Letters to the Editor

Suicide concern

August 8, 2008


To the editor:

"Double Take" addressed a serious public health concern: suicide. Still, those worried parents and others struggling with how to help a loved one, would benefit from additional guidance.

We need to know that we are doing all we can to get help for our loved one(s). It can mean literally getting her/him in the car and driving to a counseling center or hospital. It means sharing what you know about your loved one's thoughts, actions, and feelings that convince you that s/he is in urgent need of help with the clinician who is guiding mental health treatment.

Best practices in managing suicide risk include bringing all of her/his primary support people into the counseling room. The person needing help must agree to this level of sharing. If s/he is not yet willing to allow this, loved ones still have the right to share information with the clinician. And that information can truly be life-saving.

Family support is available through our local and state chapters of the National Alliance on Mental Illness (NAMI.) Lawrence Memorial Hospital provides the safety net of crisis stabilization within the emergency department. We have several affordable therapy options in our community. And 24 hours daily Headquarters Counseling Center, credentialed as meeting national standards in suicide prevention, is available free of charge at 841-2345.

Suicide is NEVER someone else's fault. But when a loved one dies in this way, guilt is one of the common reactions for survivors. Please use supports for every concern about suicide.

Marcia Epstein, director,

Headquarters Counseling Center, Lawrence


gr 9 years, 10 months ago

"Suicide is NEVER someone else's fault."Funny, I thought it was the Internet's fault. You know, when you visit those sites you don't want to visit and continue reading things you don't like to read, and people say things about you which you don't like to hear, but you keep coming back for more.

Pro_Counsel 9 years, 10 months ago

"Best practices in managing suicide risk include bringing all of her/his primary support people into the counseling room. The person needing help must agree to this level of sharing. If s/he is not yet willing to allow this, loved ones still have the right to share information with the clinician."Sadly, this is not completely true. If the patient does not expressly agree to allow such contact, the clinician can not even acknowledge that the patient is under their care.A few years back, when I was working in an acute-care psychiatric hospital, I was involved in such a case. The patient was on a 96-hour hold, and the family made constant efforts to participate in the patient's care, but were prevented from doing so because the patient refused to sign releases. They did talk to the coordinator at the mental health court, but could not speak directly to us. The hospital pursued a 30-day hold, and the family was at the courthouse, but his attorney objected to their presence and the judge would not let them in the courtroom. As he had done nothing dangerous during his four days at the facility, the judge had no grounds to grant the hold, and ordered him released.Six days later he was dead. But then, that's one of the first things they taught us in school - if someone really, really wants to kill themselves, there's nothing I, or anyone else, can do to prevent it. As others have said, their pain is over, but it lingers for the survivors. Help is available, and I can only add my own urging that those suffering from such a loss take advantage of it.

Left_handed 9 years, 10 months ago

But suicide is painless, it brings on many changes, and you can go on living if you try.

Pro_Counsel 9 years, 10 months ago

"Mental health clinicians whose continuing education includes research-based training on managing suicide risk are aware that indeed, working with the client's support network is essential..."Essential, perhaps. However, it's not always possible. The fact is that, particularly in our post-HIPAA world, if the patient doesn't want you talking to his support network, you simply can't do it. Obviously it is better to do so when feasible, particularly in those ambivolent cases you mention. But someone determined to end their life can, and often will, prevent a clinician from involving those who might have helped.

kansasrose 9 years, 10 months ago

Suicide may end the pain of the person who dies, but often the pain is just beginning for the survivors. Guilt, shame, anger and sadness take over. Helping someone you suspect is suicidal may mean leaving your comfort zone, doing or saying things that aren't easy to hear or do. But, in the end, you may be helping to save that person's life, and, helping yourself in the process.

