Everything I can't tell you about Suicide

I want to write something about suicide. 

Tyler Hilinski's apparent suicide at Washington State University struck a nerve with me. As a Licensed Mental Health Counselor (LMHC)  I deal with suicide on a regular basis. I see clients of various levels of suicidal ideation each day in my private practice. Some are recovering from a previous attempt and can't believe they ever go to that point. Some are actively battling suicidal thoughts but can't see a way out. Some were contemplating suicide but have  improved dramatically in treatment. I also assess inmates on suicide watch at the county jail each week. In the last year I have had to go into multiple schools to offer counseling to the student body following the suicide of a fellow student. So I would have expected myself to have a more professional response to the news of Tyler Hilinski's being found dead in his apartment of a self inflicted gunshot wound with a suicide note. I went Washington State. I lived in Pullman. I was on that campus. I was part of that community. 
I want to tell them something that will make them feel better. Something that will empower them as individuals to stop future suicide. Something that will give hope to all of those struggling with suicidal thoughts of their own that are on that campus and in that community even as I write this. Something that will change the attitude and perspective of both those that didn't even think of suicide until they heard the news about Tyler, and those that sit and worry about things happening to people, students, athletes just like Tyler everyday. 
I have a lot I want to say. But I can't say it. 

I want to say that suicide is not a Mental Healh disease and it can't be solved by the Mental Health industry the way the CDC can contain an epidemic. Suicide is an individual's chosen course of action impacted by countless factors mental, social, and environmental. It requires personal not just systemic intervention. 
But that undermines my entire profession as a Licensed Mental Health Counselor as Mental Health resources are absolutely essential to stopping and preventing suicide. 

I want to say that government struggles to balance autonomy with public well-fair and suicide falls directly into that divide. 
But that could be interpreted as the government should stop funding Mental Health initiatives like suicide prevention, which clearly are necessary. 

I want to say that suicide is more like a stomach virus in that there is little that medicine can do for a patient. Being suicidal is not a condition that gets cured or even treated, it is just waited out, while you try to keep the patient as safe and comfortable as possible. It's usually a temporary state lasting a few hour to a few days. And that should be an optimistic thought. This too shall pass. 
But that implies suicide is rather benign and not an overwhelmingly arduous challenge for anyone to grapple with. It also insults all the people whose lives have been changed by attentive doctors fine tuning their pharmacology. 

I want to say that Depression is not being suicidal. In fact, if you are too depressed you don't have the wherewithal to attempt suicide and you actually have to cheer up a bit to become suicidal. 
But that might be misconstrued as saying depression doesn't impact suicide, when it obviously does. 

I want to tell you that the best systemic solution to suicide is to get rid of guns and drugs. Access to firearms and being under the influence of a substance are the 2 risk factor that cause the odds of a person completing suicide to skyrocket!
But that only upsets the near universal agreement that suicide is a serious problem into 2 of the most intensely debated controversies in this country.

I want to say that I love Malcom Gladwell, but his characterization of suicide as a social epidemic in the Tipping Point may have thrown the entire field of suicide prevention off track. I agree with the point he was making about the spread of ideas. But having it juxtaposed with fashion trends and smoking, makes suicide seem frivolous and beyond interpersonal control. It's simultaneously too big a problem for individuals to do anything about, too random for a systemic response. He should have put it in Blink which is about human decision making, a far more appropriate context to discuss suicide. 
But Gladwell is a well respected, award winning, and best selling author, journalist, and researcher. I'm just an individual with an ax to grind at the moment. 

I want to say that suicide prevention is un-American as it denies the autonomous freedom of an individual to live and die as they choose.
But that is insulting to Americans as it portrays them as callus and unconcerned with the problem of suicide. 

I want to say that collectivist cultures can inadvertently encourages suicide with an emphasis of the the needs of the many outweigh the  the needs of the few. 
But that is insulting to collectivist cultures and ignores  the individual struggle of those within such a society that have suicidal thoughts.  
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I want to say that people become suicidal because of inherent evolutionary impulses or instincts associated with shame, that human society has always sought to amplify and increase in a perpetual misguided attempt to motivate people to do better. 
But that really is just a theory.

I want to say that suicide is only the natural and obvious solution that any person would consider when they want out of a situation but believe that the consequences of quitting will be worse than the untenable thing it's self. 
But that makes it sound as if I am blaming those contemplating suicide of just taking the easy way out. 

I want to say that suicide is a people issue, and it really can only be contained with people truly loving and caring for each other. 
But that sounds like hippy dippy cum-buy-ya pie in the sky platitudes from a children's nursery rhyme. It's obviously not that simple. 
Or is it?
I'm not providing statistics. I'm not quoting experts. I'm not piecing together a compelling argument. I'm just irresponsibly spouting off my option. All of these statements come from my experience as a Counselor. I believe them to be true, but that would be misrepresenting my personal beliefs as professional expertise so I can't tell you that.

However the one thing I can say is that if you look at all the things I can't say about suicide they all point to a singular truth. 
Suicide prevention is a personal responsibility we have to ourselves as individuals and to each of our fellow human beings. No amount of government and healthcare administration or regulation can make up for it. It can't be done alone and it can't be managed by the system.
Only You can prevent Suicide
​But you need everyone else to do it too.

Given everything I can't say thus far, I certainly can not say definitively "This is how we prevent suicide." No one can at this point. That is the problem. That is our shared frustration. If I were to  try it would be something like this:

​Stopping suicide is a matter of changing a culture of personal responsibility into a culture of interdependent  responsibility. It begins with you but it ends with everyone. 

Your feelings matter, attend to them before they become unbearable. 
Your neighbor's feelings matter, attend to them before they become unbearable. 

See counselors, doctors, coaches, advisers, or any other source of support and guidance regularly or occasionally as needed. Treat these experiences the same as you would going to a football game or to practice. Don't deny yourself the resources available. The state appropriations committee does a bang up job of that all by its self. Then tell your family and friends about the experience. Say how it helped or if it didn't. What did you like and what didn't you like about the experience. Maybe you tell them why and maybe you don't. The choice is yours. Then Recommend they do the same and support them in doing so. 

Tell your regular doctor about your feelings, especially if they fail to ask you about them. 

Treat everyone you encounter as if they are included and belong in your life. 

Make sure those that you love know that you love them and that they matter. 

Ask people who you may be concerned are stressed if they are thinking of hurting themselves. Do so gently but explicitly. One of 3 things will happen. 
1.) They get insulted by the question and go on public record with a resolution that they are not going to hurt themselves. They may not be out of danger but they have just taken a mental step in the right direction. 
2.) They say "yes", and then you can help them stay safe. This is actually the best possible outcome. You want them to say yes because the 3rd possible outcome is...
3.) They lie and say "no" to keep you from interfering in plans to commit suicide. This is by far the least likely to occur. 

If you ask and they say "no", explain your concerns and inform them of your intentions to follow up with them. 
Then follow up with them.
Follow your instincts. Call for help anyway if you doubt the truth of their response. Deal in good faith with those whom you have a sincere relationship.

Remember, you never have to take away people's pain. You never have to rid them of their suicidal thoughts.
You can't do that. No one can. That is not the task at hand. The task at hand is to give them safety. Safety is what they need at that moment. That's all you can do.  And it is usually enough. 
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Let love be your motivation instead of fear, because people, especially people on the edge of suicide, can tell the difference. And it makes a big Difference.
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