Suicide – Don’t Be Afraid to Ask

It’s September, which is National Suicide Prevention Awareness Month.  Let’s start with awareness. According to the Centers for Disease Control, rates of death by suicide have increased in this country by 35% from 1999 to 2018.  More specifically, the rate has increased by 2% every year from 2006 to 2018.  The overall rate of death by suicide in 2018 was 14.2 people per 100,000.  For men, the rate is higher than the rate for women, with a suicide rate of 22.8 per 100,000 for men and 6.2 per 100,000 for women.  The rate for women, however, increased by 55% between 1999 and 2018.

According to the most recent data released by the Bureau of Justice Statistics, the rate of death by suicide in state prisons was 21 per 100,000 up from 14 per 100,000 in 2001.  In federal prisons the rate in 2016 was 12 per 100, 000 down from 13 per 100,000 in 2001.  In local jails, the rate of death by suicide in 2016 was 46 per 100,000 down from 48 per 100,000 in 2000.

These rates tell us despite our efforts in training, education and suicide prevention within our jails and prisons, people are still choosing to take their own lives.

Suicide is the intentional ending of one’s own life. Think about that.  Just sit and think about the fact that thousands of individual human beings, every year, decide that the life they have should end.  Many of these individuals experienced emotional and cognitive distress beyond what they believed they could handle and saw death as the best possible choice in the moment.  They likely felt alone, isolated, trapped and hopeless.  Like there was nowhere to turn. We can change that.

Warning Signs and Prevention

For those of us who work in correctional settings, we know that these feelings can be exacerbated by the environment of prisons and jails.  This is where prevention comes into play.  Each day, we have the opportunity, through our words and our actions, to help people feel less alone, isolated, trapped and hopeless.  In addition to clear warning signs such as:

  • Threatening to hurt of kill themselves
  • Talking about wanting to hurt or kill themselves
  • Looking for ways kill themselves
  • Talking or writing about death, dying or suicide

The American Association of Suicidology provides the following list of warning signs for suicide:

  • Increased substance (alcohol or drug) use
  • No reason for living; no sense of purpose in life
  • Anxiety, agitation, unable to sleep or sleeping all of the time
  • Feeling trapped – like there’s no way out
  • Hopelessness
  • Withdrawal from friends, family and society
  • Rage, uncontrolled anger, seeking revenge
  • Acting reckless or engaging in risky activities, seemingly without thinking
  • Dramatic mood changes
  • Giving away prized personal possessions

What Can We Do?

The National Alliance on Mental Illness (NAMI) has published a guide to assist in navigating mental health crises. In that guide, NAMI reminds us that first and foremost, if you suspect that someone is thinking about suicide, start a conversation.  You can always begin by simple stating why you suspect that someone may be suicidal.  You can say something like, “I’ve noticed that you have been spending more time alone in your cell than usual and you seem down, are you thinking about suicide?”  If the answer is “Yes” the next steps are critical.  Do not leave the person alone.  Take a few minutes to listen, express concern and reassure the person that you are going to help them through this.  Let them know that you are here to help and that together, you will get them the support they need.  Explain to the individual that while you may not understand exactly how they feel, you care about them and want to help.  Explain the next steps you plan to take, including contacting mental health staff and getting the person somewhere safe.

During these times, it is important not to make promises of secrecy, not to try to handle the situation alone and most importantly, not to try to talk the person out of suicide or debate the value of living.  Also, do not minimize the person’s pain by saying things like, “we all go through hard times” or “this too shall pass.”  For people thinking about suicide, the world has narrowed, and they are unable to see beyond their pain.  For them, there is no “tomorrow” when things will get “better.”  They can only see right now, and they can only see that they need to end their lives.  Remember, for people experiencing a suicidal crisis, words may be difficult to find.  They are likely going to struggle to talk about what they are going through, and they may even have difficulty understanding what you are saying.  The primary steps here involve getting the individual to a safe location, not leaving the person alone, and contacting a mental health professional.

Everyday, those of us who work in corrections have the opportunity to provide support for someone in emotional pain and to assist them in getting the help they need.  We can save lives.  We just need to be aware and ask questions.

What I have shared here is my opinion, based on my training, research and experience.  I could have missed something or just be plain wrong.  If you think I’ve got it wrong, please let me know why in the Comments.

Do you have any recommendations for suicide prevention?  Please feel free to share.

3 thoughts on “Suicide – Don’t Be Afraid to Ask

  1. I totally agree!

    In 2010 my husband, a Correctional Officer committed suicide. I was aware of his mental health issues as well as prescription opioid use/abuse and had taken him to multiple doctors in an effort to help him but in the end his illness won. On two occasions prior he had stated that the world would be better off without him and I rushed him to get treatment but he told the doctors that I was over-reacting because I was a Mental Health/ Substance Abuse nurse and they allowed him to continue on, prescribing even more addictive substances. At the time of his death he was on OxyContin; Lortabs; Clonazepam; Ambien; Flexaril – feeding his addiction but not treating his disease.

    I learned after his death that he had called multiple coworkers that evening to tell them he was going to commit suicide and had even put a post on Facebook that he was leaving but quickly pulled it down. No one said a thing. Not one person.

    I know that my life would have been a living hell if I had called his employer but he might be alive.

    I know his coworkers did not want to report his talk about suicide because “what if he was just talking?” but he might be alive.

    I know they might not have wanted to report it because they didn’t want him to “get into trouble” but he might be alive.

    I know he was in pain and didn’t want to ask for help but he might be alive.

    I know that each of us thought that the other would report it but no one did.

    Please I ask you to REPORT and stay with the person. I would rather have an ALIVE person who is angry with me than a successful suicide. I also don’t wan to carry the guilt of knowing that if I had been brave enough to have asked the questions, reported the answers and stayed with the person the outcome may be a life saved.

    I now over-react. I over-report. I’m over the top about potential suicidal talk and actions. I have been changed by suicide. You can’t cause the person to commit suicide by asking, talking, listening, staying or reporting but you can save their life!

    • I am deeply saddened to hear of your loss and am grateful to you for your bravery and honesty in sharing your experience with us. I appreciate hearing your thoughts and your support for taking action in spite of the fears it may raise or the “social” costs. Please take good care of yourself.

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