Friday, May 11, 2001

Strategies needed
to prevent suicides

Health officials say not
enough is being done for
suicide prevention

QPR may help prevent suicides

By Helen Altonn

MORE HAWAII PEOPLE die by their own hands each year than by homicides or traffic deaths, yet little is done to prevent suicides, says Greg Farstrup, Mental Health Association in Hawaii executive director.

Oahu had 109 suicides in 1999-2000, up 10 percent from 99 the previous year, according to the medical examiner's office. The count from July last year to March 30 was 73, and it is expected to be higher before the fiscal year ends June 30.

In contrast, Farstrup noted, there are about 25 to 30 homicides per year, and in 2000 there were 65 traffic deaths.

He also pointed out that for every successful suicide, 15 are attempted.

"Not only is a lot of anguish and grief connected with that," he said, but health care costs average $5,000 to $30,000 per suicide attempt, totaling from $8.25 million to $49.5 million.

The Suicide and Crisis Hotline operated by Helping Hands Hawaii assisted 14,251 callers in 1999-2000.

In observance of Suicide Prevention Week this week, Jane Maxwell, program manager for the crisis team, said, "We're just trying to heighten awareness about this as a public health problem and let people know there are supports in the system and a hot line."

The number is 521-4555.

Suicide is the eighth leading cause of death in the country, with one suicide occurring every 17 minutes on average, Maxwell said.

QPR may help prevent suicides

QPR -- Question, Persuade, Refer -- for Suicide Prevention is designed to help someone prevent a suicide.

Suicidologist Paul Quinnett of Greentree Behavioral Health in Spokane, Wash., introduced the concept at training sessions held here last fall by the Mental Health Association in Hawaii, Helping Hands Hawaii and Hale O'io on Kauai.

With suicides the second-highest cause of death for 15- to 20-year-olds, high school teachers wanted to learn how they could help prevent student suicides.

Keys to prevention, it was noted, are early recognition of warning signs, active intervention and referral to those who can help.

These lifesaving skills are suggested:

Q: Question the person about thoughts, feelings and plans about suicide.

P: Persuade the person to get help.

R: Refer the person for help -- an adult or parent if the person is a child or adolescent, or minister, rabbi, teacher, coach or counselor. Or call 911.

The QPR method involves reaching out, asking questions, talking things out and getting others involved.

If persuasion fails, call your mental health center, local hot line or emergency services.

For more information, call the Mental Health Association in Hawaii at 521-1846; Helping Hands Hawaii, 536-7234; or Greentree Behavioral Health, 1-800-256-6996.

Source: Mental Health Association in Hawaii.

"It's pretty shocking for people to see that," she said. "Now there are twice as many deaths due to suicide than to HIV or AIDS. And for every two homicides in the nation, there are three suicides."

Adolescent suicides tripled from 1952-1995 because it is a "very troubled period of time," Maxwell said. Caucasian males over age 65 make up the top group for all suicides in the nation, she said.

"It's pretty critical that we do something at this point to take a look at what suicide prevention strategies we can get going in our country," she said. Hawaii's suicide rate ranks 41st in the nation, but many incidents are not reported for cultural reasons, according to Helping Hands Hawaii.

"Some traffic accidents are probably undiscoverable suicides," Farstrup said. "People do commit suicide by running off the road. And some people also do suicide by cop: They do something dangerous for police to shoot them."

A recent survey for the National Mental Health Association showed as many as 8.4 million American adults (4 percent) have contemplated suicide. More than 6.3 million adults (3 percent) had continuing "thoughts of suicide throughout the same two-week period," the survey found.

Michael Faenza, president of the national association, said, "In the majority of cases, suicide is the most tragic result from common and treatable mental illness."

Surgeon General David Satcher issued a report declaring suicide and suicide prevention as critical public health problems.

"The idea is to address this as a public health problem and come up with a national strategy to address it," Maxwell said.

She said she is working on a project with other crisis centers to evaluate hot lines to determine how effective they are in preventing suicide.

They are also trying to develop some strategies to reduce the stigma of having mental or substance abuse problems, she said. "We know these are factors that can contribute to suicidal behaviors."

The centers are looking at how they can improve mental health services for substance abusers as one way of preventing suicide, she said.

Most suicides are attempted nationally during springtime, a post-holiday slump period, Maxwell said.

"People who are severely depressed, and in depression, don't have the psychic energy to do something about it. When they take medications, the worst period of time for them is when energy level returns a little but the symptoms haven't abated."

Professionally trained experts in suicide assessment and intervention staff the Suicide and Crisis Center of Helping Hands Hawaii.

They have been offering educational presentations for community groups this week to increase the awareness of suicide and available intervention services.

May also is Mental Health Month in Hawaii, and the Mental Health Association emphasizes that mental illnesses are treatable, with better success than many other persistent health problems.

"Mental illnesses like anxiety and panic disorders and depression are real -- people don't fake them," Farstrup said. One out of five people -- more than 240,000 in Hawaii -- have mental health problems, he said.

The association and other advocates for the mentally ill have been working to get equal health insurance coverage for mental health problems.

"One of the life-threatening dangers is suicide," Farstrup said. "If they had better mental health coverage in health insurance ... that would help with suicide concerns and other health-care problems."

Inability to handle stress in life and abuse when people are young cause or contribute to physical health problems, he said, "because mental health is not getting the kind of help it needs."

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