One of the foundations of medical care is that when someone's life is in danger you do what you have to do to help them. Someone coming into the hospital for a heart attack is not told, "We're full. Try the place down the road.... or Go home, we'll call you when we get space...."
But in Tennessee and many other places the burden to provide care is no longer sacred if someone is suicidal and in danger of killing themselves. Care is mandated, but only if economically feasible.
The law in Tennessee is Title 33. It is the law that governs the terms of commitment when you pose a threat of harm to yourself or others. In Tennesse it now says that you can only be placed if "suitable accomadations" (ie- a bed) are availible. If they are not availible then you will be locked in an emergency room or jail until they are. North Carolina is farther along in that process than Tennessee. Recently they had someone handcuffed to a hospital bed for 8 days awaiting "suitable accomadations." One can only wonder at the effect that had on his mental health.
The basic effect is to criminalize suicidality. People can now be locked up without trial until "suitable accomadations" are availible. There crime is to be inconvenient and cost too much at a time where virtually everything costs too much. Nobody wants these detentions to be a long term affair, but what defines long? 8 days for someone who is suicidal and whose mental health is in danger of slipping to the point of no return sounds like a long time to me. Already mental health consumers distrust the system. How many people will refuse to go the hospital or lie and cover up their problems for fear they may be handcuffed to a bed. Who can blame them? How many people will die, because they were afraid to seek the help they so badly needed. It does not matter how many "detentions" happen. The perception that it is possible or likely will be enough to substantially effect people's decision to seek help.
And this does not even consider the effect on the hospital trying to do things it is not equipped to do or police officials having to guard people whose only crime is to be sick when "the house is full." Officials in North Carolina report this "brief detentions" as being extremely expensive, taking time, energy, resources, and money away from areas it could have been used much more fruitfully.
But the implications go even far past what happens to any specific individual. It further fuels an attitude already present and already growing that mental illness is an "elective disease" and that needed treatment need not be provided when it is "financially inconvenient." All over the country advocates have been fighting to save mental health budgets and the services needed for people to have any chance of a decent life. If the services needed to save life are conditional then what does that mean for other services. What does it say about us when we say some people are disposable and others are not? The answers I believe are scary.
Thursday, July 30, 2009
Wednesday, July 29, 2009
On QPR
QPR was borne in Seattle, Washington several years ago. It was developed by Dr. Paul Quinett and was that community’s effort to address the crisis of a rising suicide rate. From the initial success in Seattle QPR has spread throughout the country and is now recognized widely as one of the most effective ways to teach ordinary people the skills they need to help someone at suicidal risk to stay safe.
QPR teaches someone three basic skills:
How to question a person about suicide and what is going on with them. Q
How to persuade that person to get help. P
How to refer that person to the appropriate resources for help. R
QPR compares itself to the Heimlich maneuver in the sense that it is a series of basic techniques that almost anyone can learn, that requires no real specialized training, and that by the application of it saves lives. QPR has been taught to many different populations and has been successful in almost every instance of decreasing the suicide statistics of that area. It is not meant to be a form of counseling or treatment and does not attempt to substitute for that. Its’ focus is to get people past the moment of crisis and to the help they need to turn their life to positive directions.
During QPR training you learn a lot about suicide. You learn warning signs and you also learn some of more common myths about suicide. You learn, for example, that suicide to the suicidal person seems, not like a problem to be avoided, but a solution to be embraced. At the same time you learn that although somebody might see suicide as a solution, no one wants to see it as a solution and you learn how to appeal to that natural ambivalence.
