Op-Ed: Commissioners: Vermonters must work together to prevent suicide — Mark Levine and Melissa Bailey

Several high-profile deaths by suicide, along with a new report from the Centers for Disease Control and Prevention, have put this public health issue in the spotlight once again.
In Vermont, where suicide is now the eighth leading cause of death, we are working to put systems in place that help people before a crisis. At the same time, we need to recognize the many contributing factors that lead one to self-harm or to attempt suicide.
This will require a cultural shift for all of us. We must work together to remove the shame associated with mental health conditions such as depression and embrace social connection as a protection that supports people in crisis.
We can save lives if we pay attention, show up and connect, ask questions, and remove lethal means from the homes of those who are at risk.

What’s the Vermont story?
Since 2010, more than 100 Vermonters have died by suicide every year except 2012, and more than 1,000 were hospitalized or visited the emergency room each year as the result of a suicide attempt.
Tragically, we have seen these numbers rise in our state by nearly 50 percent over the past 17 years, compared with a 30 percent increase nationwide.
Over half of all suicide deaths in Vermont are caused by firearms, and most hospitalizations for self-harm are due to poisoning or cutting/piercing. Each statistic represents a person in pain, and the numbers reflect only a fraction of the people who are suffering.

Who are we worried about?
The data shows that certain groups of people are at higher risk for suicide in Vermont. Males are more likely than females to take their own lives regardless of age, and females are more likely to be hospitalized for self-harm with poisoning or cutting/piercing.
Veterans are at much greater risk for suicide than non-veterans, as are older white men in general along with refugees/new Americans living in Vermont.
The 2017 Youth Risk Behavior Survey found that Vermont teens, especially those who are lesbian, gay, bisexual or transgender and students of color are at higher risk than their heterosexual or white, non-Hispanic peers.
The CDC report also highlights an important fact: More than half of all people who died by suicide did not have a known mental health condition. This means we should not be complacent about a person’s risk if they exhibit warning signs but lack a prior history of poor mental health.

Why do people attempt suicide?
Suicide is rarely the result of any single factor, but research suggests some common reasons that lead people to consider, attempt, and die by suicide. An individual’s emotional health changes over time. Some people have a mental health condition, such as depression. Personal challenges – difficult relationships, alcohol or drug use, stress due to illness, financial hardship, legal problems, divorce or job loss, social isolation – can add up to overwhelming feelings of hopelessness and despair.
Loneliness and isolation are the common threads in stories of suicide, regardless of age, gender, sexual orientation or race. We know that positive human connections during a crisis saves lives.

What to do if you’re thinking about suicide
If you’re in crisis, remember that even the worst feelings of sadness will pass, and the desire to hurt yourself is likely temporary. Crisis data shows that the time between thinking about suicide and an attempt is relatively short, so make a connection before you act.
Call the National Suicide Prevention Lifeline at 800-273-8255. Dial 2-1-1 to reach a counselor in Vermont. Dial 9-1-1 or go to the closest hospital emergency department.
Prefer texting? The Crisis Text Line (text VT to 741741), offers immediate counseling and support via text messaging.
Ten community mental health centers offer 24/7 crisis services and ongoing support. Click the red “In Crisis?” button online at mentalhealth.vermont.gov.

How to help a person who is having thoughts of suicide
If you suspect that someone is thinking about suicide, ask them. Asking shows that you care and opens the door to connection. It doesn’t increase the likelihood that somebody will think about or attempt suicide. Help them get support from a professional mental health care provider.
Most people who survive a suicide attempt do not go on to die by suicide later, so helping someone through a crisis can save their life. Also, reducing access to the lethal means of harm in a person’s home including firearms, lethal doses of medications and alcohol which can lead to an unsafe choice.
In Vermont, we value our sense of community and tradition of helping in times of crisis. It will take all of us – as individuals, families, communities, workplaces and schools, and with state government – to reverse the tide.
Dr. Mark Levine is Vermont’s Health Commissioner. Melissa Bailey is Vermont’s Commissioner of Mental Health.

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