CCMS Medicine Spring 2017 - 20

www.CHESTERCMS.org

Suicide Prevention

in Chester County

BY TRACY BEHRINGER, CONSULTANT,
COMMUNITY OUTREACH, EDUCATION,
CHESTER COUNTY MH/IDD

I

t's a word that no one wants to say, let
alone discuss. Suicide, still able to evoke
fear and shame in those it touches, has
become the public health concern no one
talks about.
How can it be that more Americans
now die by suicide than car accidents? How
can suicide be the second leading cause
of death on our college campuses today?
More importantly, what's being done to
change perceptions and the trajectory of
the upward trends?
"Suicide is currently on the rise
nationwide, and Chester County is
unfortunately no exception," said Renée
Cassidy, M.D., Chester County's Public
Health Physician. "Suicide is as grave a
problem as the opioid epidemic here, with
approximately the same number of deaths
by each in 2016."
The American Society of Suicidology
studies and tracks suicide data. In its latest
report, more than 44,000 Americans
died by suicide in 2015, which equates
to about 121 a day, or one suicide every
11.9 minutes in the United States. In
Chester County, the suicide rate has
increased almost every year for the past
decade, from 28 deaths in 2006, to 64 in
2016. Every one of these tragedies leaves
family members, friends, coworkers, and
even acquaintances in shock and disbelief,
tangled in a profound and lasting grief.
It's been 25 years since Carol Harkins
lost her 15-year-old son Jimmy to suicide.
The teen's sudden death blindsided his
Chester County family, and the ripple
effect continues more than two decades
later. Harkins acknowledges the tragedy
was a contributing factor to the end of her
marriage, but it was also the motivation
for her to return to school and eventually
become a suicide prevention advocate.
Today she is one of the co-chairs of
Chester County's Suicide Prevention Task
Force (CCSP) and a certified instructor
for Mental Health First Aid and QPR
(Question, Persuade, Refer) suicide

prevention training. She shares the story
of losing her son to raise awareness and let
others know they are not alone.
"I was on my home from picking up
flowers for Jimmy's school dance that
night. It was one of those sunny days in
May, and I just remember driving into our
neighborhood, looking out the window,
and thinking about how beautiful it was,"
Harkins recalled. "And then I got home,
and my life fell apart."
A good-looking kid who played three
sports, Jimmy Harkins was a high achiever
who was persistently hard on himself and
could be somewhat demanding of others.
His mother noted that her oldest child
could be strong willed at times, and always
seemed to need more attention than his
two younger siblings. In the days before the
school dance, he'd persuaded his mother to
take him out to buy a new suit.
"He'd worn a sports coat to the first
dance that year, and he didn't want to do
that again. He really wanted that new suit,"
Harkins recalled with a smile.
But if Jimmy Harkins displayed any of
the classic warning signs for suicide, his
family didn't recognize them as serious
concerns.
"In the weeks before, his grades were
not quite as good, and he did seem a little
mopey," Harkins said. "But I remember
thinking that was what 9th grade boys are
like. I thought it was normal adolescent
stuff."
It's difficult to imagine or understand
why anyone would take his or her own life,
especially someone we love and care about.
The American Foundation for Suicide
Prevention says there's no single cause
for suicide attempts, and suicide most
often happens when stressors exceed the
coping abilities of someone suffering with
a mental health condition. But suicide is
preventable, and anyone can be trained to
help.
Assessing a person for suicidal ideation
may sound intimidating, but it is a skill

20 C H E S T E R C O U N T Y M e d i c i n e | S P R I N G 2 0 1 7

everyday people are learning with public
education classes designed much like Red
Cross First Aid, CPR or the Heimlich
Maneuver. Primary care physicians, often
on the front lines with patients reporting
physical symptoms related to their mental
health, should be aware of the conditions
to consider, and the questions to ask. Dr.
Cassidy notes that up to 45% of those who
complete suicide had contact with their
primary care physician in the month prior
to suicide, and many received treatment in
an Emergency Department.
"We know that many additional
attempts and completions occur following
discharge from the ED. For these reasons,
suicidal assessment in primary and
emergency care settings is essential and lifesaving," Dr. Cassidy said.
There are many different factors, or
conditions, to consider when assessing
someone for risk of suicide. Some include
having a diagnosed mental health concern,
such as depression, anxiety or bipolar
disorder. Other factors are substance
abuse, trauma, loss, previous suicide
attempts and family history of attempts.
Certain populations, such as the LGBTQ
community, older adults, veterans, or those
working in law enforcement, have higher
risk of attempting suicide. One of the most
significant recent trends is among nonHispanic, middle-aged white men, who
have seen a 43% increase from 1999 to
2014.
Beyond the risk factors, suicidal people
often display warning signs. Unfortunately,
these signs may only be recognized by
friends and family in hindsight, after a
loved one has taken his or her own life.
Suicide prevention programs aim to change
that.
Mental Health First Aid, an eighthour comprehensive course, and QPR
(Question, Persuade, Refer), a 2-hour
training focused solely on suicide
prevention, are two public education
programs that have been researched


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