residents and professionals.

In the blogs that follow, I will explore a variety of subjects that I think will interest the general public, professionals, leadership, and people who care about human life everywhere. 

I intend to be blunt. I will pull no punches.  While I am a professor and an academic, I promise never to bore you. At 74 years, I can wear purple and say what I want, and that’s what I will do.

For openers, I am completely aware that someone reading this blog right now may have a loved one or friend or colleague or coworker who they know to be thinking about suicide or at risk of suicidal self-directed violence.

If fact, you could be thinking about suicide yourself.  You would not be alone.  Millions of Americans and others around the globe are thinking actively about suicide today.   Which is why you will find resources on this blog to get help right now (see side bar). 

More resources will follow, including some exciting new developments in access to care, emerging treatments available through your mobile device, and other breakthroughs in helping those considering self-destruction.   

If you are worried about someone right now, you know what to do: get this person to a professional for assessment and possible care.

Before you take this person to a professional – whether to a hospital emergency room, a clinic, a private practice, mental health center –  please consider that while many primary care physicians (PCPs) are skilled in working with suicidal people, the majority are not.   They simply do not get the training necessary to assess, treat, and manage suicidal patients. 

There are exceptions, yes, but unless you know otherwise, your first choice should be a mental health professional – a psychiatrist if you can get to one, as this is the only mental health profession with specific training in this area of practice. 

If you have concerns, ask questions.  If you are uncomfortable asking questions, have someone in the family ask them.  Ask, “Have you had specific training in how to assess, treat, and manage suicidal patients?”  If the answer is no, keep looking. Make sure you feel comfortable.  A life is at stake.

A quick story. When my oldest son was 17 he needed major surgery for Hashimoto’s syndrome, a disorder of the thyroid. When the surgeon asked him just prior to the surgery if had any questions. My son said, “Yes, doctor, since you are going to cut my throat open, what kind of grades did you get in surgery?” 

In surgery and suicide care, skill and knowledge matter.

Of the 100+ Americans who will die by suicide the day you read this, an estimated 30% will be in active treatment with a healthcare professional. That the current crop of health professionals is inadequately trained to provide knowledgeable and competent suicide care to the public is one more reason why we must bring about change together.

In future blogs, I will cover a variety of topics, emergent social policy, the roles various organizations and professions can play, and I will write a number of open letters to people and groups who should be at the suicide prevention table today, but who are not currently attending.

We are faced with a huge public health problem that is at once preventable through education and training,  yet remains in the shadows of our conversations. One thing I have learned is this: You can’t fix a problem you can’t talk about. 

This blog is intended to get us all talking.

Thank you for your attention and time, and I look forward to corresponding with you if you so choose.

Dr. Paul

Preventing suicide… it's what people do.

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