Bernards Voices

Using more comprehensive data to nail down economic trends, the new study found a clear correlation between suicide rates and the business cycle among young and middle-age adults. That correlation vanished when researchers looked only at children and the elderly.

via Study Ties Suicide Rate in Work Force to Economy – NYTimes.com.

But this study should give communities and doctors a better sense not only of when risk is high, but in whom — working-age adults, in this case. “Once people age out of the work force, there seems to be no relationship between the business cycle and their vulnerability,” Dr. Florence said.

On December 19, 2010, Trip Gabriel reported in the The New York Times that:

Stony Brook is typical of American colleges and universities these days, where national surveys show that nearly half of the students who visit counseling centers are coping with serious mental illness, more than double the rate a decade ago. More students take psychiatric medication, and there are more emergencies requiring immediate action.

Experts say the trend is partly linked to effective psychotropic drugs (Wellbutrin for depression, Adderall for attention disorder, Abilify for bipolar disorder) that have allowed students to attend college who otherwise might not have functioned in a campus setting.

A recent survey by the American College Counseling Association found that a majority of students seek help for normal post-adolescent trouble like romantic heartbreak and identity crises. But 44 percent in counseling have severe psychological disorders, up from 16 percent in 2000, and 24 percent are on psychiatric medication, up from 17 percent a decade ago.

Stony Brook has seen a sharp increase in demand for counseling — 1,311 students began treatment during the past academic year, a rise of 21 percent from a year earlier. At the same time, budget pressures from New York State have forced a 15 percent cut in mental health services over three years.

The article then tells a good day-in-the-life story of the college counselor. The triage they do to make sure the serious cases get dealt with the right way. Many colleges have systems where the campus psych services give a few sessions to the students, but they are designed to refer the students out to a private practioner, just so that there will be enough hours left to deal with all the demand.

On recent day … two dozen volunteers in black T-shirts reading “Chill” stopped passers-by in the Student Activities Center during lunch hour.

“Would you like to take a depression screening?” they asked, offering a clipboard with a one-page form to all who unplugged their ear buds. Students checked boxes if they had difficulty sleeping, felt hopeless or “had feelings of worthlessness.” They were offered a chance to speak privately with a psychologist in a nearby office. Sixteen said yes.

The depression screenings are part of a program to enlist students to monitor the mental health of peers, which is run by the four-year-old Center for Outreach and Prevention.

Students monitoring the mental health of peers. This sounds similar to the Mental Health First Aid program that we’re starting with HOP.

“I don’t have motivation for things anymore,” the student said. “This place just depresses me the whole time.” [The student] had been unaware that students could walk in unannounced to the counseling center. “I thought you had to make an appointment,” she said. “Yes,” she said, “I’ll do that.”

We hear things like this all the time. Help is available. But people, like this student, are unaware just how easy it is to ask for help–if they are willing to ask. We recommend the NJmentalhealthcares helpline for that first call for help. It is staffed by professionals. They assess, and connect, the callers to the right services. And they offer a follow-up call in a week to make sure the connection is made. That is just the surface description of the job, but they become very personally engaged, like the counselors at Stony Brook who are discussed in this article, in making sure the callers get the help they need.

Two recent articles in the New York Times address suicide.

On October 10th, Despite Army Efforts, Soldier Suicides Continue:

20 soldiers connected to Fort Hood are believed to have committed suicide this year. The Army has confirmed 14 of those, and is completing the official investigations of six other soldiers who appear to have taken their own lives — four of them in one week in September. The deaths have made this the worst year at the sprawling fort since the military began keeping track in 2003.

Colonel Philbrick said that more soldiers were seeking help for psychological problems than ever before — it was the leading reason for hospitalization in the military last year — but that the number needing help had also grown at a rapid pace, a natural consequence of nine years of combat deployments. So even though the Army now has 3,800 therapists and psychiatrists, two-thirds more than it did three years ago, there is still a significant shortage, he said.

General Chiarelli and other top commanders have argued that the roots of the rise in military suicides are complex and that blame cannot be laid solely on repeated deployments. The majority of soldiers who have committed suicide — about 80 percent — have had only one deployment or none at all. Another factor is that after years of war, the Army is now attracting recruits already inclined toward risky behavior and thus more prone to suicide, according to a 15-month Army review of suicides released in July.

On October 7th, Medical Student Distress and the Risk of Doctor Suicide:

Always, we ended up asking one another the same question: How could a doctor — who most likely knew about what he was suffering from and about the treatments available — never seek help?

For several decades now, studies have consistently shown that physicians have higher rates of suicide than the general population — 40 percent higher for male doctors and a staggering 130 percent higher for female doctors.

The grim statistics for medical students have hardly budged over the last generation.

“There certainly is some overlap,” Dr. Dyrbye said. “But depression and burnout are two separate entities.”

Today’s New York Times reports on a nurse that ran on an online suicide chat room.

The case also brings up questions about the limits of speech on the Internet: How does one assign levels of culpability to someone who shares thoughts with people who say they are already considering suicide? And for some who counsel against suicide, it points to a growing area for worry, an online world where the most isolated and vulnerable might be touched in a way that they would not have in the past.

Groups that work to prevent suicide compare suicide chat rooms to “pro-ana” sites, Internet sites that portray anorexia as a lifestyle as opposed to a disease. Anti-suicide advocates say that there has been more than one instance recently where a person killed himself on a Webcam as others watched.

Tuesday we talked about teen-age suicide and bullying.