Ragingbear 9 years, 10 months ago

It would be more helpful if you didn't go to the ER with a suicide attempt, but because of cutbacks, you get sent home. Like they do anymore with most cases. They just make you sign a form saying you won't commit suicide. That is like making you sign a form saying you won't have a heart attack. It does not work that way.

bearded_gnome 9 years, 10 months ago

I believe that because of a combination of populations, lawrence has an above average number of suicides and attempts.

bearded_gnome 9 years, 10 months ago

good letter Ms. Epstein. also, KRT and Pro-counsel good information. often, if someone close to the person who's contemplating suicide has tried to get help, encourage his/her loved one to get help, it is that person that is cut out of the loop on purpose. the troubled person will express anger, may act out or get violent towards the family member. the suicidal person will say very hurtful things, to the caring spouse or family member. and will say hurtful things to others about that person. it does take courage to even stay in that situation with someone who is suicidal, and to avoid the very strong temptation toward anger and retribution. yes,if you're reading this and you are contemplating suicide, do call headquarters, they are very good and will help you!*841-2345anybody know if what Raging-bear describes is still true? I think that's been changed in the past few years. I will add that I wish we had a mental health ward at lmh. all of the arguments against it can be solved if we change our community's priorities: 2% for art, make that "2% to save lives!" might just save an artist's life!

Ronda Miller 9 years, 10 months ago

I attend a support group that Marcia oversees at Headquarters for those people such as myself who have lost a loved one to suicide. This group is incredible in what it offers to those of us who feel the pain, the loss, the guilt, and the sadness on a day to day, moment to moment basis. Marcia's group is wonderful, caring, confidential, nurturing, and free. I encourage anyone who has lost someone to suicide to call Headquarters for more information.Headquarters provides a huge service to our community through groups such as the one I named as well as to people who call in 24/7 about suicidal thoughts, information about drugs, etc., etc. It is also my understanding that Headquarters has lost a great deal of funding - if there is any group you would desire to assist, this would be one that affects about as many people's lives in a positive way that I can think of.

Charles L. Bloss, Jr. 9 years, 10 months ago

I have been living with what I could have/should have done since 1972. The guilt never ends. Looking back you see the warning signs, but not when they were happening. I urge anyone that is dealing with the guilt to get help. You can't change what happened, what you failed to do, but it won't hurt to talk it over with a trained professional. Thank you, Lynn

Charles L. Bloss, Jr. 9 years, 10 months ago

In the case mentioned above, I see a lot of problems and mistakes by the judge. If he would have listened to the family, instead of what happened in 4 days, he could have saved a life? Wonder how judges live with all the people that die because of their stupid decisions? Thank you, Lynn

9 years, 10 months ago

Mental health clinicians whose continuing education includes research-based training on managing suicide risk are aware that indeed, working with the client's support network is essential, and if you don't do that for other reasons consider this: practice informed by recent research, including the recommendation of establishing and maintaining good relationships with the client and her/his support network; consultation with at least one other clinician with expertise in managing suicide risk; and thorough documentation all reduce the risk of liability for a client's death.Recent research reminds us that a person does not have to let others know that s/he is suicidal; and those who do have some degree of ambivalence, meaning that even though s/he is feeling, for example, so overwhelmed with pain that s/he is seriously considering suicide, there is also some part of her/him that wants help. And reducing suicide risk means helping the person shift that balance to a higher proportion of hope.Next month's conference of the Association of Community Mental Health Centers in Kansas www.acmhck.org includes a full two and a half day track in suicide prevention: beginning with Dallas malpractice attorney Skip Simpson, including a presentation on helping military folks and their families, and ending with clinician training based on the work of clinician-researcher David Jobes and his Collaborative Assessment and Management of Suicidality (CAMS) approach.A support network for clinicians who have lost patients to suicide is available through the American Association of Suicidology www.suicidology.org The home page for the "clinican survivors" group used to say "There are two kinds of clinicians, those who have lost a patient to suicide and those who will." That's not to excuse bad practice, just to acknowledge the very high number of people who die by suicide in our country each year - over 32,000.Friends and family members who have lost a loved one to suicide deserve support, and should not be stigmatized for their loss.We need to understand that most adults who die by suicide were in so much pain and turmoil for so long that living was no longer possible. Most of those people are so immersed in their own struggles that they have lost sight of those around who will be devastated. Those who die are victims of their illness(es) and struggles. Perhaps when we have more understanding and compassion for mental health challenges, we will be more open to doing all that we can to help prevent suicide. If you haven't already lost a loved one to suicide, chances there are people close to you who have. It happens far too often in our community, across our state, and beyond. So when you have the chance, please do something to help. Suicide prevention is everybody's business.

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