Midnight Musings
Midnight Musings
Personal Reflections by April Jakubec
Personal Reflections by April Jakubec
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A New Light on Suicidality
A New Light on Suicidality
Redefining Suicide as an Outcome of the Problem
Redefining Suicide as an Outcome of the Problem
July 2024
Suicide statistics are alarming and heartbreaking.
Suicide is the 11th leading cause of death in the US.
In 2022, 49,476 Americans died by suicide.
In 2022, there were an estimated 1.6M suicide attempts.
Everyone across the board agrees that suicide prevention is important.
Current Crisis Responses
Current Crisis Responses
Research shows that psychotherapy, medication, and self-care are effective forms of treatment for suicide ideation and behavior. However, this is a long-term strategy for recovery.
What options do we have available for times of crisis?
What options do we have available for times of crisis?
Those with therapists are encouraged to talk to their therapist.
Anyone can call or text crisis hotlines to connect with a live and trained crisis counselor.
Some areas have mental health crisis teams available for support, which often have peer supporters on the team.
Police offer wellness checks.
Emergency rooms will screen patients who are suicidal for safety risk.
At first glance, this may sounds like an adequate range of suitable options. However, all of these resources are linked and funnel back to dumping people who are at high risk for suicidal behavior into the emergency room. These ER visits then lead to forced mental health inpatient hospitalizations where the person in crisis is stripped away of their personal possessions, comforts, and community, and are then “treated” with forced or coerced medication regimens.
The Way Society Defines the Problem: The Number of Deaths by Suicide
The Way Society Defines the Problem: The Number of Deaths by Suicide
Everywhere we see suicide statistics also highlights that men are more likely to die by suicide than women.
In 2022, men died by suicide 3.85 times more than women.
The way we talk about the statistics indicates what we consider the problem to be.
According to the way the data is presented, the primary problem is that people are dying by suicide, particularly men and older adults as the highest risk groups.
When we identify the problem, that informs the questions we ask, the crisis responses available, and the outcomes.
If the problem has been defined as the number of deaths by suicide, then of course our current approach to suicide prevention makes sense: we should be screening for signs, plans, and general risk of suicide, and in crises, we should send people to the ER to prevent these deaths.
But what are the outcomes of our current approach?
But what are the outcomes of our current approach?
Research shows that the highest risk of suicide is directly after discharge from these mental health hospital stays.
Research shows that the highest risk of suicide is directly after discharge from these mental health hospital stays.
Limited Alternatives for Crisis Response
Limited Alternatives for Crisis Response
If current crisis responses all funnel back to harmful mental health hospitalizations, what are our alternatives?
If current crisis responses all funnel back to harmful mental health hospitalizations, what are our alternatives?
Nothing, at least as far as I've found.
While there are some safe groups out there (namely peer support groups and respite centers), there is no consistent resource that can be accessed quickly, affordably, in any location, and importantly– will not lead back to forced hospitalizations.
Individuals with lived experience and many professionals alike are discouraged by the lack of options currently available.
A therapist recently described her moral dilemma of having sent a young, self-harming teen into a forced hospitalization knowing it will certainly “ruin their life” simply because the therapist had no suitable alternatives available to support the teen.
It’s time we rethink things.
Redefining the Problem: Not Wanting to Be Alive
Redefining the Problem: Not Wanting to Be Alive
The “gender paradox” of suicide describes that while men die by suicide more often than women, women actually report more thoughts of suicide and are 1.5 times more likely to attempt suicide than men.
It is interesting that this is not featured on the front page of the American Foundation for Suicide Prevention alongside the other statistics shared in this post. Again, I believe this relates to the problem being the number of deaths by suicide and secondarily, who is most likely to die by suicide rather than who is most likely to feel suicidal.
Let’s reconsider how we define the problem.
Let’s reconsider how we define the problem.
Let’s say death by suicide is an outcome of the problem, rather than the problem itself. Then we could say generally that the problem is when people do not want to be alive.
The questions we would then ask would be about why they don’t want to be alive, and our crisis responses would be to help individuals resolve whatever hurts and pressures that keep them from wanting to be alive.
And the outcomes for this approach?
And the outcomes for this approach?
That’s something we at AJ Life Consulting will work endlessly to find out…
What I can say as someone who has personally experienced nearly a decade of suicidality and 7 forced hospitalizations, I know this approach is one I absolutely would have chosen for myself given the chance.
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