Group Puts Suicide Prevention On Front Burner In San Diego

CAVANAUGH: The top story on Midday Edition, latest statistics show that just about one person a day commits suicide in San Diego. The number is notably disturbing and is unacceptable to the San Diego suicide prevention Council prepares an annual meeting tomorrow the group will gather for a community forum on what existing efforts are working and what still needs to be done to bring the San Diego suicide rate down. I'd like to welcome Stan Collins. He's a consultant for San Diego suicide prevention action Council and Stan, welcome to the program. COLLINS: Thank you for having me, and thank you for shedding some light on the subject. CAVANAUGH: The latest numbers from 2011 indicate that 320 people took their own lives last year. Was that a high rate or a typical rate for the County? COLLINS: It's hard to quantify any numbers or leads to suicide and say they are not too high. One is too high for us. We have seen an increase; this is true for the country as well. We had 411 suicides in 2012, so we are fortunate in San Diego that we…get very current information. CAVANAUGH: So the suicide rate has actually gone up? STAN COLLINS: We talk about rates. The group we are most concerned that we seen a rise in is a middle-aged group 35 to 65. For a long time we've been concerned about rates and the elderly as well as youth population. Fortunately since 2001, we've seen a slight decline in the suicide rates. CAVANAUGH: Does the incidence of military suicide factor in the San Diego County rates of suicide? COLLINS: Well, it's interesting with military suicide; sometimes we don't have all the access to the information we'd like. And people throughout the suicide prevention committee, one of the big pushes is data collection. What we do know is for the most part in any given time. Military represented 10% of the suicides in the 15 to 24-year-old age group and if you figure you are not entering the military until 18 years old that's a large number to be taking up 10% of the population so we are absolutely concerned. And then of course, nationally speaking, suicide has been the second leading cause of death for military members right behind accidents right for the three or four years CAVANAUGH: Stan, the San Diego Suicide Prevention Council is not just dedicated to reducing the numbers. Your goal is to bring the number down to zero. Is that a realistic goal? COLLINS: It's hard to say whether it's realistic but it's also hard to what is an acceptable number of suicides is it five, is it 100? So we got together and we just said let's make the goal zero. Maybe we have our doubters; maybe we can't get to the number. Maybe that's unrealistic but that's what we have to strive for. CAVANAUGH: San Diego County has been involved in a suicide prevention mental health outreach program called It’s Up to Us San Diego. Tell us about the program. COLLINS: Yeah, I'm hoping that most people are familiar with the commercials, billboards. We are fortunate through all the efforts we've partnered with, which is a company running Up to Us but they've been fantastically responsive and getting the right messages out if you go to up2us.org, you can check it out. You can get resources, you can get video profiles from folks but they are just an absolutely amazing research, top-notch websites and social marketing for us. CAVANAUGH: Have you gotten any feedback as to how people are using the service? COLLINS: It's actually not specifically a service other than the website. The website has a bunch of traffic that comes their everyday linking people to resources, local resources, they also have a resource for people in the medical field so that they can be better prepared but also resources for people in our sorts of fields, so that's just been a great partnership for us to be able to have those types of resources because one of the most difficult things for people accessing mental health treatment and help is where do I start where do I go and be up to us is a great place for people to begin searching for the help that they need. CAVANAUGH: It must be somewhat daunting for you as working in mental health working in suicide prevention to see that even with this initiative that San Diego County has launched, the number, the actual number of people who has taken their own life seems to have increased. And I'm wondering what you think about that, what do you think is missing COLLINS: I think the missing piece is that unfortunately a lot of people do not get involved in or educate about suicide prevention until it affects their lives either they have someone in their life who attempts suicide or maybe they lose someone to suicide and then they want to become educated and unfortunately people just need to be proactive and realize that suicide has affected many of our lives and we don't all need to have a story and if we get educated I lost a friend to suicide when I was a 14-year-old at Poway high school and when I finally became educated about suicide prevention a few years later I look back and I thought if someone had taken the time to educate me about this about what to look out for but most importantly what to do how to respond what to say I feel I could have saved his life or maybe he would've been in a place where he felt comfortable reaching for help and so I firmly believe and have seen to my work that just knowing how to respond, because you know, see a lot of times people are so worried about saying the wrong thing to say anything they are so worried about doing the wrong thing that they don't do anything and really what the training is going to do we provide QPR presentations