Prevention is learning the warning signs

KALAHEO — Plenty of reports and statistics regarding National Suicide Prevention Month are out there, but caregivers want September to be more about teaching people how to help save the life of a loved one in a crisis.

“Most suicidal people desperately want to live and they are just unable to see alternatives to their problems,” said Dr. Krishna Kumar, of Kalaheo. “Most suicidal people give definite warning signals of their suicidal intentions, but others are often unaware of the significance of these warning or unsure what to do about them.”

Kumar is a Distinguished Life Fellow of the American Psychiatric Association in part for his advocacy work on mental health parity, reducing the stigma of mental illness and suicide prevention. He said it is good and to think about these issues all year, not just for one month. It is often up to families and friends to help approach a loved one about dealing with stress and hopelessness.

Kumar lists 30 suicide warning signs that range from suicidal ideations and acceptance attitudes, to depression, confusion, desperation or feeling no way out. A loss of purpose or a feeling of having no reason to live is another, along with rage and risk-taking, divorce, financial troubles, a terminal health diagnosis, or alcohol and drugs.

And it can affect anyone.

“Suicide occurs across ethnic, economic, social and age boundaries,” Kumar said. “Surviving family members not only suffer the loss of a loved one to suicide, but are also themselves at higher risk of suicide and emotional problems.”

Most often a suicidal thought is triggered by the death of a spouse or family member, or a failed relationship, he said. After age 50, the issues of financial difficulties, a diagnosis of a serious illness, or not preparing for life after retirement are other factors.

The Suicide Prevention office of the Hawaii State Department reports that suicide accounted for 24 percent of fatal injuries in Hawaii from 2005 to 2009. The numbers rise significantly if undetermined deaths are included.

The report states that Kauai had 85 suicides between 2007 and 2011, but the number increases to 132 when combined with 47 more deaths of undetermined intent. In either category, Kauai leads Oahu but trails Hawaii and Maui counties in either category.

A Department of Health review of suicide autopsy records found that 72 percent of victims documented at least one negative life event. These included troubled or failed relationships, a family crisis or discord, work-related problems, loss of job, financial problems, bereavement, residence issues, and seniors were more likely to report health related issues.

Age-specific suicide rates start to appear by age 15, and peak in the 45 to 54 age range. They decline again until age 85 and older, according to the report. The teen suicide rate is higher than average in Hawaii and autopsy reports for victims under age 21 report intimate relationship issues, family problems, bereavement and school issues.

Kauai Public Schools Superintendent Bill Arakaki said that teachers focus on developing positive behavior patterns with regard to decision making and resiliency skills in elementary school students. The goals are to promote a positive learning environment to prevent bullying and other negative social behaviors from developing.

Middle and high school teachers are instructed to spot “signs of suicide” to better understand at risk student mental health along with emotional health in an alcohol and drug free lifestyle. Developing positive behavior and high self esteem in youth is the goal, he said, along with goof decision making skills and character development.

“Schools not only work with students, many of the supports and interventions include the families, teacher, staff and community stakeholders,” Arakaki said. “It takes the entire village to raise a child.”

Spotting the early warning signs and tuning in to be supportive is the early help that comes from friends and family, according to Kumar. A person may convey concern by becoming withdrawn, non-talkative, irritable and other symptoms include lack of sleep, overeating or not eating at all.

A family member, close friend, relative or teacher is in a position to feel when something is not right. They are in a position to approach the person and telling them that by knowing them and observing them with their heart that there is concern. Adults relationships are more complex but it is just as important to let them know you are there to listen and not to judge, he said. If a problem seems beyond their ability to deal with it then encourage them to seek professional help by saying you care about them and want to do your part.

“Tell them ‘I am here and available to you and at your own pace to open up to whatever is comfortable for you,” Kumar said. “Tell them, ‘I am here listen and to understand. I am encouraging you to be more open’.”

The Kauai number for the HDH 24-hour Mental Health Crisis Line is 1-800-753-6879.

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