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The Riverbend Awareness Project brings you a new conversation each month about important causes and issues in our community. Every month of 2024 we will sit down and have a conversation with a professional from our community about significant issues like heart health, Alzheimer’s, literacy, and more. We’ll then share that conversation with you on the Riverbend Awareness Project Podcast, with the goal of sharing resources, and information that will help you have a better understanding of the particular problems, and solutions, associated with each topic.
Disclaimer: The views and opinions expressed in this podcast episode are solely those of the individuals participating and do not necessarily reflect the views or opinions of Riverbend Media Group or the Riverbend Awareness Project, its affiliates, or its employees. It is important to note that the discussion presented is for informational purposes only and should not be construed as medical advice. Listeners are encouraged to consult with qualified health care professionals for any medical concerns or decisions. The Riverbend Awareness Project is a product of Riverbend Media Group.
Emma: Welcome to the Riverbend Awareness Project. Each month, we learn about important nationwide topics that also affect our community.
Melissa: September is National Suicide Prevention Month, and today, Rick Croft from Community Suicide Prevention and Madison Cares has graciously come in to talk with us. Could you give us a brief little introduction of yourself, Rick, and what you do at Madison Cares and Community Suicide Prevention?
Rick: Yes, I'd love to. Thank you. And thanks for having me this morning, I appreciate it. So my name is Rick Croft. I'm a licensed clinical professional counselor here in the state of Idaho, and I do a few different things.
My day job— I work for and love the Madison School District. I am the director over the mental health department for the school district, which is called Madison Cares. And we have a team of 11 of us, and what we do is we work with our students in our district from kindergarten to 12th grade, or as I say, K to graduation. But we work with students who have mental health challenges, and when those mental health challenges start to impact their academic functioning. And typically what happens then is a parent, a teacher, or a principal notices that, notices that their student is struggling, and they'll make a referral to us.
And then we go out into the schools and work with those students one-on-one, and we see them once a week. And we provide psychosocial educational skills where we teach like coping skills, coping strategies, emotional regulation skills to our students. And so we find that we have a lot of success with that. Our services are fairly time-limited, so we do refer out to therapists in the community when we need to. And we work closely with families and include them in everything we do. That's kind of what I do for Madison Cares and for the Madison School District, and I do just need to say I have the best team ever that I work with, and they do a fantastic job.
For Community Suicide Prevention, Community Suicide Prevention is a nonprofit organization based out of Idaho Falls really, but our coverage area is quite expansive. Our coverage areas— from the Idaho-Utah border, really to the Idaho-Montana-Wyoming border. That's our coverage area.
And so we have an esteemed 21-person board of directors. Our board members are from Saint Anthony clear to American Falls, Pocatello, Blackfoot... And so we have good representation from our surrounding communities on our board, and we just do a lot with community suicide prevention— a lot of community education, we'll teach suicide awareness prevention classes to the community. We've worked with different mayors from different communities, and I'll talk about that a little bit later, but we have monthly meetings. They're free to the community. Community members can come in and attend. We provide lunch. Generally, we just have a presenter there that will talk about what suicide awareness prevention looks like in their line of work. And then we'll also just talk about anything that we have upcoming through CSP.
For instance, we have an annual conference on suicide awareness and prevention that will be in September. And with September being National Suicide Prevention Month, we do want to kind of talk about that conference, and I can talk about that a little bit later too.
So, I think I think as far as what I do with Madison Cares and Community Suicide Prevention, that kinda sums it up. There's a lot more that I could talk about, but maybe I'll just stop right there.
Melissa: Sounds like you're a busy guy.
Emma: What inspired you to become involved in mental health and suicide prevention?
Rick: So really for mental health, what had me kinda get started is if I go back to my undergraduate schooling, I studied a lot of psychology. I then applied for and was accepted to the Idaho State University Counseling program, Masters of Counseling program, and I completed that. And I really just found that I enjoyed working with people, kinda helping them through their, you know, kinda life struggles, if you will. And I just... I really... I really appreciated them in trusting me to be a part of their life, such that I could maybe provide some help, support, or guidance.
And then I've just been in the mental health field ever since. And so, as far as kind of suicide prevention goes, just working in the mental health field in my career, there's just been opportunities where I've worked with individuals that are suicidal in like a psychiatric hospital setting. I've worked at a couple different psychiatric hospitals in my career, one locally and one in Seattle, Washington. The hospital I worked at here locally, I was able to do some mental health evaluations, or really suicide assessments, in the emergency room at EIRMC.
And I did that for a few years. And again, I just found it... I guess you could say maybe interesting in that every person that came in really just kind of presented with a different situation, but the commonality was that these individuals just didn't wanna live anymore. And so my working with them and kind of assessing them and providing resources, including trying to determine whether they needed to be hospitalized for their own safety or not, you know, I just... I really enjoyed that work. I really enjoyed helping other folks and working with people and trying to get them to choose life.
Melissa: So in our researching and kinda trying to come up with questions, we noticed that some people might be scared to talk about suicide because they worry that it might increase thoughts of suicide. So what are some healthy, helpful ways to talk about suicide and suicide prevention?
Rick: Great question, thank you. And I'm excited to hear you've been doing a little research on the subject. That's great. I think we all need to do that, a little research on the subject.