The training itself last about 1-1.5 hours. It can be done in large groups, but the ideal groups are one that allow for maximum interaction. My wife Linda and I have been trained as QPR trainers by the Tennessee Suicide Prevention Network. We are available to train your group and would be delighted to talk with you further about that. If you have questions or would like to learn more please let us know.
from http://hopeworkscommunity.wordpress.com
QPR teaches someone three basic skills:
How to question a person about suicide and what is going on with them. Q
How to persuade that person to get help. P
How to refer that person to the appropriate resources for help. R
QPR compares itself to the Heimlich maneuver in the sense that it is a series of basic techniques that almost anyone can learn, that requires no real specialized training, and that by the application of it saves lives. QPR has been taught to many different populations and has been successful in almost every instance of decreasing the suicide statistics of that area. It is not meant to be a form of counseling or treatment and does not attempt to substitute for that. Its’ focus is to get people past the moment of crisis and to the help they need to turn their life to positive directions.
During QPR training you learn a lot about suicide. You learn warning signs and you also learn some of more common myths about suicide. You learn, for example, that suicide to the suicidal person seems, not like a problem to be avoided, but a solution to be embraced. At the same time you learn that although somebody might see suicide as a solution, no one wants to see it as a solution and you learn how to appeal to that natural ambivalence.
The training itself last about 1-1.5 hours. It can be done in large groups, but the ideal groups are one that allow for maximum interaction. My wife Linda and I have been trained as QPR trainers by the Tennessee Suicide Prevention Network. We are available to train your group and would be delighted to talk with you further about that. If you have questions or would like to learn more please let us know.
from http://hopeworkscommunity.wordpress.com
On a slow death
It was 3 oclock in the morning when the call came. I was working as a counselor at a crisis center and was struggling to stay awake. I quickly woke up.
Her voice was quiet and at first I had a hard time hearing her, but her words shook me to my foundations: "I am getting ready to die...I just wanted to talk to one more person before I did it..."
She was in a borrowed truck in the middle of a field somewhere. She described to me the pills she had. With a little bit of prompting she started to tell me her story.
She had been married and had two small kids. The previous Christmas (about 4 months prior) her husband had been getting ready to go Christmas shopping. He was going to take the 4 year old and she was going to keep the 2 year old. The 2 year old was real hyper and starting crying and begging to go and so finally she relented and they all went off to go shopping, leaving her at home.
On the way to the store they were hit by a drunk driver and all 3 were killed. She started to describe to me the 4 months of death that had followed for her. She had kept all their clothes and stuff and every day all she saw was their absence and the hole in her heart. The drunk driver had killed her husband and the 4 year old, but she really wondered if she had not killed the two year old. Each day was an ocean of depression piled on the previous days ocean. She felt like she was dying and told me she just cursed how long it was taking. She was starting to hear their voices and felt sure she was going crazy.
On top of it all she had found out her mother had terminal cancer and she was the only support her mother had. Each breath she felt was colored in more pain than the previous one.
We talked for 3 1/2 hours that night. I finally asked her, "What died when your husband and kids died? Did your love for them die?" I told her that they lived now only in her memory and if she died the last of them would be gone too. She cried... A lot.... I think maybe I did too.
Finally she agreed to meet me at the local emergency room and about 7 am that morning I finally met her. We hugged and cried some more... She ended up going into the hospital for a short time and got some help for the incredible weight she was carrying. She stopped. She didnt die. She chose to live.
I dont know exactly how things ended for her. I am sure death was with her for a while. When it grips you it doesnt leave easily. But I hope she is now as free as she can be and I hope she is as glad as I am that she chose life.
Her voice was quiet and at first I had a hard time hearing her, but her words shook me to my foundations: "I am getting ready to die...I just wanted to talk to one more person before I did it..."
She was in a borrowed truck in the middle of a field somewhere. She described to me the pills she had. With a little bit of prompting she started to tell me her story.
She had been married and had two small kids. The previous Christmas (about 4 months prior) her husband had been getting ready to go Christmas shopping. He was going to take the 4 year old and she was going to keep the 2 year old. The 2 year old was real hyper and starting crying and begging to go and so finally she relented and they all went off to go shopping, leaving her at home.
