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By Yen Duong

Last week, the North Carolina Child Task Force released a report showing that suicide among 10 to 17-year-olds reached its highest rate ever in 2018, with 52 child deaths by suicide in North Carolina.

That report underscores the need that pushed two groups in Charlotte to hold community suicide awareness and prevention events last month.

On Oct. 10, the nonprofit group Healthy Charlotte Alliance ran its annual Community Health Classroom fundraiser in a local church, bringing in speakers on mental health from hospital giants Novant Health and Atrium Health, recovery center Hopeway, psychiatry practice Southeast Psych and advocacy organization Mental Health America. Just a week later on Oct. 16, Atrium held a suicide prevention community event at Project 658, a nonprofit service-based ministry.

“[I’m] really here to continue to raise awareness, to continue to fight stigma so that people do know that this is a brain disorder that we do have treatments for, and people can be helped and there is hope,” said Dr. Elise Herman, chair of psychiatry at Novant, in an interview. “The only way that we’re gonna get better is if we do something about it.”

Dr. Elise Herman was the keynote speaker at the Healthy Charlotte Alliance Community Health Classroom. Photo credit: Yen Duong.

The benefits of talking about suicide

Both events stressed the importance of opening up deeper conversations about suicide, which is the second leading cause of death for young people ages 15-34. Ian Murray, a Southeast Psych counselor who specializes in adolescents, noted that celebrity suicides can cause more suicidal behaviors in young people. Tackling conversations head-on can help prevent suicides.

“I get this a lot: ‘Oh, it’s just normal teenage behavior. It’s normal sadness. You’ll get over it or just, you know, get through middle school, get through high school,’” Murray said during a panel. “It’s bigger than that. It’s important that we help teens talk about what’s going on.”

In her keynote talk at the Healthy Charlotte Alliance event, Herman noted that community events such as these can help reduce the stigma around talking about suicide and can thereby prevent it. Suicide is the 10th leading cause of death for North Carolinians.

Infographic credit: American Foundation for Suicide Prevention

At the Atrium event, Kevin Champion, the chaplain at Charlotte Behavioral Health, said that directness is key if you think someone is suicidal. He encouraged audience members to practice asking “Are you having thoughts of suicide? Are you thinking about killing yourself?” and to take a free, eight-hour Mental Health First Aid course, which is offered throughout the state.

“Asking someone about their suicidal feelings and thoughts and intentions gives them the opportunity to express what’s going on with them, and therefore [is] a deterrent to the possibility of suicide,” Champion said. “It’s like taking the lid off of a boiling pot and letting some of the steam and the heat out. We’re allowing that person to release some of the emotions and feelings that they are having.”

Warning signs and what to do

In her keynote speech at the Healthy Charlotte Alliance event, Dr. Elise Herman listed some warning signs and risk factors for suicide:

  • Talking about suicide, giving possessions away and talking about not needing things anymore, wishing aloud that they weren’t here
  • Changes in alcohol or drug use, substance abuse especially of psychotropic substances
  • Aggressive behavior, mood swings, acting out in different ways
  • Social withdrawal
  • Family history of suicide, experiences of trauma, bouts of prolonged stress
  • Access to firearms

Herman also listed a few things that someone can do to help people who may be suicidal:

  • Physically visit with a face-to-face interaction and make them feel supported
  • Encourage exercise, meditation or deep breathing and gratitude

The National Suicide Prevention Lifeline operates a 24/7 hotline at 1-800-273-8255 and a live chat available at https://suicidepreventionlifeline.org/chat/

Why Mecklenburg

Last year, Atrium joined the national Zero Suicide initiative, starting training for its health professionals and collecting and sharing data. Since then, Atrium providers have screened more than 600,000 patients who came through its emergency departments for suicidality. One Atrium provider dubbed the screening “the fifth vital sign.”

Victor Armstrong speaking at a suicide prevention event put on by Atrium Health. Photo credit: Yen Duong

Charlotte’s jail had five suicides last year and Mecklenburg County had 24 teen and child suicides from 2013 to 2017, nine more than any other North Carolina county, noted Victor Armstrong, vice president of Atrium’s behavioral health services, who spoke at both events. In comparison, Wake County had 14 young people commit suicide in the same time frame.

He made the point that suicide touches every community, especially veterans, first responders, law enforcement officers, firefighters, and lesbian, gay and bisexual children.

“Suicide doesn’t care if you’re young or old, gay or straight,” Armstrong said at the Atrium event. “It’s not an issue in the black community or the white community or the Latino community, it is an issue in our community. It’s a public health issue that will require a public response, a community response.”

Specific communities: veterans, white men, African Americans

Every day, about 22 veterans die by suicide in the U.S., and more Vietnam veterans have died from suicide than American soldiers who died in the Vietnam war, Armstrong said. One audience member at the Atrium event, psychologist Nicole French, said that Charlotte is one of 14 American cities chosen for a study called “Operation Deep Dive,” which interviews loss survivors within six months of a veteran’s suicide because Charlotte is a “hot spot” for such suicides.

“Helping a veteran find a job is suicide prevention,” said French, who is the director of a Charlotte nonprofit supporting veterans and a veteran herself. “Helping a veteran really understand their benefits is suicide prevention. Connecting a veteran to community so they have a natural support system is saving a life and it’s suicide prevention.”

Herman noted in her speech that 70 percent of veteran suicides are from firearms. Though controversial, limiting legal access to guns for people at risk of suicide is “one of the number one things we can do” to prevent suicide, she said.

As another intervention, raising the minimum wage could address the trend of increasing suicide rates among white men, Herman said in an interview.

“If you think about our working-class communities, especially in North Carolina … those are people who want to provide for their families, and that is a lot of their identity,” Herman said. “They need to be able to live on a working wage, in order to be able to do those things and the stress of all that can impact them and their families and in ways we may not even have realized.”

From left: Dr. Elise Herman of Novant Health leads a suicide prevention panel with Victor Armstrong of Atrium Health, Tom Gettelman of Hopeway and Ian Murray of Southeast Psych, all in Charlotte. Photo credit: Yen Duong.

Armstrong noted that in the African American community, suicide is sometimes seen as a “white people problem,” but that there are “almost 3,000 reported suicides for African Americans in the U.S. each year.” He spends some of his time reaching out to faith communities to decrease the stigma around mental health and encouraging clergy to speak about suicide to their congregations.

“There’s a huge role that the church can play in reducing stigma around mental health and particularly on suicide awareness,” Armstrong said. “What has historically happened is that in a lot of faith-based settings, African American or otherwise, suicide and depression had been looked at as signs of weakness, as signs of spiritual moral failure.

“Part of my mission now is to get churches to stop perpetuating that kind of thinking,” he said. “Suicide is not a sign or depression is not a sign of moral or spiritual weakness, it’s a sign of pain and needs to be addressed that way.”

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Yen Duong

Yen Duong covers health care in Charlotte and the southern Piedmont for North Carolina Health News.