Effects of suicides acutely felt in rural communities

 By Joseph Boushee
Yellowstone Newspapers

EDITOR’S NOTE: This is the second story in a series focusing on suicide. 

“The tragedy and community impact of suicide is nowhere more intensely felt than in rural and frontier communities, where connections are deep, interactions are constant and memories are long,” said Aliceann Carlton, a licensed clinical professional counselor, in a report titled “Responding to Suicide Risk.”
Carlton, who has worked in the mental health profession for about 25 years, works four days a week at the Eastern Montana Community Mental Health Center and one day a week at the Prairie Community Hospital in Terry.
“I think the community impact of suicide is huge, and it’s long-lasting,” Carlton said. “I think the impact tends to be deeper, longer ... more keenly felt.”
In May, Custer County District Court sponsored a telephone seminar featuring Terry L. Wise, an international speaker, author and suicide attempt survivor. 
The seminar took place in a packed courtroom in the Custer County Courthouse.
Wise lectured on her own suicide attempt, survival and recovery, from the perspective of a patient who spent several years in mental health treatment.
Wise, widowed at 35 following her husband’s death from Lou Gehrig’s Disease (ALS), survived a near-fatal suicide attempt after ingesting large amounts of pain medication that had been left over from her husband’s prescriptions.
“I had taken enough pills to kill an elephant,” Wise said during the conference.
She said that the pressures leading to her suicide attempt included the stresses of full-time caregiving.
“Grief begins at the day of the diagnosis, not the day of the death,” she said of her husband’s ordeal.
In addition, Wise said she had been a witness to domestic violence and child sexual abuse.
“Suicide had become like a coping mechanism to me; suicide was a way out,” she said.
When Wise overdosed on medication, she had no desire to live and no intention of waking up. But she did.
“Contrary to the laws of science, I was alive. One of my worst fears had become a reality: I had survived suicide,” Wise told the audience.
Upon waking up, Wise began feeling things she hadn’t felt in a long time.
“When you plan on dying, there are a lot of emotions you don’t have to contend with: fear, anxiety, sadness.”
Wise went through years of therapy, and emerged from it not only a suicide survivor but an international speaker, acclaimed author of “Waking Up: Climbing Through the Darkness” and recipient of the National Mental Health Award.
“Many people who die by suicide didn’t want to end their life, they wanted to end their pain,” Wise concluded. 
A national suicide prevention hotline, 1-800-273-TALK, is available 24 hours a day to anyone involved in a suicidal crisis or in emotional distress. Calls to the hotline are re-routed to the callers’ region, where he or she can talk directly with local mental health providers, Viki Waddington, advocate for suicide prevention said.
Other local resources include the Local Advisory Council, a board dedicated to addressing the issue of suicide in the community and raising mental health awareness.
The Eastern Montana Community Health Center has a crisis line — 234-1688 — which is open even after hours, weekends and holidays. 
“There isn’t one way to prevent suicide, there are 600 ways to prevent suicide,” Wise said. 
Reducing the stigma on mental healthcare
Waddington believes there’s a stigma surrounding mental illness, which may be keeping people away from the care they need.
“There seems to be a dividing line between physical and mental illness,” she said. “Mental illness is a factor in very many suicides. There seems to be a feeling almost of a person being responsible for their mental illness, whereas we would not tend to blame a person for a physical illness.
“We’ve come a ways in working against that stigma, but it keeps people away from care or asking for help, as if there’s something wrong with saying ‘there’s something wrong.’ ”
An independent attitude and lifestyle can be good, she said, but it should not prevent a person from seeking help when he or she needs it.
“There’s something great in that attitude, but when you are dealing with someone who has lost all hope, they’ve lost the ability to say, ‘I want to survive.’ ”
“Maybe the most important thing you can say to someone is, ‘You don’t have to be alone in this, and I care about what happens to you.’ ”
Wise echoed Waddington’s comments about attitudes concerning mental health, stressing at the teleconference, “Depression is not a sign of personal weakness.” 
Waddington also feels that there’s a shortage of mental health resources.
“Mental health resources are tough to come by” she said, “but the ones that we do have, I believe are good ones.
“To serve a region this size, mileage-wise, is incredibly difficult, and so we struggle with how we spread those resources around and serve the people that need to be served.”
Reducing the stigma on mental health problems and associated care is another goal of the Signs of Suicide (S.O.S.)  program, as it addresses conditions in Health classes that are responsive to treatment. Another focus is to increase self-efficacy and access to mental health services for at-risk youth and their families.
“Mental illness is just an illness,” Waddington said. “Suicidal ideation is just something wrong with the thought process.”
Along with a stigma on mental healthcare, Waddington believes there are some problems with suicide terminology, such as the phrase “commit suicide.”
“’Commit’ adds an aura of criminality around the act,” Waddington explained, who lost her 13-year-old son, Todd, to suicide on August 31, 2000. “Todd didn’t commit a crime. He was led to a destructive decision. Not someone, but something made him. It’s not a choice, it’s a lack of choice.”
Also, suicides should not be called “successful,” but rather, “completed,” she said.

Published July 1, 2009

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