which are steps for question prevent and refer and educates people about the warning signs but most importantly focuses on a conversation with questions to I ask is it okay to ask the question and we let people know that if you are worried it's absolutely okay to ask the question are you thinking about suicide. CAVANAUGH: In your experience how was depression related to suicide? COLLINS: Studies show that 80 to 90% of people die by suicide have a diagnosable mental illness but the key word there is diagnosable. In our society we are just getting to the point where we are comfortable for the most part going and seeking mental health treatment but a lot of times people wait until the mental health issue rises to the level of a crisis situation where there is a suicide attempt before seeking help so early treatment you know there's a lot of analogies you could use but say for instance, cancer if I told you right now you have cancer you would immediately walk out of the studio, you would go see a doctor but I told you I think you might have depression, maybe you would wait a couple weeks maybe you wait a couple months until it really becomes a crisis. CAVANAUGH: I know we did see a spike in suicide perhaps we are still seeing and suicide attempts because of our economic factors, people losing their jobs losing their houses there were some really high-profile suicides where a family took their lives, or murder suicides, this kind of situation and couple years ago. Is that a trigger, does that actually spark someone to go over the edge as it were, some sort of pressure like that? COLLINS: It's not so much the specific pressure, so could be economic issues. Could be family issues, going through a divorce one of them most common things we hear is the breakup of a romance so you can point to a lot of stressful life circumstances that people say are the strong that breaks the camels back but really what it is is the inability to break deal with the stress we have the capacity to deal with stress to appoint whether it's economics or whether it's a divorce or job loss that's what pushes us over and we no longer have the capacity to deal with stress so that's why everyone should feel comfortable accessing a therapist so they are being seen for may be mild anxiety as opposed to three months down the road when it becomes full-blown depression. CAVANAUGH: I understand you don't necessarily like the phrase commit suicide, why not? COLLINS: The suicide prevention community yesterday clarified with the people who refer to actions related to suicide so specifically commit suicide when you think about other actions that we commit in this world we commit sin, we commit crime a lot of people aren't aware that my family sexually from law enforcement up until about 30 years ago in most states in part of the country was illegal to attempt suicide so someone would be picked up and brought to jail if they didn't have any life-threatening injuries. We are trying to get away from the ideas of committing a crime but also the idea of committing a sin. A lot of religions are about even the thought of suicide but if your faith institution is legal for support whatever gets mixed up and you are not comfortable going to them for that we want people to feel good about reaching out to them for whatever but also other phrases you people refer to a successful suicide attempt or unsuccessful suicide attempt but if you think about it there's really no success talking about suicide because an unsuccessful suicide attempt means the person is still alive and success is getting the person what help that they need. CAVANAUGH: Another is a common belief that people who attempt suicide and do not wind up killing themselves this is actually a cry for help. What is the current thinking in the adult community about suicide attempts? COLLINS: Well, the data is always going to be very low on suicide attempts we will never know how many truly happen, but the number of suicide attempts is obviously far greater than actual death by suicide so that's something we want to be concerned about primarily because of previous suicide attempt is the biggest protector of a future attempt. It is said that on average there's about 25 adult attempts per suicide death and there's 100 to 200 attempts per youth depths of the number of attempts is in the hundreds of thousands to millions every year and we are looking at that large group who is as you said crying out for help those people need to know that it's okay to ask for help. CAVANAUGH: Is it the understanding now that this is someone who really does not want to take their lives or is it an attempt for want of a better word, failed COLLINS: I guess the answer is what I've come to understand about suicide is that most often people are not working for a way to die, it's that they do not want to live it sounds like the same thing but it's often very different things. Where someone is dealing with such deep psychological pain that they don't think anything is going to get better if today was worse than yesterday and yesterday was worse than the day before why should I tell you believe you when you tell me to tomorrow will be better we need people to believe there is hope there's treatment, there's a lot of miseducation about available treatments and really people need to start with taking care of themselves when you're feeling stressed out getting a good amount of sleep eating right and exercising which are the first three things we cross off our list when we are stressed out are the things we need to focus on doing. CAVANAUGH: Stan Collins, you said that a lot of people don't say anything because they do not