So really two things there. One, you're really kind of addressing one of the biggest myths out there about suicide, and that is that suicide, like if you talk about it with someone, you're gonna put the thought in their head. That is actually... like I said, that's a myth. The fact to that is actually kinda just the opposite.
If you talk with someone that is suicidal and if you work around individuals that are suicidal, I think what you learn is that suicidal thoughts are actually, I think, more common than people realize and that more people have suicidal thoughts than you realize.
The second part of your question, what are some healthy, helpful ways to talk about suicide? You know, I think to begin with, it's just— the person that you're visiting with, you need to make them feel comfortable. You need to make them feel like what they're getting ready to tell you or talk about— because it is deeply important to them— and so you just need to make them feel comfortable, you need to be present, you need to be in the moment and ready to listen.
And so helping them feel comfortable is really... is really kind of the first key to talking to somebody in a healthy and helpful way. In talking with them and giving them your full attention, it's also just showing that you care about them. And sometimes that's one of the most critical things you can do, is just show that you that you care about them. That you're taking time out of your day, time out of your life to give it to them, because you care enough about them that you wanna listen to them and you wanna help them. And so I think those are some ideas as to how you can talk with somebody that is that is suicidal in a helpful way.
Emma: Do you have any examples of good questions to ask somebody if you're worried that they might be struggling with suicidal thoughts?
Rick: I do. I think, you know, there's a couple things that you can say to somebody that is suicidal, and one is you could just always, you know, say, "hey, I... you know, will you go with me to get some help?" That might be a nice thing to say.
Or, "will you let me help you get some help?" You know, "what can we do for you right now to keep you safe right now?" You know, those are some things that you can say. As far as asking good questions to somebody who might be struggling with suicidal thoughts, there are some questions that you can ask, and I wanna kind of go through those in some detail here, if that's okay.
And so I think first of all, if you're visiting with somebody that is suicidal, if you're in doubt, you're thinking they're suicidal, you're not sure, maybe they've not totally verbalized that yet, and you just have a hunch or a suspicion based on what you're hearing that that might be going on, that they might be having some suicidal thoughts— if in doubt, ask the question. Ask them if they're having suicidal thoughts. Ask them if they're thinking about wanting to die.
It's okay to ask those types of questions to somebody. Again, kind of going back to that myth that we talked about, where talking about it does not put the thought in someone's head. It gets to the point where when we kind of feel or have a hunch that somebody is suicidal, they probably are. And it's not like we're gonna present something to them that they've never heard of, thought of, you know, maybe even talked about.
And so I think just asking the question, I think we need to be prepared that if that person is a little reluctant to visit with us and open up and kinda tell us what's going on, it's important to be persistent with them. And now I would say being persistent isn't being annoying, but being persistent is, for instance, if we ask somebody if they're suicidal and they say no, it's okay then for us to kind of listen to them and have them start telling us about what's going on with them and what is causing them some life stress.
You know, 3 minutes, 4 or 5 minutes from now, we have to kinda circle back around and ask a question about safety. If they're feeling suicidal, well, that's okay. And that's kind of an example of what being persistent means. It's just hanging in there with them and maybe having to revisit that question and re-ask it. I think it's important to talk with someone in kind of a private setting.
If you are concerned about somebody and concerned that they're suicidal, and you wanna visit with them, you don't wanna do it in a crowded hallway, business, around a lot of other people. And some of that is just... if you kinda turn that, you kinda look at yourself, where would you feel most comfortable in talking with somebody? And it's gonna be in a quiet, kind of private setting. And so I think we need to think about that for someone else and offer that to someone else. We need to allow that person to talk freely about what's going on.
Sometimes the best thing we can do is just listen non-judgmentally, and that is just get them talking about their life stressor and what's going on with them and what they're struggling with. And sometimes it's kinda like silence is the best intervention. I mean, sometimes we just need to be silent and we just need to listen to what that person wants to tell us and also kind of recognizing and realizing that as they're talking with us, it's also just relieving that emotional stress that they've been carrying around with themselves for quite some time.
And if we're gonna talk with somebody about suicidal thoughts, we also need to make sure that we're taking the time to do that. If you have to be somewhere in 10 minutes from now, it's probably not a good question to ask somebody, "are you feeling suicidal?" Because then you're gonna have to wrap up that conversation pretty quick and of course, you know, that that's probably not gonna be in the best interest of that person that we're visiting with. You know, definitely would not wanna say, "hey. Could you hurry this up? I gotta go." So just allow yourself plenty of time to visit with that person.
And then I think just have some resources handy that you can give to that person, like the 9-8-8 Suicide Hotline, having that as a resource to give to them. And with that real quick, the 9-8-8 National Crisis and Suicide Lifeline, that 9-8-8 is a new number, newer number. I think it's been out about 2 years now. But the old suicide hotline number used to be this long 1800 number that that was pretty difficult to remember. And especially if you think about it for a minute, if you're in a moment of acute stress, your memory may not be working the best that it can.
And so anyway, our Congress, United States Congress decided to pass legislation in creating this 9-8-8 number to be consistent with the 9-1-1 number, and everybody knows 9-1-1, and the hope and the goal is that over time, everybody will know 9-8-8 as well as they know 9-1-1. And so I think just having those resources handy, that's important to give to a person.
So I think too, when you're talking with someone that is suicidal, it's not so much that you ask the question in a right way as it is that you just ask the question. Asking somebody if they're thinking about harming themselves, hurting themselves, killing themselves. And there's a couple different approaches that we can kind of look at and think about when it comes to talking with somebody that is suicidal.
