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Beyond the Clinic , Winter 2019 | Volume 2, Issue 1

Final Thoughts: Is Suicide Preventable?

Jamie Holms RVT, CPT1 Adobe Animal Hospital Los Altos, California

Jamie Holms, RVT, CPT1, has 17 years of experience in the veterinary field, most in emergency and critical care. In a prior life she was an animal control officer and currently is a veterinary team manager for Adobe Animal Hospital in Los Altos, California. She is also the administrative manager for Dr. Andy Roark and Uncharted Veterinary Conferences. Jamie is passionate about mental health and suicide prevention in the veterinary community and is a firm believer that education reduces stigma and increases survival. She is a certified Mental Health First Aid responder, QPR gatekeeper, and certified gatekeeper instructor. Jamie is an administrative rock star, organizational aficionado, tea geek, and workaholic—not necessarily in that order.

Final Thoughts: Is Suicide Preventable?
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START THE DIALOGUE

In the veterinary community, we must show compassion when talking to colleagues and coworkers who are at risk for suicide.

Veterinary community, sit down. We need to talk. This conversation is going to be uncomfortable, and that’s okay. It is far more important that we have this conversation than we stay comfortable. In the United States, every 12 minutes someone dies by suicide. For every person who dies, 25 attempt.1 The suicide rate in the veterinary community is as much as 4 times that of the general population.2,3,4 As a community we have the capacity to help change the suicide rates and stigma in our community and in the general community. Suicide can no longer be a topic that is off the table for polite conversation in veterinary medicine.

What if I told you that suicide is both predictable and preventable? You aren’t helpless and you have the tools to respond to individuals in crisis.

With practice, you can get more comfortable talking about suicide. You can have open, nonjudgmental, compassionate conversations with colleagues and coworkers about suicide. You can speak up against suicide shaming and misinformation in our culture.

Plenty of myths about suicide and suicidality are still pervasive. Let’s debunk a few.

Myth: People who talk about suicide don’t do it.
Fact: Almost everyone who attempts suicide has given verbal clues. They should be taken seriously.

Myth: If a person has made a plan to kill themselves, nothing is going to stop them.
Fact: Suicide isn’t about dying. It’s about stopping pain. The impulse to end it all, however overpowering, does not last forever.

Myth: Talking about suicide may give someone the idea.
Fact: You don’t give a suicidal person ideas by talking about suicide. Removing the stigma and discussing it openly is one of the most helpful things you can do.

Here are some warning signs that should concern you:

  • Talking about wanting to die, directly or indirectly, including talking about feeling hopeless, being in unbearable pain, being a burden to others, or feeling isolated; or threatening suicide
  • Increasing the use of alcohol or drugs
  • Attendance and performance issues at work
  • Risky behaviors
  • Seeking access to means of harm
  • Giving away possessions
  • Sleeping too little or too much
  • Recent trauma or crisis
  • Changes in behavior, including sudden calmness
  • Changes in appearance: weight gain, weight loss, looking unkempt

If you see someone exhibiting these behaviors, tell them that you are concerned and ask how you can help.

ENGAGE

Remember that this is a conversation and you need to be open to hearing that someone is struggling. Here are a few ways to start this conversation:

  • “Can we go for a walk or maybe get a cup of tea?”
  • “I’m concerned. You haven’t seemed to be yourself lately. Is everything okay?”
  • “I know things have been really difficult recently. It seems like it hasn’t let up. Are you feeling hopeless?”
  • “I can’t imagine how you must be feeling. Would you be willing to talk to me about it?”
  • “Do you have a plan to end your life?”

ACKNOWLEDGE

  • Listen nonjudgmentally and offer hope.
  • Don’t minimize how this feels for the other person. It’s totally okay to say, “I don’t have any idea what you’re going through,” but saying, “You have so much to live for” isn’t the right tack.
  • Keep in mind that suicide isn’t selfish, but it isn’t about you, either.
  • Remember that we are people first: obtain consent.

RESOURCES

  • Don’t know what to say? Dial the crisis line number and sit next to the person in crisis while they talk.
  • Do research in your area to find local resources.
  • Use employee assistance programs.
  • National Suicide Prevention Lifeline, a suicide prevention telephone hotline funded by the U.S. government, provides free, 24-hour assistance: 1-800-273-TALK (8255).
  • Crisis Text Hotline: Text HOME to 741741 from anywhere in the United States, anytime, about any type of crisis.
  • The QPR (Question, Persuade, Refer) program isn’t therapy—it is a tool anyone, including children, can learn to use. avma.org/ProfessionalDevelopment/PeerAndWellness/Pages/Wellness-Gatekeeper-Training-for-Veterinarians.aspx

Community creates connection. Connection creates hope. Hope anchors the soul.

References

  1. American Foundation for Suicide Prevention. afsp.org/about-suicide/suicide-statistics. Accessed November 2, 2018.
  2. Nett RJ, Witte TK, Holzbauer SM, et al. Notes from the field: prevalence of risk factors for suicide among veterinarians – United States, 2014. MMWR Morb Mortal Wkly Rep. 2015;64(5):131-2.
  3. Larkin M. Study: 1 in 6 veterinarians have considered suicide. American Veterinary Medical Association website. avma.org/News/JAVMANews/Pages/150401d.aspx. Accessed November 1, 2018.
  4. Bartram DJ, Baldwin DS. Veterinary surgeons and suicide: Influences, opportunities and research directions. Vet Rec. 2008;162:36–40.

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