On the way to the store they were hit by a drunk driver and all 3 were killed. She started to describe to me the 4 months of death that had followed for her. She had kept all their clothes and stuff and every day all she saw was their absence and the hole in her heart. The drunk driver had killed her husband and the 4 year old, but she really wondered if she had not killed the two year old. Each day was an ocean of depression piled on the previous days ocean. She felt like she was dying and told me she just cursed how long it was taking. She was starting to hear their voices and felt sure she was going crazy.
On top of it all she had found out her mother had terminal cancer and she was the only support her mother had. Each breath she felt was colored in more pain than the previous one.
We talked for 3 1/2 hours that night. I finally asked her, "What died when your husband and kids died? Did your love for them die?" I told her that they lived now only in her memory and if she died the last of them would be gone too. She cried... A lot.... I think maybe I did too.
Finally she agreed to meet me at the local emergency room and about 7 am that morning I finally met her. We hugged and cried some more... She ended up going into the hospital for a short time and got some help for the incredible weight she was carrying. She stopped. She didnt die. She chose to live.
I dont know exactly how things ended for her. I am sure death was with her for a while. When it grips you it doesnt leave easily. But I hope she is now as free as she can be and I hope she is as glad as I am that she chose life.
Tuesday, July 28, 2009
He said he had a gun
He told me he had a gun and was prepared to use it on himself. I knew he had tried before. He had a huge scar on the side of his face. He hadn't died, but had left himself with seizures and a whole host of problems.
He was part of an online support group that I did and although we had never "met" we knew each other. He had been badly abused as a child- the kind of abuse you see in movies. He had been in and out of hosptals, in and out of jails his entire life. He had lost a family and never really had any friends. He was lonely and lonely. He talked to his dog and talked online. He never really thought anybody would want to be his friend- never really understand why anyone would go to the bother for him.
About 12 years ago he went into a psychiatric hospital. They ended up discharging him and telling him that he was "hopeless." That was the afternoon he tried to blow his brains out.
That afternoon I didn't really know what to do. He was about 1500 miles away. I didnt even know for sure what town he was in. I couldn't think of any way to call the police, so I just listened and talked.
We talked for 3 1/2 hours that day. We talked about pain and loneliness and feeling like you were disposable and would never be missed if you were gone. I told him that he had courage and he at first thought I was just saying it. I explained. "Every day you have to fight yourself. Every day you have to decide not today. Every day you have to wait for a better life you really don't believe is coming. Every day is an act of courage for you."
I thanked him for being my friend and told him that I wanted him to live. He seemed astounded that anybody really cared. By then he had put the gun in another room and we talked about him going into treatment. He didnt want to do that but we talked about the difference betweeen good places and bad and I told him that right now he could choose. If things got worse he would be involuntary and probably not end up in a great place.
I left him my phone number and told him to call whenever. About 3 or 4 weeks later he did call. He had just gotten out of treatment, had different meds and didnt even sound like the same person.
He thanked me. He told me I had saved his life. I told him that I was honored to be his friend and that he was a gift in my life.
All over the world are people who see themselves as disposable people. They see hope as an empty promise and people as lies put there to torture them about the life they wish they had. Someone once asked me, "Whose 3 oclock in the morning call are you? Who knows you will be there when they need somewhere to go?"
More than anything people need people and they need to know that they have value to another living person. Without that suicide for them is just the second part of death. Depression, bipolar, and all the other "mental illnesses" have astronomical rates of suicide. 1 in 5 people with bipolar die from suicide. One study I saw said that if you are both bipolar and schizophrenic 1 in 3 die from suicide. And one of the most hurtful things these conditions do is that they isolate you from other human beings. They leave you alone regardless of the size of the crowd.
There are many pieces of knowledge you need to help people in need. Nothing you hear here will substitute for professional help or make you a professional. But do not underestimate the power of caring. Whose place of refuge are you and just as importantly where is your refuge?
Thank you and God bless.