There are kind of less direct questions, or a less direct approach to asking questions. Some of those examples might be, "have you been feeling unhappy lately?" "Are you thinking about hurting yourself?" "Do you feel like giving up?" These are kind of just more indirect questions that we could ask somebody that we think is suicidal.
More of a direct approach to asking the question would be more like saying something like, "you know, when some people are as upset as you seem to be, they sometimes wish they were dead. I'm wondering if you're feeling that way too." Another way would be, "I'm worried about you. I wonder if you're thinking about suicide." Or a very direct way of asking that question is just, "are you thinking about killing yourself?"
Now with my saying that there's a less direct approach and a direct approach, neither one of them is necessarily right or wrong. It's really personal comfort in how you feel comfortable in asking that question to someone. Again, remembering that how you ask the question isn't as meaningful as it is that you actually ask the question.
There are a couple ways that you don't want to ask the question to someone that is suicidal. One example would be saying something like, "you wouldn't do anything stupid, would you?" Or, "suicide is a dumb idea. Surely, you're not thinking about suicide." And even, I think, as I say those, I mean, it just rings through that, well, no, you wouldn't ask somebody a question like that. But I think clearly seeing as I ask those questions that we don't wanna pass that kinda judgment onto such a question, because I think what we would risk is somebody just if we answered or— excuse me, if we asked the question in those two examples that I just gave is that that person is just gonna shut down and not wanna talk, not wanna open up and tell us what's going on because they already feel judged before they can even talk to us.
So those are just some things I think I would say about, you know, kind of some good questions that we can ask somebody that's struggling with suicidal thoughts.
Melissa: Thank you. I like the idea too, like, you're gonna ask questions. Be prepared to listen without judgment. Like, if you really wanna help this person, that's the approach. You gotta be ready to sit there and listen and engage.
Rick: Yes. Absolutely. And if I could just say this to that: so listening non-judgmentally, that's so important because when someone starts telling us about all the reasons why they're feeling suicidal, there may be things that they're telling us in their life that religiously we don't agree with, spiritually we don't agree with, morally we don't agree with. And so sometimes it might be hard sitting there listening to somebody just talk about what's going on with them, but it is so, so important if we can remember that it's really... it's about them, not us.
And where it's about them is we just need to be present. We just need to listen and kinda keep our stuff in check, if you will, and just keep our focus on them.
Emma: So you've asked the question and you've had a conversation with someone about suicide. What are some protective factors that could be helpful?
Rick: Great question. Let me let me first just kinda define what a protective factor is. So a protective factor is a characteristic or attribute that really reduces the likelihood of attempting or completing suicide. Protective factors are like skills that we have, strengths that we have, or resources that help people deal more effectively with stressful events. That's really kind of what a protective factor is, and protective factors enhance resilience and help really to counterbalance risk factors.
So if you kind of think of protective factors and risk factors as a two sided scale, you know, we never want there to be more risk factors on the risk factor side of the scale weighing the scale down in favor of the risk factors. I mean, it's important to also on that scale have at least as many protective factors. But ideally, we have more protective factors than risk factors, and then that scale tips in favor of the protective factors. And so that's just maybe one way to kinda look at that.
Some examples, I think, of protective factors, just to kind of throw this out there— and again, these are just a few examples, but having access to mental health care in our communities, that can be a protective factor. There are some rural communities in Idaho where there just isn't a lot of mental health care available, and so having access to mental health care can be a protective factor.
Us being proactive about our own mental health, that can be a protective factor. Taking care of ourselves, and however that might look, kind of some self care stuff or whether you like reading self-help books, if you will, but also just kinda having a support system. So just being proactive about our own mental health.
Feeling connected to family and community supports is another protective factor. So, I mean, really, we're all social beings, and so there's a lot of positive good things that can come from just being connected and feeling connected to friends, family, to our community.
Another protective factor, another example would be just having healthy problem solving skills and coping skills.
Another example, limiting access to lethal means. And we'll kind of talk a little more later. I just wanted to kind of expand on that a little.
Cultural and religious beliefs can encourage connection with others and can create a strong sense of purpose or self esteem. So cultural and religious beliefs can be a protective factor.
For youth, having at least one trusted adult can be critical for them. Trusted adult, someone that they feel like they can go to and open up and tell things to that they feel safe in doing that. A friend of mine that is actually a mental health first aid instructor, he and I teach together and he'll tell a story where his football coach knew more about him at that time in his life than his own parents. His football coach became his trusted adult. His football coach was an adult that he could really tell anything to at any time. And so that's pretty important for youth.
Maybe last thing I would just say about protective factors is... I just gave some examples of protective factors. Again, kind of back to my analogy of the scale in looking at protective factors and risk factors— having more protective factors is gonna be what's most important. And so the examples I just gave, if you have one of those in your life that I just mentioned, that's fantastic. If you have two, that's even better. If you have three or more, that's even better. And so we really just need to build up the number of protective factors in our life, and we definitely want our protective factors to outweigh our negative risk factors.
Melissa: Thinking about... kind of risk factors, what are some signs or warning signs that someone might be more at risk for suicide?
Rick: I have some examples that I wanna just share as far as kinda some warning signs— and I'll kinda break them down into like verbal warning signs and behavioral warning signs and situational warning signs.
