Headquarters Counseling Center director to discuss suicide prevention

December 7, 2010

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Marcia Epstein, director of Headquarters Counseling Center in Lawrence, says suicide prevention is everyone’s business.
Epstein will answer questions about the counseling center, suicide prevention and suicide bereavement.
Every 16 minutes someone in the United States dies by suicide. Every day, someone dies by suicide in Kansas. Every month, one or two people die by suicide in Douglas County.
For our chats, WellCommons doesn't require users to verify their identity. If you have a question about suicide prevention, you can ask the question anonymously using your LJWorld.com, lawrence.com or KUsports.com login.


I want to thank Marcia Epstein for coming in today. I am health reporter Karrey Britt and will be moderating this chat. Can you start by telling a little about yourself and Headquarters Counseling Center?


The center is getting ready to celebrate our 41st anniversary next week. These days we talk to people of all ages about any concern, we provide "life support" counseling free of charge 24/7 at 785.841.2345 As for suicide prevention and bereavement counseling, we provide that everyday, too.


First off, Marcia, thanks to you and the Headquarters staff for providing this amazing service to our community. You've saved and helped many lives.

My question is about teens and suicide risk. It seems like adolescence is a really tough time for everyone; what are warning signs or red flags for adults (teachers, parents, family friends) to look for in a teen's words or behavior that might indicate they are at risk for suicide?


Thank you for your kind words.

From national and state-wide studies, we know that teens have a higher rate of suicide ATTEMPTS than older adults, but actually currently the age with the highest rate of DEATHS by suicide is middle age adults.

However, we should all take teens very seriously, because they need and deserve to have safe, caring adults in their lives.

As for warning signs, I advocate for being aware that the same warning signs can put a teen at risk for a number of unsafe, unhealthy choices. So let's not wait for clear signs of suicide risk. Let's give help when we notice any of these kinds of things.

The short list:
1) situations of loss: examples include, not making a team, relationship breakup, not being accepted by other teens, or bullying, among other possibilities
2) feelings that are intense and long-lasting
3) thoughts such as: I can't take this anymore; Why me?; It's all my fault
4) behaviors or symptoms: changes in patterns of eating, sleeping, hygiene, interacting with others, grades; or physical signs such as stomach or head aches, or "clumsiness" and injuries

Certainly when a teen hints about suicide, or talks directly about suicide, maybe even indicating s/he has a plan, immediate, caring, adult help is needed.

Whenever someone is at risk of suicide, it's important to limit access to danger such as firearms, or large amounts of medications.

All that said, it is NEVER someone else's fault when someone attempts or dies by suicide. Still do what you can to help, including getting trained help from places like our center, the Bert Nash Center, or in most dire situations, the Emergency Department at LMH.


How do you respond to a person who says, when someone has attempted suicide, that "they just did it to get attention" and therefore should not be taken seriously? Shouldn't all attempts be taken seriously?


Thanks for the opportunity to address something really important - that so many people do not understand!

Whenever someone of any age talks about suicide or attempts suicide (even if the attempt was not highly dangerous), please, please, please take this seriously.

When a person says or does these things, s/he needs and deserves help. And if help is not provided, s/he may become at even higher risk of acting in a more dangerous way.

Attempting suicide is not shameful. People need kindness and support, to get through whatever brought them toward suicide.


Someone close to me had a parent commit suicide a few years ago, and unfortunately they share a birthday. Do you have any advice for how I can help them celebrate their special day without making it seem like I'm ignoring the elephant in the room?


Because I don't see questions in advance of them appearing on the screen, I am taking this opportunity to answer another important question. What about suicide and bullying of LGBTQ teens and young adults? We heard about this nationally not so long ago. Ok, here goes. It's essential to know that bullying is never ok. It's essential to know that just because someone has experienced bullying, s/he does not have to choose suicide. It's essential to know that there is nothing flawed about LGBTQ folks that makes them at higher risk of suicide. ANY person who is consistently mistreated, whose very being is stigmatized, is at risk of the level of depression and hopelessness that could lead her/him toward thoughts of suicide. The problem is the cruelty of others, and in some communities, the high acceptance of such cruelty.


wmathers here is your answer: I relate to your friend, as my my mom died by suicide, by prescription drug overdose after a lifetime of depression, on MY birthday. After the death of a loved one, by suicide or other cause, special days - birthdays, holidays, anniversaries - are different. It is important for the person who lost a loved one to develop new traditions. The survivor is encouraged to do what feels right to her/him, as long as it's safe. And what s/he chooses may vary over time. As the friend of the survivor, you can be helpful by being understanding of such changes. And by talking and listening. Your discomfort is nothing compared to the feelings of the survivor, so please say something. Maybe, "I know your birthday is coming up, and that it has to be different now that your parent has died. Is there anything I can do to be helpful for you?" And if you knew the parent, please share stories about her/his life. We do not want our loved ones to be forgotten. If you never knew the parent, ask about her/him. Will your friend cry? Maybe. But chances are s/he will cry anyway. So be open to talking.


From your years of experience do you notice people needing more help with suicide-related issues during the holidays, which can be stressful?
Are there any signs or behaviors that family members and friends should be concerned about if they notice them?


From my vantage point, the holiday season spans from Halloween to Valentine's Day. All of these "special days" get so much attention in the media and in stores and restaurants, that it's not likely that a person can ignore them. And we pick up expectations of what holidays are "supposed to be" that are rarely like our own experiences. During that long holiday season, we definitely hear from people who feel increased stress related to holidays. And the specifics of that can vary immensely. As for warning signs, you will find a simple list in one of the previous answers. Fortunately, suicide deaths are NOT highest during this time of year. So, here's my suggestion. Be kind to yourself and others. Be realistic in your expectations of what you do during this time of year. And make a point of being kind to others, especially the ones who are the hardest to be kind to. In line at the grocery with some grouch behind you? Smile and offer that person your place in line. You'll never know the full impact you had, but you will feel good for reaching out to another, even in this simple way.