He was part of an online support group that I did and although we had never "met" we knew each other. He had been badly abused as a child- the kind of abuse you see in movies. He had been in and out of hosptals, in and out of jails his entire life. He had lost a family and never really had any friends. He was lonely and lonely. He talked to his dog and talked online. He never really thought anybody would want to be his friend- never really understand why anyone would go to the bother for him.
About 12 years ago he went into a psychiatric hospital. They ended up discharging him and telling him that he was "hopeless." That was the afternoon he tried to blow his brains out.
That afternoon I didn't really know what to do. He was about 1500 miles away. I didnt even know for sure what town he was in. I couldn't think of any way to call the police, so I just listened and talked.
We talked for 3 1/2 hours that day. We talked about pain and loneliness and feeling like you were disposable and would never be missed if you were gone. I told him that he had courage and he at first thought I was just saying it. I explained. "Every day you have to fight yourself. Every day you have to decide not today. Every day you have to wait for a better life you really don't believe is coming. Every day is an act of courage for you."
I thanked him for being my friend and told him that I wanted him to live. He seemed astounded that anybody really cared. By then he had put the gun in another room and we talked about him going into treatment. He didnt want to do that but we talked about the difference betweeen good places and bad and I told him that right now he could choose. If things got worse he would be involuntary and probably not end up in a great place.
I left him my phone number and told him to call whenever. About 3 or 4 weeks later he did call. He had just gotten out of treatment, had different meds and didnt even sound like the same person.
He thanked me. He told me I had saved his life. I told him that I was honored to be his friend and that he was a gift in my life.
All over the world are people who see themselves as disposable people. They see hope as an empty promise and people as lies put there to torture them about the life they wish they had. Someone once asked me, "Whose 3 oclock in the morning call are you? Who knows you will be there when they need somewhere to go?"
More than anything people need people and they need to know that they have value to another living person. Without that suicide for them is just the second part of death. Depression, bipolar, and all the other "mental illnesses" have astronomical rates of suicide. 1 in 5 people with bipolar die from suicide. One study I saw said that if you are both bipolar and schizophrenic 1 in 3 die from suicide. And one of the most hurtful things these conditions do is that they isolate you from other human beings. They leave you alone regardless of the size of the crowd.
There are many pieces of knowledge you need to help people in need. Nothing you hear here will substitute for professional help or make you a professional. But do not underestimate the power of caring. Whose place of refuge are you and just as importantly where is your refuge?
Thank you and God bless.
Sunday, July 26, 2009
One of the myths of suicide
A major myth about suicide is that you can't change someone's mind when they make their mind up to die. People use it to justify inaction, because dealing with this issue is such a scary thing for them.
The truth is that although suicide is seen as a solution to life's problems it is not a solution that anyone wants to believe. People have a lot of ambivalence-- even those who attempt. They did a study of the people who jumped off the Golden Gate Bridge and lived. The results were important. They asked people the obvious question, "What went through your mind as you jumped?" Almost to a person the answer they got was the same, "What a stupid thing to do? What now? How did I ever decide to do this?"
Ambivalence saves lives. It makes people keep on looking for a better way. Talk to a person in trouble. Tell them that what they really wanted to be true is true. They don't have to die.
The truth is that although suicide is seen as a solution to life's problems it is not a solution that anyone wants to believe. People have a lot of ambivalence-- even those who attempt. They did a study of the people who jumped off the Golden Gate Bridge and lived. The results were important. They asked people the obvious question, "What went through your mind as you jumped?" Almost to a person the answer they got was the same, "What a stupid thing to do? What now? How did I ever decide to do this?"
Ambivalence saves lives. It makes people keep on looking for a better way. Talk to a person in trouble. Tell them that what they really wanted to be true is true. They don't have to die.
Saturday, July 25, 2009
On the narrow edge of suicide
The following post appeared first on http://hopeworkscommunity.wordpress.com/ and then on Facebook on the "stop suicide" cause. It is a description of what it meant to one person to confront suicidal impulses in her life.