Some kind of direct verbal warning signs, of course, are gonna be if we hear someone around us— and it could be friend, family member, loved one, but it may just be someone in the community— but a direct verbal warning sign is if we hear someone say, "I've decided to kill myself." "I wish I were dead." "I'm gonna end it all." Those are clearly... those are more direct verbal warning signs.
More indirect verbal warning signs would be comments like, "I'm tired of life." "I don't know if wanna go on." "Pretty soon, you won't have to worry about me." Those are just a little more indirect— saying the same thing, but just a little bit more indirect.
Some behavioral warning signs, if you will— any previous suicide attempt is a behavioral warning sign. Acquiring a gun or stockpiling pills, maybe putting your personal affairs in order, which at an age in your life, it just doesn't seem like that's the right time for somebody to be putting their affairs in order, kind of like end-of-life affairs in order.
Giving away prized possessions, that's another kind of behavioral warning sign that we need to kinda watch for. I was watching a documentary once regarding Robin Williams, the actor comedian Robin Williams. And in the documentary, it said that a couple days before he died by suicide, he had gone over to a friend of his' house— and Robin Williams collected fine watches. He had a watch collection. Well, a couple days before he died, he went over to a friend of his' house, knocked on the door, and ended up giving his friend his watch collection and then walked away and went back home. And so... and then we all know what happened a couple days later, but that's an example of giving away prize possessions. For someone that's younger, it might be maybe giving away Pokémon cards if that's what they collect, just as an example.
Another behavioral warning sign would be like a sudden interest or disinterest in religion. And then maybe finally, just kind of some situational warning signs would be being fired from a job or expelled from school, loss of any major relationship, death of a spouse, child, or best friend, and especially if that death is by suicide, loss of financial security, and feeling like you're a burden to others.
Those are all kinda situational warning signs. And so there are a lot of warning signs that you and me and all of us can kinda be looking out for. And those are just some examples of those.
Emma: Could you please teach us more about some suicide prevention skills?
Rick: Absolutely. And I think we have been talking a little bit about just some suicide prevention skills, but I think one thing in addition that I'd like to add is that there are some wonderful suicide awareness prevention... they call them gatekeeper trainings, trainings on learning how to recognize the signs and symptoms that somebody might be suicidal.
Some of those examples are there's a class called QPR— Question, Persuade, Refer is what QPR stands for— and it's just one of the many gatekeeper trainings, and it helps the person that takes that class recognize, again, kind of the signs and symptoms that someone might be suicidal. Another great class to take is youth Mental Health First Aid. That's another course that is offered in in our communities.
There's also an adult Mental Health First Aid class that people can take. And then maybe just one other one that I'll mention is it's called ASIST, and ASIST stands for Applied Suicide Intervention Skills Training. And each of these classes really goes over all the same information, if you will. The QPR class is kind of a shorter class. You can actually take that class in about an hour and a half, give or take.
The Mental Health First Aid classes last about 6 and a half, 7 hours, 7 and a half hours. The ASIST class is a 2-day class, and so it gets pretty in-depth into talking about suicide and suicide prevention. And so if you're interested in taking any of those classes, oftentimes in our communities, you can find one of those classes that's provided free. And with QPR and with Mental Health First Aid, once you complete those classes, you actually kind of like have a certification, and the certification lasts for 3 years. So, valuable classes to take.
Like I say, they're often offered in our communities for free. But what I would say about the classes that I just mentioned is that Community Suicide Prevention, the nonprofit organization that I'm involved with, we offer all of those classes. And so if you're interested in in taking one of those classes, then you could certainly reach out to Community Suicide Prevention by going online and looking at our website and reaching out to us. That's one thing I think I would say in addition to kinda what we've mentioned already about suicide prevention skills is maybe take the time to take one of these classes. I think you'll be glad that you did.
Melissa: You mentioned in one of the risk factors earlier that if you lost a family member or a loved one to suicide, that that can be, you know, prompting other possible bad emotions or mental health situations. So what are some suicide postvention skills?
Rick: Postvention skills, you know, those two words together may not resonate as, you know, commonly to us as hearing about suicide awareness and prevention. Postvention when it comes to suicide is really... it's like an organized kind of immediate, short-term, long-term response to the aftermath of a suicide. And the response, the postvention response, is really to promote healing and to mitigate any negative effects or exposure to suicide.
Postvention is also pretty critical to do when it comes to preventing a phenomenon called suicide contagion. Maybe some folks out there have heard that, and it is a thing that happens sometimes, and contagion could just be that there was a completed suicide, and then a couple weeks later there's maybe another completed suicide, and then a few days after that, you know, another completed suicide. And if there's some kinda connection between all of those individuals, then that can become a contagion. And so postvention is critical in terms of, you know, not only just, you know, kind of promoting healing and mitigating the effects of a suicide, but also to work with those that might also be suicidal and to give support to them such that that doesn't become an option for them.
For instance, in a school setting, let me just say, kinda select postvention would be— because I work for the Madison School District, so let's say we have a suicide in our district. It's important for us to then put our crisis team together and respond to the school where the suicide was and then make my staff available to the school such that we can be available to students, oftentimes faculty, and sometimes parents. Sometimes parents will come to the school and their child was a good friend to someone that died by suicide. And so for us to be able to provide that in a school environment, that's really important. And so that's just one example of kinda what postvention would look like.
