By Lauren Grimes, Member of the Anti-Stigma Project | July, 2012
There were a number of workshops at the National Council’s April 2012 Conference in Chicago which touched on young adult issues, and one that centrally focused on best practices in the engagement of young adults and explored the unique circumstances that have been the catalyst for the emergence of a new culture widely known in the behavioral health field as transitional age youth. The first workshop I attended discussed suicide prevention as a best practice, but mentioned this population only as a passing statistic among many others. However, as I took notes on Michael Hogan’s and David Covington’s presentation, the relevance of what they were saying to the young adult population with which I work and of which I am also a part, and the relevance to the consumer field of peer support where both the funding for my program and my heart lie, struck me with some force. I will share a brief overview of their work, and then discuss how I believe the role of peer support, especially young adult peer support can play a part within that framework by instilling hope.
The presenters shared some compelling information which they have gathered and studied over the past 18 months through a project designed to investigate suicide prevention and intervention, and its successful practices and system implementations throughout the country. The data used in their presentation focused on suicides that were attempted and/or completed via a jump from the Golden Gate Bridge in San Fransisco. Their research included conversations with some of the few who had actually survived the jump (including Kevin Hines who was present at the workshop, and whose survival story is now a national inspiration) as well as survivors of an attempt which had been successfully intervened upon.
The research drew heavily on a study done in the 1970s about survivors of a suicide attempt from the Golden Gate, including both attempts that were intervened upon as well as survivors of the actual jump. The goal of this study was to find out how many of the survivors went on to complete a suicide later in life. The study was undertaken in the 1970s (at which point there had been more than 500 attempts from the Golden Gate) following a community discussion about erecting a barrier on the bridge that would make the jump impossible. The result of this discussion was that no barrier was erected, and although concerns regarding the preservation of the beauty and the historical integrity of the bridge were raised, the primary reason that this preventative measure was not pursued was this general assumption: ‘If someone is going to kill themselves, they are going to kill themselves.’ It was thought with close to unanimous consensus that a truly suicidal person would simply find another means, and that the point of the barrier, which was a means of prevention, would have only succeeded in being a very expensive transfer of means.
The study was completed shortly after this community consensus and so was largely ignored, but the results for me, as a suicide attempt survivor sitting in a workshop in 2012 (after more than 1500 suicides have now been attempted from the Golden Gate Bridge) were staggering. Only 6% of the survivors of a suicide attempt from the Golden Gate went on to complete a suicide afterwards. 94% of the people who stood at the edge of the tallest bridge in California with the intention of leaping because their pain was so great that it felt it would never end or it could never be managed, went on with their lives. I don’t know if they had children or grandchildren, or whether they were ever again overwhelmed by thoughts of ending their own life. That was not part of any study. But what I do know is that they continued to live, and that life offers hope.
When we are speaking about the lives that were not cut short, 94% is not only astounding, but it pulls the rug right out from under the assumption which served as the primary basis for the community decision to abandon the idea about the barrier on the Golden Gate Bridge. 94% of those who survived a suicide attempt from the Golden Gate did not simply find another means with which to complete the suicide that was assumed to be their unambivalent choice. The same type of qualitative research results were derived from their conversations with a partially new set of survivors 30 years later. They all had the same common thread: deep ambivalence. Kevin Hines and the other survivors of the completed jump offer a unique and even more striking account of this feeling. Kevin described the deep ambivalence that not only remained with him as his hands left the railing but that suddenly became deep regret in the seconds he had before he hit the water.
So what does this mean? What do we do with this information? Well, the take-away message was this: Suicide is preventable, and caring saves lives. In the United States, suicide claims over 36,000 lives annually. (www.afsp.org) With statistics like these, I believe that we all have a responsibility to take a hard look at this study, and to find a way to better prepare and educate those who provide services on all levels in suicide prevention and intervention, because as was noted, the errant assumption that people who truly want to kill themselves will find a way to do it no matter what, is not one exclusive to San Francisco nor to the general population. Many, many people in all roles within the mental health system also tend to dichotomize those who attempt suicide into two groups: those who want to kill themselves and those who are reaching out for help. However, stories such a Kevin Hines’ and many others make a sound argument for the theory that there may not be any difference between those who succeed with their suicide attempt and those who do not. The ambivalence is present for both parties, which for those of us who are providers of services, that is our “in” for saving a life.
I think these core values and the statistics from which they are derived, are ones with the potential to have us both personally and systemically reevaluate the possibilities for suicide prevention and intervention policies, and for the care that we give those who struggle with suicidal and self-injurious ideation and behaviors. I would love to see the consumer movement in Maryland be a part of this new thought process, and even more, I would love to see peer support play an integral role in instilling hope in the discussion of this topic, as well as back into the lives of those who have struggled in this way. We, as individuals and as a system, have become increasingly aware in the past few years, due to tragedies at a number of high schools and colleges throughout the country, about the issue of suicide and self-harm in the young adult population. It is the 3rd leading cause of death for people ages 15-24. (http://www.save.org) Working in the peer support field, I have also seen organizations begin adopting and reformatting their peer support programs for young adults. I think the marriage of these two knowledge bases, and the ability to talk about suicide and self-injury in a respectful and informed way could save many lives, including many young lives. It may also make it possible to do so with as little hospitalization as possible, in their community where, we as a consumer movement know, the recovery road is best walked with the supports we choose. But for this to happen, we have to be able to start the conversation about it.
The National Council, just a few weeks ago, held its annual Hill Day, on Capitol Hill where mental health advocates from across the country met with legislators regarding behavioral health bills being introduced this session. Two of these bills have specifically to do with young adult mental health including the Mental Health in Schools Act (H.R.751), and the Mental Health First Aid Higher Education Act. Both of these bills respond to the importance of behavioral healthcare for young people, and the importance of it being present where they are: schools. The first bill seeks to fund secondary schools to be able to implement effective mental health programs in their schools, and the second to train college faculty and students in Mental Health First Aid, so they are able to respond to a person having a mental health crisis. We are all beginning to take notice of the prevalence of the mental health crisis among young people, and we have diligently responded on many levels, and I applaud this. But whether you can advocate on Capitol Hill or whether you are involved in the peer support movement, we can all take the time to educate ourselves and make ourselves comfortable with having conversations with the young people in our lives about both mental health and suicide. The statistics are too high and the capacity for change too great to not be a part of the caring that saves lives.
Suicide Prevention & Intervention Resources
American Foundation for Suicide Prevention: www.afsp.org
Suicide Awareness Voices of Education: www.SAVE.org
National Institute on Mental Health: www.nimh.nih.gov
Maryland Suicide & Crisis Hotlines: www.suicidehotlines.com/maryland.html
Maryland Youth Suicide Hotline: 1-800-422-0009