I have a close friend who almost died.
She used to describe for me what a day was like when you were suicidal. She said it was like a prison, but she could never leave. Everywhere she went it came too. It was like a thousand voices telling you to do something you really didn’t want to do and when you looked to see who was talking to you all the voices were yours. She didn’t live just in depression or discouragement. She lived in terror.
She told me about how many times in a day she would think about slitting her throat or walking in front of a car. The desperation in her voice come through clear with every word. She felt like death was the best answer for her—but she didn’t want it to be. In the end I think the only thing stronger than her passion for death was her passion for life. She held strong and ferociously to the idea that what was happening was not her, but something that was happening to her.
She has searched diligently for the right medication and so far hasn’t really found it. She seems to be a walking side effect. Most of her meds have serious side effects and she always seems to have the most serious of the side effects. She often wonders if the cure stops the disease what will cure the cure. She has gained a lot of weight and with that has come a lot of health worries. On a good day she feels bad. She has had significant dental problems from years of anticonvulsants. Many of the everyday stresses that she deals with are described in the medication packages where it starts with “side effects include.”
She has been in the hospital before and may well have other visits ahead for her. She hated it, because she felt like her dignity as a human being was disregarded there, but it was a safe place in an unsafe time and may well serve that function again.
She is a prayerful person. She turns daily to Him and in her weakness has found His strength. She is grateful for the many blessings she has gotten and told me once that even this overwhelming depression that seemed cloak everything she said or did was at bottom an opportunity to get closer to Him. Even when the worst of things seem to occupy every inch, every breath, every beat of her life she tries to rejoice in the opportunities ahead.
She is in many ways a miracle. In her illness she has tried to find a path to what she can be instead of a complaint about what she can’t be.
Sometimes she is very much afraid. She knows terror well. But hers is a terror ultimately of herself and the edge to which her strange brain chemistry drives her. She loves life and loves God with all her heart, but knows the terror of that which tries to entice her, to browbeat her and threaten her until she finally gives up on what she loves and buys their counterfeit truth.
She has won no wars, but fights many battles. Some days are better some days are not. One day she may die. The illness will not go away and constantly demands more of her life. I asked her once what she had learned and what she could tell other people and I liked what she said.
“I have learned what it is like to live in a prison of one. I have learned to keep other people close so that the walls don’t rise. I have learned that there is wisdom sometimes in fear and to always be open to it. I have learned that no matter how much I feel like doing something I don’t have to do it. I have learned I am not my illness. I have learned that I do not prosper in the denial of my illness, but in knowing that my freedom, as much as I have it, is in deciding what of its demands I listen to. I have learned I can decide not to die, but I must decide so every day. I have learned that God is with me and I matter to him. And I have learned when the demons come upon me and their chorus grows louder and louder, I can say with His help, “No. No, not this time.”
She remains each day in my prayers. I hope now she will be in yours.
I have a close friend who almost died.
She used to describe for me what a day was like when you were suicidal. She said it was like a prison, but she could never leave. Everywhere she went it came too. It was like a thousand voices telling you to do something you really didn’t want to do and when you looked to see who was talking to you all the voices were yours. She didn’t live just in depression or discouragement. She lived in terror.
She told me about how many times in a day she would think about slitting her throat or walking in front of a car. The desperation in her voice come through clear with every word. She felt like death was the best answer for her—but she didn’t want it to be. In the end I think the only thing stronger than her passion for death was her passion for life. She held strong and ferociously to the idea that what was happening was not her, but something that was happening to her.
She has searched diligently for the right medication and so far hasn’t really found it. She seems to be a walking side effect. Most of her meds have serious side effects and she always seems to have the most serious of the side effects. She often wonders if the cure stops the disease what will cure the cure. She has gained a lot of weight and with that has come a lot of health worries. On a good day she feels bad. She has had significant dental problems from years of anticonvulsants. Many of the everyday stresses that she deals with are described in the medication packages where it starts with “side effects include.”
