Suicide Prevention Update Addresses Growing Concern
| As chief medical officer of the American Foundation for Suicide Prevention, Christine Yu Moutier, M.D., hears countless stories of desperation and pain every day from those who have lost loved ones as a result of a self-inflicted death.
With her authoritative approach and calm demeanor, Moutier surprised many of those attending a recent public forum by admitting to once having suicidal thoughts of her own.
“I had my own mental health crisis when I was in medical school; I was living with a life-threatening mental illness and not talking to anyone about it,” said Moutier at the Arkansas Suicide Prevention Update, organized by the University of Arkansas for Medical Sciences (UAMS) Psychiatric Research Institute and held April 10 at the Ron Robinson Theater in Little Rock.
Moutier shared her story with the audience during an engaging discussion led by Laura Dunn, M.D., chair of the Department of Psychiatry and director of the Psychiatric Research Institute.
Luckily, a colleague convinced Moutier to seek help from a counselor who helped her overcome her struggles. Since earning her medical degree and training in psychiatry at the University of California at San Diego, Moutier has been a practicing psychiatrist, a professor of psychiatry at the university, dean of the university’s medical school, and medical director of the Inpatient Psychiatric Unit at the VA Medical Center in La Jolla. She’s also authored a clinical suicide prevention handbook, published in 2021, and numerous articles and book chapters for medical and general audiences.
One of the best ways to address suicide is simply talking about it, said Moutier, whose organization sponsors the Out of the Darkness Walks, a series of fundraisers offering supporters the opportunity to raise awareness about suicide by sharing their stories.
“At all of those walks, people are telling their stories of loss. That’s just one way we can destigmatize suicide,” she said.
Another way is to form partnerships with organizations that are heavily impacted by suicide, said Moutier, who related a project initiated last year between the American Foundation for Suicide Prevention and the international construction and engineering firm Bechtel. Construction workers have one of the nation’s highest rates of suicide, which led to a $7 million commitment from Bechtel to fund a coalition aimed at reaching the 500,000 workers in the industry.
Moutier also challenged the audience to rethink the language used to discuss suicide.
“The phrase ‘commit suicide’ implies committing a crime or committing some kind of morally reprehensible act,” she explained. “We don’t say ‘commits cancer,’ and suicide is every bit the health issue that cancer and heart disease and other complex health outcomes are.”
Jessica Coker, M.D., talks about Arkansas’ maternal mortality rate, which is one of the highest in the United States.Tim Taylor
Three members of the Department of Psychiatry faculty presented about suicidal behavior patterns found among specific demographics. Elissa Wilburn, Ph.D., focused on the younger population, pointing out that suicide is the second leading cause of death for Americans between the ages of 10 and 24.
“Most young people do not want to die, they want their pain to end,” said Wilburn, adding that changes in mood or appearance, feelings of hopelessness or aggression and social withdrawal are warning signs that a young person may be considering taking their life. Talking to them about these indicators is the first step in preventing self-harm.
“There is a fear that if we talk about (suicide), it plants the seed, but research shows the opposite,” she said. “Whether you are parent, a teacher or a coach, you have the ability to save a life.”
Sara Landes, Ph.D., director of the Behavioral Health Quality Enhancement Research Initiative (QUERI) at the Central Arkansas Veterans Healthcare System, said easy access to firearms and excess medications contribute to the alarming rate of suicide among veterans. With an average of 17.6 veterans ending their lives every day in the U.S., said Landes, the need for early intervention becomes increasingly important.
She said one way to identify possible suicide threats is Recovery Engagement and Coordination for Health — Veterans Enhanced Treatment (REACH VET), a program established in 2017 that analyzes existing data from veterans’ health records to identify those at a statistically elevated risk for suicide, hospitalization, illness or other adverse outcomes.
Another is a program that Landes helped implement in a variety of VA settings, Caring Contacts, which entails sending short, caring messages to veterans at risk of suicide. “In the last 12 months, the Veterans Crisis Line sent cards out to over 100,000 veterans,” she said.
Jessica Coker, M.D., the medical director of the Psychiatric Research Institute’s inpatient units, pointed to inadequate access to care, substance use disorders and domestic violence for Arkansas’ disturbing maternal mortality rate, which is one of the highest in the United States.
“Women experiencing intimate partner violence are three times more likely to attempt suicide,” said Coker, adding that routine mental health screenings and crisis support for new mothers could significantly contribute to improving maternal survival rates across the state. “Maternal suicide is a preventable problem.”
The Arkansas Suicide Prevention Update, which was funded by a UAMS Chancellor’s Circle award, included a panel discussion that featured Jacqueline Sharp, Arkansas area director for the American Foundation for Suicide Prevention; Aresh Assadi, Ed.D., director of counseling services at the University of Arkansas at Little Rock; Joshua Gonzales of the Arkansas Crisis Center; Priscilla Buffington, LCSW, the suicide prevention program coordinator for the Central Arkansas Veterans Healthcare System; and Rebecca Pittillo, president of Arkansas Blue Cross/Blue Shield’s Blue & You Foundation for a Healthier Arkansas.