Suicide During the Pandemic

 

This past week, I had the opportunity to attend a training about Suicide Assessment & Prevention.  And it got me thinking about society's collective mental health condition as a result of the "Quarantine" over the past almost 6 months.  

Isolation, even partially, is especially difficult for many people.  People who regular socialize with many people, who consider themselves extroverts, and who get their energy from being with people, are especially affected during this pandemic.  The lack or decrease of being around people significantly impairs their emotional well-being.  This puts more people at a higher risk of suicide.

I have a full time job as a Social Work Supervisor with Child Protective Services AND I work as a private practice therapist.  In those roles, I have to be keenly aware of any changes in mood, even ever so slight, that could indicate that someone I work with or one of my clients is depressed or having suicidal thoughts.  While this is something that I must be aware of at all times, I've found that I must now pay extra close attention to warning signs and I must ask difficult questions.

Some of the professional responsibilities a therapist has are:

1)  to make reasonable effort to identify risk factors for suicide

2)  take reasonable action to prevent a client from harming themselves

3)  may exchange information in order to provide appropriate treatment

4)  may exchange information with a party reasonably able to prevent or lessen harm.

The training I attended, reminded me of the seriousness of asking screening questions of clients regarding suicidality.  These questions are often awkward to ask and I believe that many therapists may be afraid to ask, because either (1) they're afraid to give their client any ideas and (2) they don't feel fully equipped to deal with the answer.  But what we find is that if a client has contemplated suicide at all, then your mention of it isn't going to be the tipping point or isn't going to suddenly put the idea in their head.  So, instead of being afraid to give them the idea, you should be asking about it, inviting them to share what's on their mind.  Some phrases people say when they're thinking about suicide are, "All of my problems will end soon.", "I just can't take it anymore", and "I can't do anything right."  These phrases are invitations for us to ask questions, to show there are other solutions, to show them there IS help.  

If you're afraid you're not equipped to deal with the answers, then consider just being present with the client as they express themselves.  Normalize their experiences and be direct with them.  

To assess for suicidality:

1)  Identify risk factors - not those that can be modified to reduce risk

2)  Identify Protective Factors - note those that can be enhanced

3)  Conduct Suicide Inquiry - suicidal thoughts, plans, behavior, and intent

4)  Determine Risk Level/Intervention - determine risk; choose appropriate intervention to address and reduce risk

5)  Document - assessment of risk, rationale, intervention, and follow-up

Suicide is a scary thing, both in life and in our clinical experience.  Right now, our clients needs us more than ever.  These times of COVID are unprecedented times and people have not experienced this level of isolation and depression in a very long time.  

Children are experiencing an inability to socialize, which is retarding their cognitive and social abilities.  Part of a child's normal and necessary learning and development comes from socialization with peers their age.  So, we have to ask what will be the consequences of this pandemic on our children, over the next few months and years.

Adults are out of work and experiencing financial and emotional stress, which decreases their ability to cope, leading to addiction, domestic violence, and physical abuse.  Many people are unable to see the light at the end of the tunnel.

Please make sure you're taking care of yourself and your loved ones.  Seek help if you need it.  

Check on your friends and family and make sure they're doing okay.  Suggest help if they need it.

Help is available.  There is hope.  There are solutions.

National Suicide Prevention Hotline - 1-800-273-8255

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