She has been in the hospital before and may well have other visits ahead for her. She hated it, because she felt like her dignity as a human being was disregarded there, but it was a safe place in an unsafe time and may well serve that function again.
She is a prayerful person. She turns daily to Him and in her weakness has found His strength. She is grateful for the many blessings she has gotten and told me once that even this overwhelming depression that seemed cloak everything she said or did was at bottom an opportunity to get closer to Him. Even when the worst of things seem to occupy every inch, every breath, every beat of her life she tries to rejoice in the opportunities ahead.
She is in many ways a miracle. In her illness she has tried to find a path to what she can be instead of a complaint about what she can’t be.
Sometimes she is very much afraid. She knows terror well. But hers is a terror ultimately of herself and the edge to which her strange brain chemistry drives her. She loves life and loves God with all her heart, but knows the terror of that which tries to entice her, to browbeat her and threaten her until she finally gives up on what she loves and buys their counterfeit truth.
She has won no wars, but fights many battles. Some days are better some days are not. One day she may die. The illness will not go away and constantly demands more of her life. I asked her once what she had learned and what she could tell other people and I liked what she said.
“I have learned what it is like to live in a prison of one. I have learned to keep other people close so that the walls don’t rise. I have learned that there is wisdom sometimes in fear and to always be open to it. I have learned that no matter how much I feel like doing something I don’t have to do it. I have learned I am not my illness. I have learned that I do not prosper in the denial of my illness, but in knowing that my freedom, as much as I have it, is in deciding what of its demands I listen to. I have learned I can decide not to die, but I must decide so every day. I have learned that God is with me and I matter to him. And I have learned when the demons come upon me and their chorus grows louder and louder, I can say with His help, “No. No, not this time.”
She remains each day in my prayers. I hope now she will be in yours.
The beginning of 16 Minutes
With this post begins "16 Minutes." It is a blog built around two things. Every 16 minutes someone commits suicide. It doesn't have to happen.
The idea for this blog grew from a cause on Facebook: "Stop suicide. Every 16 minutes someone dies from their own hand." Within 2 weeks over 230 people from all over the world had joined the cause and the comments that I got talked about their personal experience of suicide, rather it being during a hard time for them, or the act of a family member or loved one. And person after person said: "This is a tragedy that shouldn't happen." And so I decided to start something that reached beyond simply Facebook. The cause on Facebook continues to grow and hopefully will grow more. But this is an issue that we need to reach out to everyone on. We have the knowledge and services to help. We lack simply the will or decision to do so.
Within this blog you will find several things:
The idea for this blog grew from a cause on Facebook: "Stop suicide. Every 16 minutes someone dies from their own hand." Within 2 weeks over 230 people from all over the world had joined the cause and the comments that I got talked about their personal experience of suicide, rather it being during a hard time for them, or the act of a family member or loved one. And person after person said: "This is a tragedy that shouldn't happen." And so I decided to start something that reached beyond simply Facebook. The cause on Facebook continues to grow and hopefully will grow more. But this is an issue that we need to reach out to everyone on. We have the knowledge and services to help. We lack simply the will or decision to do so.
Within this blog you will find several things:
- Stories shared by survivors. The goal is both to serve as a memorial of sorts to those who tragically died, but also in sharing their stories to help motivate action to avert this terrible tragedy for other families.
- Information. There is a tremendous amount of information out there about the phenomenon of suicide and the different factors that influence it.
- Resources. Links to different organizations and sites that provide resource and assistance in dealing with the issue.
- What can you do to help? And perhaps most importantly what can you do to make an impact on this important issue.
Comments are welcome. Please feel free to address any issues you feel relevant. It is through sharing our experience, knowledge and perspectives that all of us grow. If you are a survivor of suicide or an attemptor and wish to share your experience I would be most grateful to hear from you. We can all make a difference.
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