Melissa: Thank you. It actually... that reminded me when I was in high school. I think I was a sophomore, maybe a freshman. There was someone in our high school that committed suicide, and I wasn't super close with them, but it was still... it was terrible. But it was just so... I don't wanna say the wrong word. It was so odd coming back to school and knowing that I— like, all these people around me were horribly, horribly sad and I wasn't not sad.
But I didn't know what to do with my emotions specifically because I'm like... I'm not super... I wasn't super close or friends with him or in his same grade, but, you know, like, even just knowing, okay, how do I respond to this? Even, like, more of an outsider, but still knowing him and, like... so I think... I don't know, just knowing what to do with any of those kinds of emotions in response
Rick: Sure.
Melissa: is an important thing
Rick: Sure.
Melissa: For sure.
Rick: And I think... thinking of being a fellow student to that person, that student that died by suicide, you know, maybe they were in a locker five lockers down.
Melissa: You never know.
Rick: Yeah. Maybe you had second and fourth hour with them and now their desk is empty. There are a lot of students that have a lot of emotions that sometimes they don't know what to do with them.
Sitting there, staring at an empty desk can be pretty difficult, you know. And so yeah. I hear you. I mean, that's... and again, I think that's why a postvention, I hate to say intervention because it's postvention, but that's why postvention is so important.
Emma: What does recovery look like for families and loved ones affected by suicide?
Rick: Yea, that's a good question. You know, I think the best way I could answer that would be to just say that I think recovery is gonna look different for everyone. You know, when someone dies by suicide and a family is left to try to navigate the difficult emotions and life changes that have taken place, I really think that that recovery just is gonna look different for everybody, and I think it kinda goes back to what we're talking about as far as protective factors go.
And it could just be that someone having a lot of protective factors— that's gonna be critical, I think, in recovery. And if they don't have a lot of protective factors, I think, during the course of recovery is trying to bring more protective factors into your world, you know, into your life.
Also, just having a support system. Through community suicide prevention, we have a survivors of suicide loss support group. So recovery might look like also attending a survivors of suicide loss support group and going to a support group and being able to make friends with, visit with, talk with other people who have lost someone to suicide, you know, that can be part of the recovery process.
You know, somebody that has lost a child or lost someone to suicide, you know, I think I'd wanna say that recovery doesn't mean that you're gonna reach a day where you don't have those memories anymore or you're totally good with what took place. That's not recovery. Recovery is gonna be more of a process. You're always gonna have love and memories of that person that you've lost. It's gonna be lifelong.
It's just important during your recovery process to not feel rushed, not feel like there's a time limit, not feel like there's a deadline, and to just know that it's a process and it could potentially take the rest of your life to just kinda continue to work toward recovery.
Melissa: We talked about one misconception earlier— talking about suicide can lead to suicide. Are there other common misconceptions about suicide and suicide prevention?
Rick: Yes, there are. Let me actually talk about some other myths. I had referenced earlier in the interview that one of the largest myths out there is that if you talk about suicide, you're gonna put the thought in someone's head. So let's just kinda work through here some other some other myths and then some facts about suicide.
I will revisit that first myth that talking about suicide increases the chance that a person will act on it. Actually, the fact is just the opposite. Talking about suicide can actually be relieving and release some emotional pressure in someone that's talking about that. I'd mentioned earlier that it also just shows that we really care about someone.
When I say that it releases emotional pressure, if you will, kind of think of like a pressure cooker. And there's a lot of pressure in the cooker, and to release some of the pressure, you just, you know, you loosen a valve and air starts to come out of that pressure cooker. And in many ways, talking with somebody that is suicidal kinda is that same thing. It's like talking with them is relieving some pressure that they've been just carrying around inside of themselves. And so please just note talking about suicide with someone is not putting that thought in their head. It's actually just the opposite.
I think another myth about suicide is that people who talk about suicide are just seeking attention. And let me address that for a moment, because maybe they are, but let's talk about maybe why they're seeking that attention. Maybe it's difficult for them to put words to how they're feeling, or maybe they just don't know how to express themselves in a healthy way.
They may engage in behaviors that call attention to themselves, but we do need to remember, and I believe this, all behavior is communication. All behavior is communication. And we need to be looking for or listening to what are they trying to communicate to us? What is that attention-seeking behavior communicating to us?
I really don't like those two words together, "attention seeker." I more prefer "attention needer." And to just expand on that just a little bit— if someone is demonstrating behavior that seems attention-seeking, to me, they're just saying, "hey, I need your attention. I need you to notice that I'm struggling. I need you to notice that I think I need some help here." And so, are they seeking attention? Yes. Are they needing attention? Absolutely. So I think that that's an important point for us to think about.
And so let's go into another myth. Another myth is that suicide cannot be prevented, that if someone's gonna kill themselves, they're just gonna kill themselves. Actually, again, the opposite is true. Suicide is very preventable. It's one of the conditions out there that is actually one of the most preventable just by, you know, like we've kind of been saying, having somebody, visit with somebody, talk with somebody, process through what they're feeling, being present for someone, and taking the time to listen to them. That makes suicide very, very preventable.
Another myth I think is that people who take their own lives are selfish, they're cowards, or they're weak. And boy have I heard that from time to time. And so let me address that, because that is such a myth, where the fact really is that suicidal thoughts often result from someone feeling like that they don't belong or feeling like that they are a burden.
