by Julie Cerel, Ph.D.
Suicide Prevention Ribbon
(Editor's Note: I want to thank the American Association of Suicidology for collaborating with The New Social Worker on this series of articles for Suicide Prevention Month 2018. This is the first in the series.)
There’s an oft-cited figure of the number of people left behind from every suicide--six people. I have spent the last several years working to eliminate that number, because it minimizes the impact of suicide. With random digit dial studies and use of a national door-to-door sample, my collaborators and I have consistently found that about half of Americans report they know someone who has died by suicide. We refer to this as “exposure,” in that they are exposed to the suicide of someone they know. This doesn’t even include exposure to celebrity suicides, which seem to be increasingly in the news. This means that for every suicide, about 135 people are personally exposed and about a third of those people have some degree of impact that might lead them to seek clinical treatment. With 44,965 suicides a year in the U.S. and 122.9 each day, that means that each year adds 2 million and each day adds more than 5,500 potential suicide bereaved individuals who might be in need of clinical services.
Suicide is a top ten leading cause of death in the U.S., but clinicians often do not have training to best assess and treat people who are suicidal or those exposed to suicide. In fact, only ten states have laws about social workers and other clinicians being trained in suicide assessment or intervention during graduate school or by continuing education. This is unfortunate, because there is growing evidence that hospitalization, the routine placement of clients deemed suicidal, often does not help decrease future suicide deaths, and the time after hospitalization might actually be a time of increased risk for suicide.
Many clinicians will have personal or professional exposure to suicide and often do not know where to turn after losing a family member or a client. One resource is the Clinician-Survivor Task Force of the American Association of Suicidology, which supports clinician survivors (www.cliniciansurvivor.org).
The most utilized resources for people who are suicidal in the U.S. are crisis hotlines, most notably the National Suicide Prevention Lifeline (1-800-273-TALK). There is also a Crisis Text Line (741-741) and specific services for LGBT youth (Trevor Project, 866-488-7386) and trans adults (Translifeline, 877-565-8860). National legislation has recently been passed to study the impact of a three-digit (a la 911) number for suicide prevention and mental health emergencies. This could be a huge step forward for ensuring that all Americans have access to crisis services and an easy-to-remember number. However, currently suicide prevention hotlines are often staffed by hard working volunteers (many times social work students and trainees), and there is a need for funding to ensure that a three-digit crisis line is well staffed with the best crisis workers.
Funding is another key area that creates myths around suicide. In 2018, federal research on suicide and suicide prevention accounted for $102 million dollars. Breast cancer, which takes the lives of approximately the same number of Americans each year, saw $755 million of research funding. Great strides have been made in early detection and treatment of breast cancer over the last few decades, in part a result of the investment in research. A recent release from CDC’s National Violent Death Reporting System indicated that more than half of people who died by suicide were not diagnosed with a mental health condition or seeking treatment at the time of their suicide. While this probably missed people who needed treatment, it points out the dire need to better understand who dies by suicide, how clinicians can help, and the long-term impact of suicide exposure.
Julie Cerel
Julie Cerel, Ph.D.
Julie Cerel, Ph.D., is a licensed clinical psychologist and professor in the College of Social Work at the University of Kentucky. She is currently President of the American Association of Suicidology.