“He was practically invisible,” [Celia Bay] said. “I tried to talk to any police I could, and most of them would have nothing to do with it. The first one I talked to told me, ‘If it bothers you, look the other way.’ And that really bothered me, because by then I was pretty sure people had died.”
About four years ago, Ms. Blay, who describes herself as a “computer illiterate,” became friends online with a young, depressed woman who had entered into a suicide pact. Ms. Blay persuaded her not to proceed, but the incident sent Ms. Blay searching for the other member of the pact.

The third leading cause of death for young people under 24 is suicide, yet most parents avoid talking about suicide with their teen-agers, believing their own children are not at risk or that discussing the topic will “put the idea in their heads.” In fact, said Maureen Underwood, licensed clinical social worker and director of the Society for the Prevention of Teen Suicide, most kids have already thought about death and suicide, have seen romanticized dramatizations or read stories, and may even know someone who has taken their life. Talking openly with your child is the best way to know what your teen is thinking and feeling and will give you the best chance of intervening effectively if, in fact, your child is considering ending his life.

Maureen introduced Scott Fritz, who spoke about the loss of his daughter Stephanie. Scott and his friend Don Quigley, who lost his son Sean, are co-founders of the Society for the Prevention of Teen Suicide (SPTS). Maureen showed a video titled “Not My Kid,” in which she appears with Lanny Berman, executive director of the American Association of Suicidology, and in which they answer questions typically asked by concerned parents. You can find this instructive video at www.sptsusa.org.

Scott spoke about bullying as a suicide risk, both face-to-face bullying and on-line harassment. Bullying is a risk factor in suicide. Parents and teachers need to know if bullying is happening so that they can intervene. In the old days, before the omnipresent internet, a student could escape the bullying after school and have a break in the safety of their own home. But these days they can be bullied into the evening over social networking websites like facebook. The teenager may feel like they have to stay on the site just to prove they’re not giving in to the bullying.

Also speaking was Barbara Barisonek, the mother of Duke, who took his life when he was a senior in college. Barbara pointed out that many different types of young people choose suicide and that the loss is deeply disturbing for their friends, as well as devastating for their families. She made the point that mental illness can happen in any family and that it’s essential that we talk openly about it and seek good medical help. Maureen and Scott reiterated this point: ask questions of professionals you contact and keep trying until you find a counselor or therapist you can trust to help you and your child. Good counseling and medication help many young people to resolve crises and manage their difficulties.

Barbara’s story is featured in a recent Bernardsville News article.

It’s vital to learn the signs of kids who may be suicidal: loss of interest in usual activities; making statements like “life isn’t worth living” or “you’d be better off without me;” abuse of drugs or alcohol; weight loss; sleeplessness or sleeping too much; recent breakup with a boy or girlfriend….look at the SPTS website for a complete list.

Your child must know that you or another trusted adult is available to talk with. Nothing you will ever do for your child is more important than listening to him or her. As difficult as it is to listen to the hurt, angry, possibly distorted feelings and thoughts of your child, it’s essential to refrain from exhorting your child to think differently (“of course you’re intelligent” or “you’re adorable”) and from offering solutions – until they are asked for. “What we all want most is to be understood,” Maureen said, and when your child knows that you understand and are available to listen compassionately, much is possible. If it’s difficult for your child to speak with you, you can say, “I understand that I may not be the easiest person for you to talk with, do let’s figure out who you can go to when you need to talk.” When kids do open up, the most helpful response is, “Tell me more” or “What else?”

All young people should know that they need to tell a responsible adult if anyone they know expresses a suicidal thought. This action could save a life and could also help to spare a lifetime of guilt for the person who heard the threat but did nothing. In the case of my own son Jamey, I heard at his funeral that he had told a friend he would kill himself if he didn’t get into a particular college. Had his friend spoken up, the outcome may well have been different.

A personal note: I have one more point to make that was not brought up at Monday’s session, which is this: keeping guns in your home increases your child’s risk of dying. The suicide rate is four times higher for adolescent boys with guns in the home than for those without. My own son put together his father’s supposedly disabled rifle and found the “hidden” ammunition.

For more information or to talk with a knowledgeable person, contact Maureen Underwood at info@sptsnj.org.

Thursday’s Bernardsville News has an article (on the front page!) with interviews of me and Barbara Barisonek—who lost her son to suicide.

She was referred to Maureen Underwood, a licensed clinical social worker in Somerville. Underwood is an expert in suicide prevention, headed the State Adolescent Suicide Prevention Project for 15 years and, with Scott Fritz, helped found the Society for the Prevention of Teen Suicide, whose focus is engaging schools in identifying kids at risk.

Underwood and Fritz will also speak during Mental Health Week, addressing “Challenges for Today’s Children: Bullying and Suicide” at 6:45 p.m. Monday, May 10, in the YMCA’s multipurpose room.

My therapist, Dr Giacalone, will be talking Tuesday morning at 9:30am.

Most of the events will be at the Y next week. Only Tuesday evening (The Mental Health Players) and Thursday evening (Dr. Brad Sachs) will be at the Bernards High School (old) auditorium.

Here is the full calendar for the week.

The New York Times Contributing Family Writer Lisa Belkin discusses everything a parent may want to to read about in her Motherlode Blog.  Subjects are culled from the news, from her own experience as a parent, from the latest books and studies and from reader input.  Of interest to readers of BernardsVoices.org, Belkin’s most recent post discusses depression and suicide ideation in teens, precipitated by yesterday’s article in the NYT about three recent student suicides at Cornell University.

A key difference between ordinary teen angst and depression is how long the “angst” lasts and the effect this mood has on the teen experiencing it. For example, if a young person’s mood seems to be affecting his or her ability to engage in family and school activities and peer relationships and is coupled with physical symptoms such difficulty eating and/or sleeping for a period of at least two weeks or longer, it is worthwhile to seek outside help.