There's a pretty famous suicide researcher in our country, Dr. David Rudd, and Dr. David Rudd's theory on suicide is that people die by suicide for three reasons. People die by suicide because they feel unlovable. People die by suicide because they feel their emotional pain is unbearable, and that their current life stressors are unsolvable. So his theory says unlovable, unbearable, unsolvable. And that makes a lot of sense to me when I've heard him talk. I've actually listened to him lecture on a few different occasions, and that really makes a lot of sense to me.
And too, I think I would just say is that, you know, suicide is very complex. There's no one reason why people die by suicide. I mean, it is a unique and personal thing, and it's complex. There's generally not one reason why someone will die by suicide. And I think too, to just kind of remember that suicide is often associated with psychiatric illnesses or disorders, disorders such as like depression or anxiety. Maybe you've heard of bipolar disorder, schizophrenia, substance use.
And I think too with this myth that people are selfish who die by suicide, and again, it's just the opposite— people die by suicide not because they want to necessarily die. People die by suicide because they are tired of being in the emotional pain or physical pain that they're in, and they've tried about everything they can think of to have that pain go away, and it just hasn't worked. And so suicide is more about trying to end living in pain rather than actually wanting to die. And I think in my saying those things, I think it becomes a little more clear that suicide is not a selfish thing.
Another myth that I've heard, I guess, is that teenagers and college students are the most at risk for suicide. I do have some data to kind of maybe change our thinking on that. This data is from 2022, and it comes from the QPR Institute, and it's based on every 100,000 people. But the age group that has the highest suicide rate are those individuals in our world that are age 85 and older. That is our highest range.
And then if we look at, well, what's the second highest range? Those individuals in our life that are age 75 to 84. Then we get a little younger, I guess, followed by the age group of age 25 to 34. And to just give you an idea, so 85 plus, age 85 and older, that number is 22.4 individuals per every 100,000 people. So the numbers I'm giving you are for every 100,000 people.
Age 75 to 84 is 19.6. Age 25 to 34 is 19.5. And then it just goes down from there. Age 35 to 54 is the next most, followed by ages 55 to 64. So really, we're kinda... so far, we're talking about a lot of our older individuals in our communities.
And then at the bottom of this list is actually those ages between 15 and 24 and ages 5— yeah, down to age 5— that's amazing, but age 5 to age 14. So those are the age groups that have the fewest suicides per every 100,000 people and those statistics are for the United States.
Two last myths: one myth is that safe firearm storage and other actions to reduce access to lethal methods of suicide don't work, and the fact is, again, just the opposite. The opposite is true here. Safe storage saves lives. And when I say safe storage, I'm talking about locking a gun up. It doesn't have to be in a large gun safe. It could be in a smaller locking safe, trigger lock, a trigger lock on a gun.
Research shows that if someone is suicidal and they've decided to end their life, that if it all sudden becomes difficult for them to obtain their means as to how they're gonna die by suicide, like a firearm, and if it's gonna take them an additional 3 minutes to get into a safe to get the gun, research shows that that 3 minutes is critical because that 3 minutes is 3 minutes where that person may change their mind. That they may change their mind and decide that that's in fact not what they wanna do. And it may even be that that's not what they wanna do right this second, but we'll take it. We'll take it. And so safe storage of firearms, for instance, does save lives.
And then the last myth I'll talk about is that suicide occurs without warning. And in fact, again, just the opposite is true. The fact is that research shows that approximately 75 to 80% of people that die by suicide, and yes, there are people that study that and research that, that 75 to 80% of people that die by suicide, when they go back and look at a week, two, three weeks leading up to their suicide, that 75 to 80% of people left at least one warning sign. Again, that's when it kinda comes back to you and to me to be kinda looking for warning signs on someone that they might be might be suicidal.
And so I think there's probably a few other myths, but I think I've kinda gone over enough there. Maybe I'll stop there on some myths.
Emma: So knowing the warning signs of suicide is really important, but what are some ways that individuals can support people who are having suicidal thoughts?
Rick: Yeah, I think there's a few things that are in play here that we need to talk about in talking with somebody that is struggling with suicidal thoughts. And I know we've addressed some of them already, but, you know, a couple other things that we really need to be looking at is that we need to assist somebody that is having suicidal thoughts into seeing a professional. They really need to get in to see a professional to kinda work through all the reasons why they are feeling suicidal. And so it's pretty important to get them in front of a professional.
Another thing I think I would just say as far as talking with somebody that is suicidal is if they end up telling us openly that they are suicidal, that one thing that we need to do is be prepared to either take that person to the closest emergency room or find somebody that would take that person to the nearest emergency room. Our emergency rooms in the area do mental health evaluations, or as I had mentioned earlier too in my introduction just saying, you know, I was on the crisis team for EIRMC and we were doing suicide assessments in the ER.
There's a trained professional that someone that is suicidal can meet with and have a full assessment done in an emergency room, and sometimes that's what's needed. Sometimes that's what's needed is to get that person in front of a professional right now, and that right now would be an emergency room because it could be that we're not gonna be able to get that person in front of a licensed therapist right now. You know, that that might take a little bit longer. So I think for us to remember that emergency rooms are an option to have someone assessed for their suicidal thoughts.
And then there's a couple other things that I just wanted to bring up, I think, that are in play.
