September is Suicide Prevention Awareness Month, an opportunity to spread the word about actions we can take to prevent suicide, and to change the conversation to one about healing, help and hope. In that spirit, the Register spoke with Michelle Hoag, the clinical director at the Southeast Kansas Mental Health Center.
The conversation, which has been edited for length and clarity, is also available as a podcast at iolaregister.com/registered, Apple Podcasts and Spotify.
This is a difficult topic for many of us to talk about. It’s scary, but suicide has become a huge issue. Suicide is now the 12th leading cause of death in the United States. What’s behind the rise in suicide rates?
Hoag: There’s a lot of data that shows that after a pandemic, suicide rates spike. I feel that individuals are dealing with more and more stressors today. There are more life demands that people have to balance. There could also be a history of trauma, and as an individual ages, that trauma and the impact of it become more severe if left untreated. But I think a huge piece is that our world has been in turmoil for the last 2.5 years because of the COVID-19 pandemic.
We see the issue of suicide having an acute impact in men. 79% of all suicide deaths are male. What’s going on with men that drives that problem?
Men typically choose more lethal methods when contemplating suicide. Unfortunately, men have a tendency to die by suicide, whereas females may have more attempts. Males may use more lethal means with substances, firearms and other modalities.
How does the SEK Mental Health Center work with men around this issue?
For anyone who is struggling, our message is to provide hope. Individuals are often taught to internalize problems and keep family challenges within the family. Our goal is to help individuals externalize those challenges and try to paint a picture of hope by looking at situations from different perspectives and identify patterns that can change life stressors.
I’m thinking of the hyper-masculinity idea that emotions equal weakness, and that talking about your problems opens you up to ridicule.
Yes, our society has taught that boys and men don’t cry. At times males are taught to suppress their feelings and emotions, so when they become stressed, if they continue to internalize and don’t utilize their natural support or professional help, the stress keeps playing over and over within them. But that happens for males and females, depending on their upbringing and coping skills.
Are we lonelier than in the past? I think about how civic participation has fallen across our society, and what that might mean for mental health. How does isolation affect mental health and suicide?
We’ve just gone through the COVID-19 pandemic. We saw businesses and restaurants shut down. A lot of our community activities stopped, and they’re just now starting back up. But individuals are still anxious about being around a lot of people, and they’re still struggling with the stressors the pandemic created, whether that’s a job loss, reduced income, or rising prices.
But here in Allen County, we have a lot of opportunities. Be open to new things. If you’re going to a community event, invite someone to go with you. When I first moved to Iola, I wasn’t aware of all the resources. Think of Farm City Days, Biblesta, Farmers’ Market. If you’re heading out, invite your neighbor or someone to go with you. One, so that others learn about what’s going on in town. And secondly, to help people get out of their homes and not isolate themselves.
Apart from American Indians and Alaska Natives, non-Hispanic whites are the demographic group with the largest rate of suicide in the US. What are some of the reasons there?
A large piece is the shift towards isolation. I also think individuals feel a lot more pressure around what they think they have to provide and contribute to their families. We’ve also seen some shifts in family support. It’s not as strong as it once was. A lot of family units have two parents working, and their kids are in school and involved in many activities. Those households are constantly running, and it has become more difficult to make ends meet.
As we look at the LGBTQ population, there are real risk factors. LGBTQ youth are more than four times likely to attempt suicide than straight youth, and transgender adults are nine times more likely to attempt suicide than the general population. That’s frightening.
As a center, we assess for risk of suicide or self-harm. And a big piece of that is listening non-judgmentally. Being present, allowing the individual to talk about what is happening and truly trying to put yourself in that person’s shoes is terribly important. The other piece for our staff is just trying to help them have hope. And so we look at the opportunities for acceptance and to explore what is helping them feel more comfortable.
From a community or society perspective, a huge piece is acceptance. When we think of this population, they just want to feel comfortable in their own skin and be accepted for who they are, just like each of us. You want people you care about to be happy, confident and comfortable with who they are. What’s right for you isn’t always right for them, and vice-versa. But we can still respect each other. If you are having a difficult time understanding something, don’t make assumptions. Ask questions politely and respectfully, and show this person you are willing to listen.
What are some warning signs around suicide?
Isolation is a big one. Withdrawing from family, friends and activities can be a sign. Watch for extreme changes in behavior. This can be more manic behavior, or more risk taking, or making choices they wouldn’t normally. Depression is a warning sign, as is more emotionally reactive behavior.
Other things to consider are an increase in substance use or the use of additional substances. Or if they have things that are important to them, and they start to give those things away. If they threaten to harm themselves or someone else, that can also be a sign.
There are many things that can be signs or symptoms. If you’re close to someone, watch for any extreme changes in behaviors.
But sometimes those warning signs never appear, right? I think about 15 minutes of really terrible decisions that can lead someone to attempt suicide. And that makes me think about firearm safety. What are some tips if you have firearms in the home to make sure they’re kept safely?
With gun safety, you can get trigger locks. We always advise to keep guns and ammunition separately. Keep the guns locked in a safe or security box.
Any time we’re working with someone who’s had thoughts of harm or suicidal ideation, we advise for the guns to be removed from the home. If there are any threats or thoughts, family members need to make sure access to firearms is completely removed.
And if you have kids in the home, recognize that kids are curious and have a tendency to be impulsive. Make sure your guns are locked up. If your children know there are guns in the home, they might have some gun safety skills, but that doesn’t guarantee other people in your home have those same skills or knowledge.
If you or someone you know is considering suicide, please call or text 988 or visit 988lifeline.org. You can also contact the Southeast Kansas Mental Health Center at 1-866-973-2241 24/7 or visit sekmhc.org. The National Suicide Prevention Lifeline at 1-800-273-8255 (TALK) and online at SpeakingOfSuicide.com/resources have additional resources.