banja-foundation

Suicide is a behavior. It is a choice which emerges from a variety of environmental and personal factors.
Immutable factors include family history of suicide, terminal illness, etc.
Factors that can be addressed include social isolation, poverty, access to lethal means, and mental illness
Suicide is a powerful, but COVID-19 brief impulse
Majority of cases occur within an hour between decision and suicide attempt. This shows that individuals use they have. Firearm safety can play a huge role in the prevention of suicide.

COVID-19

Pandemic spread globally in early 2020 bringing severe illness and death, lockdown, economic job losses, isolation, grief, fear, and reduced access to care and supports.
Firearm sales rocketed in 2020, yet remains to be one of the largest and most well defined risks for suicide.

38% of firearm owners reporter their mental health gotten a little or a lot worse in the past month

Firearm Safety

During a mental health crisis in the household, it is doubly important to remove the weapon from the house.
Throughout at-risk periods, guns must be removed, pills locked up, and depending on a risk assessment, the patient taken to an emergency room.
Families play a large role in enacting these plans, including holding/locking away weapons and medications.
Safe storage options: cable lock, trigger lock, lock box, safe, disassembled gun, smart gun

Extreme Risk Protection Order (ERPO)

Swanson et al (2017) found that CT's version of the law saved one life for every 10.6 guns seized, proving ERPO to be effective.
Reduced firearms suicides by 7.5% over 10 years, without an increase in suicides by other means.
Can be filed by family, cohabitant, romantic partner, police, or clinician (physician, psychologist, mental health worker, state health officer)

Integrating Policy, Programs, and Practices to Reducing Suicide

Suicide Prevention via a Systems Approach

The implementation of 9 mental health service recommendations in England and Wales and suicide rates. A cross sectional and before-and-after observational study.
It was found that services that implemented at least 7-9 of the recommendations had a significantly lower suicide rate.

9 mental health service recommendations:

Inpatient psych unit safety
Assertive outreach team
24/7 crisis team
7-day follow-up
Written policy on non-adherence
Dual diagnosis treatment
Criminal justice sharing
Debriefing and family contact after suicide
Front-line clinical staff trained in management of suicide risk for at least 3 years

Legislation and Policy Approaches

Improve access to affordable, effective mental health care
Strengthen chain of care for suicidal individuals
Enable billing for the services of community health workers
Integrate primary care and community mental health care
Reduce access to lethal means
Embed evidence-based approaches in educational programs (teacher colleges, medical school/residency, mental health professional training, journalism schools, etc.)
Expedite access to data to be used for action

School-Based Skill-Building Approaches

From a public health perspective, schools are an ideal place to provide mental health and wellness services to students through early identification of those at-risk, providing prevention programming, mental health services, referring to community-based providers, and supporting the entire school community in the aftermath of suicide.
Several states, including Maryland, are using the federal pandemic relief further to address the mental health impacts of the COVID pandemic.
These programs build skills and can demystify/destigmatize mental health care.

Preparing for a Mental Health Crisis

info@xtremewebsites.com (Xtreme Websites) — Fri, 12 Aug 2022 20:16:52 GMT

PREPARING for a crisis

No one wants to worry about the possibility of a crisis—but sometimes it can’t be avoided.

It’s rare that a person suddenly loses control of thoughts, feelings and behavior. General behavior changes often occur before a crisis. Examples include sleeplessness, ritualistic preoccupation with certain activities, increased suspiciousness, unpredictable outbursts, increased hostility, verbal threats, angry staring or grimacing.

Don’t ignore these changes, talk with your loved one and encourage them to visit their doctor or therapist. The more symptomatic your family member becomes, the more difficult it may be to convince them to seek treatment. If you’re feeling like something isn’t right, talk with your loved one and voice your concern. If necessary, take action to get services for them and support for yourself.

When a mental health crisis begins, it is likely your family member is unaware of the impact of their behavior. Auditory hallucinations, or voices, may be giving life-threatening suggestions or commands. The person believes they are hearing, seeing or feeling things that aren’t there. Don’t underestimate the reality and vividness of hallucinations. Accept that your loved one has

an altered state of reality and don’t argue with them about their experience. In extreme situations, the person may act on these sensory distortions.

*If you are alone and feel safe with them, call a trusted friend, neighbor or family member to come be with you until professional help arrives.

In the meantime, the following tips may be helpful:

✔ Learn all you can about the illness your family member has.

✔ Remember that other family members are also affected, so keep lines of communication open by talking with each other.

✔ Avoid guilt and assigning blame to others.

✔ Learn to recognize early warning signs of relapse, such as changes in sleeping patterns, increasing social withdrawal, inattention to hygiene, and signs of irritability.

✔ Do what your loved one wants, as long as it’s reasonable and safe.

✘ Don’t shout or raise your voice.

✘ Don’t threaten; this may be interpreted as a play for power and increase fear or prompt an assault.

✘ Don’t criticize or make fun of the person.

✘ Don’t argue with other family members, particularly in your loved one’s presence.

✘ Avoid direct, continuous eye contact or touching the person.

✘ Don’t block the doorway or any other exit.