And first thing I wanted to just share is a research study. This study is about people, whether they're getting help or they're not getting help, but I thought this was relevant, and so I wanted to share it. So in this study, people were asked one year after their suicide attempt what could have stopped them from attempting suicide? And that sounds like it was an interesting study. And so what they found was that surprisingly 52% of people polled said nobody or nothing could have stopped them from killing themselves. 52%. 21% happened to mention their relatives or friends, and only 10% mentioned a health professional.
Two things there. I think one, people may not think of a mental health professional or going to see a mental health professional if they're having suicidal thoughts, like maybe they've just not connected those two things in their mind. But then I think really the other thing that is going on is really— and this is a kind of an interpretation pulled out of the study— people experience suicidal thoughts in an egosyntonic way. Egosyntonic meaning as something that makes sense to them personally and that does not need treatment, that it's uniquely a personal thing.
And so then, just a couple other things, and again, I think that's kind of fascinating about that study that they did. Another thing that is at play here, I think, and another reason why people don't seek help— so if we kinda look at it that way. So, you know, people, at least per this study and this research that they did, people weren't interested in reaching out and getting help.
And so there are some reasons for that, I believe. One is shame. Shame is involved in, I think particularly in young people, but shame can be shame for what I have done, shame for what happened to me, shame of their physical appearance, or maybe even just shame for feeling who they are. You know, shame about who they are. And so sometimes I think shame can keep people from reaching out and getting help.
And I think there's still to this day a lot of mental health stigma that's at play. One of the myths that we talked about talked about that getting help is a sign of weakness, and I think that is still, you know, associated with stigma in our communities. So along with stigma, 47% of Americans believe that seeking professional therapy is a weakness. This number actually grows to 75% if we look at our military veterans.
And so I think that's one thing we're up against is stigma. Stigma of getting help. Also, the stigma of, you know, why can't I just do this myself? I've got through a lot in life. This is just another thing, but how come I can't get past this? I must be a weak person or something along those lines. So I think stigma. Stigma is alive and well, and I think stigma is another reason why people don't reach out to get professional help.
Melissa: We did talk about some resources already, those classes, and then mental health professionals and Community Suicide Prevention. Are there other resources available for either someone seeking support for themselves or a loved one?
Rick: Yeah, I think for us to know in our area that Idaho has an Idaho careline, and the Idaho CareLine is just 2-1-1. You just dial 2-1-1 and you'll get an automated voicemail system, but it'll just kinda walk you right through what some resources are here in the state of Idaho for Idahoans. So I think that's a good resource for people to become familiar with and know about.
We talked a little bit about the 9-8-8 National Crisis and Suicide hotline. That's a great resource. I've been pretty excited to see around our communities billboards up that have the 9-8-8 information on them, and so I think that's wonderful.
Another resource would be the Community Suicide Prevention website, and that website is community suicide prevention eid.org. Communitysuicidepreventioneid.org. And that website has a lot of really good information on it and resources on there. And then there's also contact information. If by chance you don't find what you're looking for on that website, you can reach out to us, and we'll certainly answer all your questions and point you in the right direction if we need to do that.
So I think there's a lot of resources available in addition to those that I've just talked about in our communities, and some of those are primary care physicians, school counselors, school principals, coworkers. There's a lot of resources out there if we can actually go looking for them.
Emma: So you talked about the crisis hotlines or the suicide prevention hotlines. Could you please give us just a little more information on how they work and why they're so important?
Rick: Yes. Absolutely. The 9-8-8 National Crisis and Suicide Lifeline, for those of us out there that don't know this, the Idaho hub, if you will, the 9-8-8 hub is in Boise. It's located in Boise. It is staffed 24/7. There's trained professionals on the other end of the phone that will take your call and kinda walk you through and talk you through whatever that crisis is.
As it's called the Idaho Crisis and Suicide Lifeline, people do call 9-8-8 for a variety of reasons. It's not necessarily just for someone that is suicidal. There is a report that the 9-8-8 crisis line here in Idaho puts out occasionally, and they kind of do like a pie graph, if you will. And on the pie graph, it's like all the reasons why someone has called into the hotline. And I've looked at that data sometimes, and there's been times where it's just like people are calling in for financial stress, relationship stress, school stress, and people calling in because they're suicidal.
But I think, maybe not everybody realizes that that 9-8-8 number is really also just a crisis line. So if you if you are having a relationship crisis or financial crisis going on in your life, you can also call and talk with a trained professional. And again, they'll just kinda walk you through and talk you through what's going on.
And so another thing I wanna point out is that it's interesting with the 9-8-8 number. I work up in Rexburg at the Madison School District, and so in Rexburg is the campus of BYU-I. And so we have students from all over the world that come to Rexburg to attend school. One thing to be aware of with that 9-8-8 number is the way it's set up right now is when you dial 9-8-8 from a cell phone, that system picks up your area code. And once it picks up your area code, it directs you to the hotline in your home state. And so if I'm from Tennessee and I'm attending BYU-I, for instance, and I'm in a crisis and I dial 9-8-8, I'm gonna be connected to my state hotline in Tennessee.
