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We are in a national mental health crisis, and one of the tragic results is a steady increase in the suicide rate.

Tonight, our discussion with two experts on suicide, talking about the trends, possible causes and what to look out for.

and our Steve Keegan's with the story of overwhelming demand on the helpline services.

That's the discussion on this special Mind Matters edition of northwest.

Now You.

Welcome to this Mind Matters edition of northwest.

Now, America is in the midst of a suicide crisis.

There's just no way to sugarcoat it.

The nation hit a record high in 2022 with 50,000 dead.

And here's an even more amazing number.

1.7 million American adults attempted suicide in 2021.

The trend line has been steadily creeping up about 36% since the year 2000.

When it comes to the rate per 100,000, elderly men are among the most at risk here in Washington.

Suicide is the number two cause of death for 10 to 24 year olds.

Veterans have become a particular concern since they have a 53% greater chance of committing suicide than non veterans.

About 22 die each day in the US, and it turns out American Indians and Alaska Natives die by suicide at a higher rate than every other ethnic and racial group.

Every case is unique, and the reasons proposed for this crisis range from the influence of social media to loneliness, to economic despair, to substance abuse and underlying mental illnesses like depression, which itself is at an all time high.

Steve Kiggins now with the surge in calls into the Crisis Connections helpline South Sound 911 opened its state of the art facility back in 2021.

They were finally able to bring together their nine on one dispatchers and call takers, all under the same roof.

Last summer, a pilot program also brought together 98 crisis counselors all together in the mix, and it's a program meant to deliver emergency mental health care.

Reporting completed in the new South cell number one facility on Pacific Avenue took vision and a decade of planning.

Now, with the new building and leadership, there's another evolution happening at the agency responding to mental health crises.

And to be that calm voice to help someone while help is on the way.

Diana Caber has been with South Sound nine on one for 14 years and says as dispatch technology has changed, so too have expectations from the communities they serve.

A new pilot program adds crisis counselors to the 908 Suicide and Crisis Lifeline to the call center.

The vast majority are saying, you know, no, I feel like I'm actually connecting them to the right resource as quickly as possible.

I'm not giving them a number to call.

I'm not.

It's a no wrong door type mentality.

Sometimes people call and they don't want you to fix.

They don't need your advice.

Rita Wilson is a crisis counselor with Volunteers of America, Western Washington.

She says the pilot program allows collaboration aimed at providing the right services for the right crisis.

It's really great to be able to.

Not only do I know about the service, but I know you know so-and-so is three chairs down for me, and if I need to pick their brain, I can walk over there and say, hey, like we need x, Y, or Z, and we can work together to make sure that the person who called 911 is getting every component of what they need.

988 provides that safety that the state Department of Health says calls in the 98 lifeline centers increased 40% the first year and noted a 124% increase of chat messages and 640% increase of text messages by late 2023, as more people became aware of the service.

Besides, crisis counselors are called the 90 day.

In certain cases, can dispatch mobile response teams who may offer next day appointments with mental health professionals or inpatient treatment.

The 988 suicide and Crisis Lifeline is free, confidential and provides critical support for those in need.

They want to help people.

They care about the people who are calling.

I just really would urge anyone to call, even if they're in doubt and to come.

Steve.

Kevin.

Northwest now.

in Washington.

About half of all high school students report feelings of hopelessness, with teenagers overwhelming local emergency rooms.

The most recent survey shows an improvement in teen mental health, but even so, 15% of 10th grade students report that they've seriously considered suicide.

What is going on?

Joining us now to talk about youth suicide is Claire Hillis Go, a mental health clinician at Mary Bridge Children's Hospital.

Claire, thanks so much for coming to northwest now to have a discussion about suicide.

It's a downer topic.

I certainly get that.

But we want to try to provide some good information and some usable things for folks.

First thing I want you to do those give us a short bio about who you are and then connect the dots, if you would, between Multi Care Mary Bridge and how you work with the entire system.

and what resources are there.

Yeah, absolutely.

So my name is Claire Holic.

So I'm a licensed independent clinical social worker.

I work at Mary Bridge Children's Hospital in the emergency department.

And my role there is the behavioral health social worker.

And so what I do is I manage are complex behavioral health patients that might be stuck at the hospital for a number of reasons, whether they're detained for involuntary treatment, they've been abandoned by caregivers, or there's just barriers to discharge for them.

They can't discharge safely.

I manage those patients.

I hear a lot that people come to the emergency room seeking help, and they cannot find it out.

The system, there's no slots, there's no beds, there's no treatment.

there's been a lot of stories lately where the newspaper, the media will go back and interview the parents who say, we tried.

Yes, we tried.

We could not get Johnny or Susie help.

Yeah.

What is going on with that?

Why is that?

Well, there's not a lot of adolescent beds in the state of Washington.

Inpatient beds for inpatient treatment.

There's just over 100 adolescent inpatient beds in Washington state, across the whole state.

And so, frankly, there's just not enough resources out there.

There's more need.

And there is resources at this time in the behavioral health landscape.

And Mary Bridge Children's serves as an entry point for youth in mental health crisis across the county.