A CRISIS PLAN

A crisis plan is a written plan developed by the person with the mental health condition and their support team, typically family and close friends. It’s designed to address symptoms and behaviors and help prepare for a crisis. Every plan is individualized, some common elements include:

Person’s general information
Family information
Behaviors present before the crisis occurs, strategies and treatments that have worked in the past, a list of what actions or people that are likely to make the situation worse, a list of what helps calm the person or reduces symptoms
Current medication(s) and dosages
Current diagnoses
History of suicide attempts, drug use or psychosis
Treatment choices/preferences
Local crisis lines
Addresses and contact information for nearby crisis centers or emergency rooms
Mobile crisis unit information, if there is one in the area
Contact information for healthcare professionals (phone and email)
Supports - adults the person has a trusting relationship with such as neighbors, friends, family members, favorite teacher or counselor at school, people at faith communities or work acquaintances
Safety plans

* Remember that the best time develop a crisis plan is when things are going well and you can create it together.

The crisis plan is a collaboration between the person with the mental health condition and the family. Once developed, the plan should be shared by the person with involved family, friends and professionals. It should be updated whenever there is a change in diagnosis, medication, treatment or providers. A sample crisis plan can be obtained at www.nami.org .

Navigating a Mental Health Crisis

xiomara@xtremewebsites.com (Xiomara Rivera) — Fri, 12 Aug 2022 19:14:23 GMT

WARNING SIGNS of a Mental Health Crisis

It’s important to know that warning signs are not always present when a mental health crisis is developing. Common actions that may be a clue that a mental health crisis is developing:

Inability to perform daily tasks like bathing, brushing teeth, brushing hair, changing clothes
Rapid mood swings, increased energy level, inability to stay still, pacing; suddenly depressed, withdrawn; suddenly happy or calm after period of depression
Increased agitation verbal threats, violent, out-of-control behavior, destroys property
Abusive behavior to self and others, including substance use or self-harm (cutting)
Isolation from school, work, family, friends
Loses touch with reality (psychosis), unable to recognize family or friends, confused, strange ideas, thinks they’re someone they’re not, doesn’t understand what people are saying, hears voices, sees things that aren’t there
Paranoia, suspicion and mistrust of people or their actions without evidence or justification

WHAT TO DO in a mental health crisis

IF YOU ARE WORRIED that you or your loved one is in crisis or nearing a crisis, seek help. Make sure to assess the immediacy of the situation to help determine where to start or who to call.

Is the person in danger of hurting themselves, others or property?
Do you have time to start with a phone call for guidance and support from a mental health professional?
Do you need emergency assistance?

TECHNIQUES that May Help De-esculate a Crisis:

✔ Keep your voice calm

✔ Avoid overreacting

✔ Listen to the person

✔ Express support and concern

✔ Avoid continuous eye contact

✔ Ask how you can help

✔ Keep stimulation level low

✔ Move slowly

✔ Over options instead of trying to take control

✔ Avoid touching the person unless you ask permission

✔ Be patient

✔ Gently announce actions before initiating them

✔ Give them space, don’t make them feel trapped

✘ Don’t make judgmental comments

✘ Don’t argue or try to reason with the person

If the situation is life-threatening or if serious property damage is occurring, don’t hesitate to call 911 and ask for immediate assistance.

When Calling 911 for a Mental Health Emergency

Remember to:

Remain calm
Explain that your loved one is having a mental health crisis and is not a criminal
Ask for a Crisis Intervention Team (CIT) officer, if available

They will ask:

Your name
The person’s name, age, description
The person’s current location
Whether the person has access to a weapon

Information you may need to communicate:

Mental health history, diagnosis(es)
Medications, current/discontinued
Suicide attempts, current threats
Prior violence, current threats
Drug use
Contributing factors (i.e. current stressors)
What has helped in the past
Any delusions, hallucinations, loss of touch with reality

If you don’t feel safe at any time, leave the location immediately.

Navigating Someone Considering Suicide

xiomara@xtremewebsites.com (Xiomara Rivera) — Fri, 12 Aug 2022 19:14:22 GMT

WARNING SIGNS of Suicide

Giving away personal possessions
Talking as if they’re saying goodbye or going away forever
Taking steps to tie up loose ends, like organizing personal papers or paying or debts
Making or changing a will
Stockpiling pills or obtaining a weapon
Preoccupation with death
Sudden cheerfulness or calm after a period of despondency
Dramatic changes in personality, mood and/or behavior
Increased drug or alcohol use
Saying things like “Nothing matters anymore,” “You’ll be better o without me,” or “Life isn’t worth living”
Withdrawal from friends, family and normal activities
Failed romantic relationship
Sense of utter hopelessness and helplessness
History of suicide attempts or other self-harming behaviors
History of family/friend suicide or attempts

WHAT TO DO if you suspect someone is thinking about suicide

If you notice warning signs or if you’re concerned someone is thinking about suicide, don’t be afraid to talk to them about it.

START the Conversation by sharing specific signs you’ve noticed, like:

“I’ve noticed lately that you [haven’t been sleeping, aren’t interested in soccer anymore, which you used to love, are posting a lot of sad song lyrics online, etc.] …”

Then say something like:

“Are you thinking about suicide?”
“Do you have a plan? Do you know how you would do it?”
“When was the last time you thought about suicide?”

If the answer is “Yes” or if you think they might be at risk of suicide, you need to seek help immediately.

Call a therapist or psychiatrist/physician or other healthcare professional who has been working with the person
Remove potential means such as weapons and medications to reduce risk
Call the National Suicide Prevention Line at 1-800-273-8255 or call 911

LISTEN, EXPRESS CONCERN, REASSURE. Focus on being understanding, caring and nonjudgmental, saying something like:

“You are not alone. I’m here for you"
“I’m concerned about you and I want you to know there is help available to get you through this.”
“I may not be able to understand exactly how you feel, but I care about you and want to help.”
“You are important to me; we will get through this together.”

*Please remember, a suicide threat or attempt is a medical emergency requiring professional help as soon as possible