Does Headquarters Counseling Center have support groups? If so, what are they?


For adults (college-age or above) who have lost a loved one to suicide, we have a bereavement group that meets every other Tuesday from 7-8:30pm at the center, 211 E. 8th, Suite C. We meet tonight, then again on 12.21.10, and every other Tuesday after that. Some people come soon after the death. Some people come for the first time many, many years after the death. Some also use other bereavement groups, including for parents, The Compassionate Friends. Being in the room with others who have lost one or more loved ones to suicide is powerful. Unfortunately suicide loss has a stigma that is unlike the loss of a loved one to a physical health condition like a heart attack. Imagine what it would be like to lose the love of your life, and then have people refuse to talk to you. Yes, that has happened to many who have lost a loved one to suicide. So the group is a place to talk about the range of experiences, thoughts, and feelings that are specific to suicide loss. Everything someone says or asks is helpful to others in the room. It's an amazing, loving atmosphere with new members being immediately welcomed, and experienced members appreciating being together again. In addition to the evening meetings, we have an annual "Freedom of Expression" retreat for survivors of suicide loss. To learn more, feel free to call the center at 785.841.2345 or email me at me@hqcc.lawrence.ks.us


Any statistics on how many people the center helps? How can the community support the center?


Children, teens, and adults of various ages benefit from the free services of Headquarters Counseling Center every year. In 2010, Brian Runk, our Director of Children's Programs, has taught thousands of kids and adults who care about kids, about internet safety, cyberbullying prevention, and other safety issues. I've spoken to several hundred junior high students about simple things they can do, and who they can turn to, for help for someone with depression or at risk of suicide. Other volunteer and paid staff have talked with hundreds about the services of our center, to people know how to get help when it's needed. Our bereavement group meetings average around a dozen people each time, with around 60 participating through the year. As for our 24/7 counseling services, by the time 2010 ends we will have counseled people around 20,000 times. Each day that included 10-15 people needing help because of intense depression, suicide attempts, suicide risk of a friend or family member, or suicide bereavement. We need to be here for these people and more! Community members can help in a variety of ways. United Way of Douglas County donations are part of our support. Donations directly to the center are part of our support. Volunteer effort from the high intensity of completing 2 and a half months of training and volunteering at least 300 hours as a paraprofessional counselor, to serving on our very active Board of Directors, to helping with one of the center's events, to partnering with us, as LMH did to provide a national speaker for Suicide Prevention Week. There are many ways to help here, and at the many needed educational, health, and human services in our community. To thank those who've helped us keep free counseling available 24/7, we have a reception at the Watkins Museum from 5-8pm on Tuesday 12.14.10 And for a fun opportunity to help with a donation, please join us at Set 'Em Up Jack's starting at 5pm on Thursday 12.19.10. Bring a flyer from our website www.hqcc.lawrence.ks.us so 25% of your ticket will be donated to support our services. Thanks!


From all of your experience, what do you think is the best way to prevent suicide? Is it best to pull out all stops when someone becomes depressed, to prevent a potential downward spiral?


Suicide is very complicated, and rarely results from one cause. From the mental health provider perspective, recent research on suicide prevention shows things like: empathetic counseling on hotlines, screening and referrals by physical health care providers, behavioral therapies, and follow up with people who have discontinued mental health treatment or after in-patient mental treatment are key. For community members, we need to remember that Suicide Prevention Is Everyone's Business - truly. Being aware of the basic warning signs (included in an early answer), being willing to reach out, knowing the resources in your own community and referring to those, can literally save a life. So can limiting access to firearms, when someone in the household is at risk of suicide. And simply, be kind, be kind, be kind. When people believe that they belong, and that they are valued, contributing members of their family/friend group people are not likely to choose suicide.


Hi Marcia,

From time to time I hear people say that suicide is a selfish act. How can I respond to this in a positive, informative way?


I'm passionate about suicide prevention and bereavement support, and I know that everyone needs help sometimes. Please feel free to use our center at 785.841.2345 anytime 24/7 for immediate, skilled, and caring help. We're the only center in the state of Kansas certified for suicide prevention counseling by the American Association of Suicidology, and we're the only center in Kansas on the national suicide prevention network reached by calling 1.800.SUICIDE or 1.800.273.TALK. Help IS available for you, and for your friends, family, co-workers. If someone shows you a glimpse of her/him thoughts of suicide, be aware that the person is at risk of suicide BUT the fact that s/he let someone know, means that s/he is also hoping for some help in feeling better. So please help that person find the help s/he deserves. And if you are the person, please get the help you deserve. Thanks!


monicataylor here is your answer: Suicide generally happens when someone's life is unlivable, when pain is unbearable, when someone has tried everything s/he can imagine and it hasn't helped and s/he can't live another day. And it generally happens when the person believes s/he is a burden to others. So selfishness is NOT a common cause. Losing a loved one to suicide changes the bereaved person forever. But so many who have lost a loved one to suicide come to realize that the death was not about her/him, was not to cause her/him pain, but it was to end unbearable pain for the deceased. A suicide bereavement group, reading about suicide bereavement, and/or therapy with a clinician with expertise in suicide loss can help with this healing process.


Marcia — Thanks for coming in today. You have provided a lot of great information for the community. We really appreciate your time.


Suicide touches so many. I appreciate the opportunity to give people some knowledge so that they can help. Thank you!


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