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SPECIAL REPORT: Addressing the challenges of suicide prevention

The Patriot Ledger - 7/9/2018

July 09--In a country where suicide is now a leading cause of death, opening up a dialogue about prevention and intervention, and mental health in general, has been made even more difficult because of pushback from communities over the fine line between starting a conversation and glorifying suicidal behavior.

Mental health has always been a difficult and slightly ambiguous topic to cover, as it looks different and can have different causes from case to case. But suicide prevention is, in many ways, difficult because it is not always connected to mental illness. According to the U.S. Centers for Disease Control and Prevention, more than half -- 54 percent -- of people who die by suicide have no known mental health condition,

"It has such a stigma, just like mental illness, and the two often coincide," said Jennie Babcock, chairman of the Plymouth County Suicide Prevention Coalition. "Teaching the community that it's OK to talk about it starts when they're young and not to be afraid to talk about it."

Babcock's organization, one of 10 state coalitions in Massachusetts for suicide prevention, brings education and suicide prevention strategies to schools and organizations across the South Shore.

"We try and get involved with anything in the community just so that we can get the info out there," Babcock said.

In Massachusetts, 631 people killed themselves in 2016, which is about 165 more deaths than what was counted in 1999, according to the CDC.

Nationwide suicide rates, meanwhile, increased 30 percent during the same period, and it's likely the numbers are understated. Absent specific evidence, such as a note describing one's intentions, determining suicide deaths can be tricky for medical examiners. Additionally, many believe a portion of fatal overdoses happen on purpose, but are not counted as suicides. In Massachusetts, there were 2,227 overdose deaths in 2016, according to the CDC.

Massachusetts Suicide Information

"We think probably between 25 to 40 percent of drug overdoses may be suicides, but it's hard to quantify," said the Rev. David A. Lima, chairman of Greater New Bedford Suicide Prevention Coalition.

According to an extensive report published in March by The Patriot Ledger, Massachusetts residents are now more likely to die by suicide than by homicides and car crashes combined.

Suicide rates have increased in nearly every state from 1999 through 2016.

The upward trend is clear; less clear is why it's happening.

South Shore schools have taken the initiative to aid in lowering the suicide rate by improving the social and emotional health of their students.

John Harrison, principal of Rockland High School, a school that experienced a loss due to suicide in the last five years, said that in the last two years two new programs have been implemented through funding from the state Department of Public Health.

The programs involve adjustment counseling for incoming freshman students that carries over to their health class curriculum, as well as "Signs of Suicide Prevention", a program which screens each student for signs of depression and suicidal thoughts. Thanks to this program, the school has been able to refer students and families to counseling both through the school or a local mental health professional if more action is needed.

"The Signs of Suicide program is a big deal because pretty much every kid is getting screened for depression or suicidal thoughts," Harrison said. "It's important because sometimes kids don't understand the depth of depression and don't know how to ask for help."

He said that while two years is a small amount of time to see results, he has noticed a shift in atmosphere at Rockland High School.

"I think we're very lucky in Rockland," he said. "There is an enormous sense of trust between the families, the staff, and the kids. They trust the adults in the building and that is the number one most important factor; it's key to making all of this successful."

Massachusetts is one of a few states to spend money directly on suicide prevention, allocating about $4 million annually toward statewide and community-based programs. But the funding hasn't changed much since an influx in fiscal 2009, despite the relatively consistent climb in suicides.

Contributing to the uncertainty surrounding suicides and suicide prevention is widespread disagreement about how it should be discussed. Historically, suicides haven't been discussed much in public, which many argue perpetuates the issue. Nonetheless, talking too much about suicide, or glorifying it, can result in an uptick in suicides.

The latter is known as "suicide contagion," which is often raised as a concern when there are a string of similar suicides. Last year, a Wicked Local report showed a surge in the number of suicides and accidental deaths on Massachusetts train tracks, which left transit officials searching for answers.

Babcock said that when talking about suicide it's important to do it in the right way, so as to get to word out but also be sensitive to families and friends who have been affected, and to be mindful of this "suicide contagion."

Similarly, when well-liked public figures and celebrities kill themselves, including the recent deaths of international superstar DJ Avicii, famed designer Kate Spade and renowned TV chef and advocate Anthony Bourdain, health professionals become concerned the widespread reporting and subsequent fanfare can result in more suicides.

The media can often times give suicide the wrong kind of attention with specific details that romanticize the tragedy of an event like suicide, Babcock said.

"Take Kate Spade, for instance," she said. "I remember hearing on the news something about her hanging herself with a red scarf in the doorway of her apartment. We don't need to know that. Those details don't make us understand any more about mental illness and they don't add anything to the story except a romantic film to what was a horrible tragedy. If the media reports it correctly then it gets the word out but it needs to be done in a proper way."

Babcock said that in the wake of the recent deaths reported in the media, she hopes people are more motivated to work toward a decline in suicides in coming years and decades.

"I do think the trainings we're doing have definitely increased and had an effect," she said. "There is a need and there is more of a demand now than ever that we're able to keep meeting. Working with the police departments has also helped us bring the community together about this."

Anastasia Pumphrey can be reached at apumphrey@wickedlocal.com.

Eli Sherman is an investigative and in-depth reporter at Wicked Local and GateHouse Media. Email him at esherman@wickedlocal.com, or follow him on Twitter @Eli_Sherman.

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(c)2018 The Patriot Ledger, Quincy, Mass.

Visit The Patriot Ledger, Quincy, Mass. at www.patriotledger.com

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