know what to say. When you counsel someone who has attempted suicide to, do you find that there's a common thread that there's something that could've been said or done to stop the suicide? COLLINS: Hopelessness is the common thread. Although mental illness plays a part of this in a moment what we really need to do is give people that help like I was just talking about where is my days seem to be getting worse in that moment it is about letting people know that is going to take some work but that you can't get better. Asking people the question directly are you thinking about suicide what can I do to help who would you like to see these types of questions are perfectly suitable but people have so many reservations about having that conversation. CAVANAUGH: So basically telling someone that you think they are in some way very sad and at risk and asking them if they are actually thinking about suicide, if they say yes what do you do then COLLINS: That's when you connect to help in San Diego we have the San Diego access and crisis line at (inaudible) if it's a crisis situation, an attempt is active obviously want to call 911 if there are life-threatening emergencies but otherwise by calling the crisis and access line what's great about it is that it's not just a crisis line is not just for the person in crisis if I were thinking about suicide could call into connected have counseling over the phone but if I'm the caretaker for someone who's thinking about suicide I should also feel comfortable to call that number and they could give me advice on what to say where to response phase 2 o'clock on a Friday night where do I go what do I do now and that hotline is there 24 hours a day. CAVANAUGH: When sitting down with a person like that and having a conversation without perhaps putting in a call would that be a good idea? COLLINS: If you're comfortable with where the situation is that of course you never want to live the personal on until you get them into some sort of mental health care but a lot of times with the situations we just need to slow down and really listen. There is an old saying that is we have two ears and one mouth so he could listen twice as much as we speak but a lot of times when people are telling us that their problems we are really quick to say let me tell you about I got dumped, I lost my job let me tell you about it and a lot of times I tell people what you've really got to do is be quiet and listen, just fine with the person is feeling try to avoid the clichés of time heals all wounds and plenty of fish in the sea because it takes legitimacy of the person is feeling so sit down, explore your options. Maybe the person has seen a mental health specialist before. Were they comfortable with that person? Letting people to know better information on treatment if you are not comfortable with who you are seeing go see someone else there's a lot of different options. CAVANAUGH: I'm wondering we've all heard about concern over the rates of suicide in the military. I'm wondering how closely does the county work with the VA to form some sort of safety net for returning military personnel, veterans. COLLINS: I can't speak specifically to that in the roles I play but I know that the county through all their activities including the overall theme of live well has just done a fantastic job of reaching out but obviously there's more that can be done. The VA is doing the best they can. The military is doing what they can. But I think that there really needs to be a paradigm shift in what's going on in the military. The rates, you know that we are losing more soldiers to suicide then combat is troubling and they are our heroes they are the men and women that we look up to any to figure out a better way to deal with the stresses of combat to see that someone could go see combat and go to work and not have issues with a comic that is the unrealistic way as opposed to a lot of people who think well there is more that can be done absolutely. CAVANAUGH: My last question to you, Stan, what is what are you going to be discussing what are some of the areas you will be discussing in your forum tomorrow? COLLINS: We'll be looking at the whole issue of suicide would look at the suicide prevention Council's activities of the last couple years and 2011 San Diego County became the first county in California to adopt its own suicide prevention plan so we'll be looking at different actions of some of our efforts we found the schools collaborative track to get schools together to talk about what they can do we've reached out to the faith communities bringing in faith of all different types to work together also doing first responder training, primary care trainings so we are trying to get everyone this information so we will be talking about how many trainings, how many people have we been able to educate on the issue of suicide and also talking about what are our caps what are we missing what loopholes do we need to close to make sure everybody has the safety net? CAVANAUGH: That's tomorrow at the Jacob Center STAN COLLINS: Correct, at the Jacobs Center from 9 to 4 and we will be looking at everything we can do to help make the issue of suicide go away here in San Diego County. CAVANAUGH: And the community is invited COLLINS: Everyone is invited and also invited to talk to us about the TPR presentation the suicide prevention gatekeeper training and maybe we could get that information on the website for folks to view, absolutely. CAVANAUGH: that would be at KPBS.org. I have been speaking with Stan Collins he's with San Diego Suicide Prevention Action Council, thank you very much. COLLINS: Thanks for having me