You get to still talk to somebody, and that's wonderful, and somebody's gonna answer that phone and talk with you. But just to point that out for people to know, because I think to myself sometimes like if... let's say I'm from West Virginia and I call 9-8-8 from Idaho Falls, Idaho... How familiar is the crisis line in West Virginia gonna be? How familiar are they gonna be with resources that are available in Idaho Falls, Idaho and surrounding communities? And so I would hope that they are pretty knowledgeable about those resources, but that's one thing that I think we all ought to know about that 9-8-8 hotline and how that works.
Melissa: That is really helpful to know because I'm from out of state. So it's good to know that I'm gonna get transferred to California rather than somewhere in Idaho. So I think that's really useful information.
Rick: Well, like, and I think for you to know for someone that you might give that number to, right?
Melissa: Yeah. Because who knows? Like, there's lots of people moving here too. Like, and you don't always change your number because that's a hassle. So, like, even just...
Rick: Right.
Melissa: people who aren't at school, like, general population.
Rick: Yeah.
Melissa: It's really helpful.
We're kind of rolling on with this conversation of resources and diving deeper into them. Can you tell us about community support groups and how they can be beneficial to someone experiencing suicidal thoughts?
Rick: So there are some real good support groups in our communities. Communities really kind of, you know, Ashton, St. Anthony to Pocatello, American Falls.
And I'd mentioned earlier the Community Suicide Prevention, the organization, we have a survivors of suicide loss support group. We have one of those support groups in Pocatello. There's a support group that runs here in Idaho Falls also. You know, those are important groups to have. They're very focused. They're very focused on the topic of a survivor of suicide loss.
There are other support groups in the community. Another way to find out about those support groups would be to call that Idaho Care Line at 2-1-1 and visit with them about what resources are available.
And too, I think, you know, one thing to the last part of your question that I just wanted to talk about is like a support group for people that are experiencing suicidal thoughts. To my knowledge, there's not a lot of those available. There's not a lot of those around in our communities. And I believe it's for this reason. If you look at somebody that is suicidal, we've talked a little bit about that they may feel like they're unlovable or things are unbearable or unsolvable. Oftentimes, somebody that is feeling pretty suicidal has lost hope. So if we think about— if we put 8 to 10 suicidal people in a room, there's just a possibility that there's gonna be a lot of kinda negative emotions. There's gonna be a lot of hopelessness. There's gonna be a lot of despair. And sometimes it's just not the most therapeutic thing to do is to put several individuals that are suicidal all together to talk about all the reasons why they're suicidal and all the reasons why they wanna end their life.
And so I have heard of some support groups for survivors of suicide attempts. I am just not aware of in our surrounding communities who is all holding a support group like that.
But support groups can be valuable. Often, they're free. It just takes your time and attendance. And so I would just say finding the support group for you that's gonna work for you is something that would be important.
Melissa: Is there anything we missed you wanna talk about?
Rick: Well, yeah. I appreciate you giving me a chance to just kinda share some other thoughts.
I think one thing that I would like to share just to everyone listening here today is that there's really this movement in the study of suicide that's important that I wanted to pass on and share with everybody, and a lot of this comes from survivors of suicide loss. And that is how we refer to a suicide. I know— and myself included my entire life, I grew up hearing "committed suicide."
"They committed suicide." "Did they commit suicide?" Commit, commit, commit. In the field of suicide, like I say, kinda driven by survivors of suicide loss, we're wanting to move away from the word "commit." The word commit has a negative connotation to it, and this is what I've heard from people. The word commit is often used with commit a crime, commit a sin, commit adultery, and these are all negative things. And so referring to somebody as committed suicide, that's language that we wanna move away from.
And we really wanna replace that with two ways, "completed suicide" or "died by suicide." And those two phrases are really kind of the new ways to refer to suicide.
And I know that we've worked with some media groups in our communities through Community Suicide Prevention to try to get that new language implemented into to news stories and radio stories and so on and so forth. And we've been pretty successful at that. There's still some work to do, but it's really important.
That's one thing that I would add is that we really wanna move in the direction of using completed suicide or died by suicide and doing away with the word commit. Another thing I think we don't wanna say is "successfully..."
Melissa: Yeah.
Rick: "completed suicide."
Melissa: It's not a success.
Rick: That's correct. So there is just some language that we're wanting to move away from and replace it with more sensitive language.
Emma: Thank you. And suicide, it can be a very, very heavy topic because there's a lot of emotions involved in that. So we also wanted to ask you if there's any message of hope or healing that you would like to share.
Rick: Yeah. I think there's a lot of hope, and I think that individually for us sharing hope with someone, that can be really powerful. You know, some statements of hope could be, "I want you to live." "I want you to be here longer." "I want you in my life." "I'm on your side." "I want you to get some help." "I want you to get better."
Maybe asking, "who else could support you?" Could it be a family member, a friend, coworker, someone that's been there for you in the past? Can they be there for you again this time? You know, that person that was supportive of them last time, if they give them a lot of hope, then let's lean on that person to be support again.
I think just letting that person know that you care about them and that they mean something to you can give them some hope. I think what I would then just kinda conclude with saying is just us sharing care and concern can save a life, and our being interested in them and concerned and worried about them and willing to help them can give them hope.
Emma: Thank you so much, Rick, for joining us today and for teaching us more about suicide prevention and awareness. If you enjoyed today's episode, please remember to share, subscribe, and rate the Riverbend Awareness Project.
Melissa: If you'd like to send us an email, you can reach us via podcast@riverbendmediagroup.com. Thanks for listening and join us next time on the Riverbend Awareness Project.