9/06/2022

How Education Helps with Suicide Prevention

Kara Cadwallader, MD, FAAFP, Healthwise Medical Director

In his 30s, Heath learned he had rheumatoid arthritis. The diagnosis explained the pain he’d been feeling for years, but it also meant he would be managing a chronic condition for the rest of his life. Heath began meeting with a monthly support group and worked with his doctor to find a helpful medicine. Life felt stable, but then the COVID-19 pandemic began, and everything changed.

During the pandemic, Heath’s support group meetings were canceled, his entire company started working from home, and the community softball league he played in was put on hold for the summer. The stress of a pandemic also took a toll on his relationship, and he and his boyfriend broke up. Suddenly, Heath felt isolated and depressed. As the pandemic stretched on, these feelings worsened. He started thinking it might be better if he was dead. Then as COVID-19 numbers dropped, Heath had a routine doctor’s visit. During prescreening, his doctor asked if he was feeling down or hopeless or feeling less interest or pleasure in things. Heath finally felt like he had someone to talk to. Heath’s doctor referred him to a counselor, and now his depression has improved. But what would have happened to Heath if he hadn’t met with his doctor?

September is suicide prevention awareness month. According to the CDC, in 2020, overall suicide rates dipped after rising for decades—but the United States still had one death by suicide every 11 minutes.¹ And suicides are still increasing among certain age groups, including males ages 25 to 34 and among Black, American Indian/Alaskan Native, and Hispanic males.² While research in the area is still developing, a number of studies have found a connection between racial discrimination and suicidality.^{3, 4, 5}

Lesbian, gay, and bisexual youth seriously contemplate suicide at almost three times the rate of heterosexual youth, and 40% of transgender individuals have attempted suicide in their lifetimes. Additionally, the suicide rate for veterans is 1.5 times higher than that of the general U.S. population.⁶

What can we do to help?

How can education help prevent suicides?

Most suicides worldwide are related to mental health disorders.⁷ So educating people about what to do when their mental health spirals is key for prevention. Prevention and education are inextricably linked. If people can easily access helpful education resources or know they have somewhere to turn, they’re less likely to die by suicide. In fact, one of the three factors that the National Action Alliance for Suicide Prevention pinpointed to improve suicide prevention is educating patients, families, and health professionals as part of evidence-based clinical care practice.⁸

Three ways that education helps raise mental health awareness and improve suicide prevention include:

• Stopping the stigma
  In a culture that celebrates individualism, mental illness is often thought of as a personal failing, and even pop culture promotes that idea. For example, the 2019 movie “Joker” perpetuated negative stereotypes about people with mental illness. This stigma is even stronger for some diverse racial and ethnic communities.
  
  The stigma around mental illness can make people confused about when to seek help, or even make them doubt whether they should seek help. And the stigma also makes recovery more difficult. A 2017 study showed that among 200 individuals with mental illness, those with greater self-stigma had poorer recovery during that time frame.⁹ The more people understand mental illness, the less stigma it will have. Evidence-based education about mental illness can help people better understand it and realize it’s a treatable medical condition, not something to be ashamed of.
• Treating mental illness like a health condition—because that’s what it is
  If most people had a persistent skin rash that affected their daily lives, they’d go see a doctor. Many people don’t perceive mental illness in the same light—instead, they view it as different from other health conditions. Because it can’t be seen, some think those suffering from mental illness are making it up and they should “just get over it.” One study discovered that more than half the people with mental illness in the U.S. don’t receive any help for their disorders.⁹ If people can accept that mental illness is like any other condition that needs treatment, they’ll be more likely to go to their doctor for help.
  
  Although it may not be a solution for everyone, accessing the healthcare system is a first step toward getting help with mental health needs. If people go to their doctor, even if the doctor is not a mental health provider, the doctor can link them to education, social work, counseling, and other resources in the community. For folks outside of healthcare systems, using apps or telehealth can make counseling more readily available.
• Providing next steps
  For people contemplating suicide, having someone to call in the moment of crisis is crucial. Recently the U.S. Department of Health & Human Services launched the 988 Suicide & Crisis Lifeline. Anyone in a mental health crisis (or anyone trying to help someone in crisis), can dial or text 988 on their phone and be connected with trained crisis counselors.
  
  Making sure people know about resources like the 988 Lifeline is crucial. Other resources, whether in people’s hands or on a portal, can help reach patients too. These resources should provide inclusive, accurate, and accessible education in various formats. Whether you provide a video of someone who looks like the patient talking about how they have depression, a graphic, or plain text, it’s important that people feel supported.

Healthwise recognizes the impact that the availability of mental health content can have on individuals managing their well-being. Our evidence-based education includes formats that engage all learners and populations, including teens and young adults. Working with healthcare providers, we can decrease risk with education and support.

¹ https://www.samhsa.gov/find-help/988
² https://www.fiercehealthcare.com/practices/suicide-deaths-decreased-2020-but-rose-among-certain-groups
³ https://pubmed.ncbi.nlm.nih.gov/31597538/
⁴ https://pubmed.ncbi.nlm.nih.gov/24690042/
⁵ https://pubmed.ncbi.nlm.nih.gov/27137139/
⁶ https://www.healthaffairs.org/do/10.1377/hpb20201228.198475/full/
⁷ https://www.mhanational.org/conditions/suicide
⁸ https://www.healthaffairs.org/doi/10.1377/hlthaff.2015.1672
⁹ https://www.psychiatry.org/patients-families/stigma-and-discrimination