We also get youth outside of the county that come to us in mental health crisis.

And that's really kind of where Mary Bridge sits in the whole continuum of behavioral health care.

We serve as an entry point often for folks who are really struggling or who might be in emergent mental health crisis and who need support.

I know that you deal with Mary Bridge, but I also know you go to conferences and whatnot, talk to your your compadres in other health care systems around western Washington.

I hear that the emergency rooms and the emergent care piece is being overrun by young, patients in mental health crisis.

Talk a little bit about what what's what's going on out there.

For those of us who aren't tied into the system like you are.

Yeah, well, mental health has always been a concern amongst young people.

Between 2015 and 2018, the percentage that of youth who arrive to the emergency department in mental health crisis, that's risen by about 400% since 2015.

On average, we see over 130 patients a month who come through the emergency department for mental or behavioral health concerns.

This has been exacerbated by Covid, but this is an issue that existed before the pandemic.

And much like a lot of other systemic issues, Covid simply illuminated this for us and exacerbated the problem.

But it's certainly existed prior.

There has been a little good news that came out recently.

The survey that they do with high school kids in the state does.

That survey shows that mental health is actually getting better among that age cohort?

They say it's about the best it's been in 20 years.

So there's some good news there.

Yeah.

In perspective, instead of 20% of 10th graders saying they've updated suicide, only 15%, there's still a lot of kids.

It is.

And I'm wondering with that sharp increase, I look back and say to myself, I wonder if that's if that really does point to Covid as being a sharp decline.

And now a pretty quick pull out of it is my two rosy.

Is that two rosy of an assumption?

I don't think it's a rosy assumption.

I mean, I like to maintain hope with situations like this.

Right.

And I also think that it has to do with the way that our community has responded.

Our systems responses have been coordinated and strong.

And at least in Pierce County, we've seen this increase and we've really come together as a community, to say, what can we do about this and how can we increase access in quality to behavioral health care?

We did a program, one of these mind matter specials that we've done, about loneliness and that connectedness and loneliness, peace, keeps reemerging.

There's no real research that does cause and effect.

It's been very elusive on suicide, but that is a consistent theme.

If you will talk the talk a little bit about loneliness and connectedness, particularly how vulnerable that demographic is.

Sure.

Yeah.

Loneliness is a major risk factor for suicide.

And things are complicated, right?

Humans are complex, and so loneliness can pop up along the continuum for people.

Sometimes it's not the only reason, but it can certainly be a compounding factor.

The major protective factor against suicide, especially in young people, is connectedness, connectedness, connectedness to their community, connectedness to their peers, connectedness to a safe adult that they could seek support from.

So that is really the major key here in preventing suicide is helping people feel more connected to their community.

When people feel lonely and disconnected, that increases their risk for suicide significantly.

Speak to our demographic here.

What role can grandparents have?

Not mom and dad.

Who are the heavies?

Yeah, but Grandma and Grandpa talk a little bit about that connected piece, and I know I'm dropping this on you, but what role can can the older generation play?

Being supportive and listening non-judgmental.

We don't have to understand an issue to be able to support somebody through it.

Right.

We can serve as links or connectors, as being a safe adult, to simply listen to a young person about what they're experiencing, asking curious questions, and genuinely trying to understand what they're going through can make all the difference.

We don't have to have all the answers, and we don't expect people like grandparents or family members to have all of the answers, either.

Simply just being a supportive adult and showing that you're safe to talk to means the world to young people.

And I think, too, for grandparents, there's a one sentence guideline to what to do.

Just love on them.

Absolutely, absolutely unconditional love.

Non-judgmental stance means everything to young people.

Now we talk about that connectedness piece and everybody's connected, right?

Oh yeah.

We're all connected on screen time and on social media.

and there has been some compelling research there that shows just how toxic it is for people in that age group, and particularly for young girls.

Yeah.

I don't want to be the one who goes on a rant about social media.

So let me ask you your take about what you perceive its role to be.

And have you noticed anything working in the emergency room is is what's your take on social media?

Oh, it's a complicated take.

I you know, it's a complex problem, but what I can say is that too much of anything isn't good, right?

Things can bring a positive spin to our lives.

They can also bring a negative spin to our lives.

It's really about managing the risk, right?

So what we see a lot of the time is that as adults, we feel really overprotective of youth in the material world.

And we're pretty under protective of youth in the internet world.

Right.

And so youth are very savvy now with technology, and they're starting to really outpace us in their understanding of the internet world, social media technology.

And so really, I think it's about partnering with young people to explore what safe, what's not, and helping them kind of navigate that.

Social media can also serve as a really positive place for young people to feel connected to communities that they might not be able to access in their physical space.

So too much of anything isn't great.

But I really think it's our role as adults to have those open and honest conversations with young people around the dangers of social media and helping them navigate that on their own.

What, can parents or grandparents or caring adults look for?

everybody always wants to know what what the signs are.

and they the problem is they present differently in everybody.

But maybe there are some common threads you can kind of lay out about if you're seeing this or this or this.

Yeah.

You know, maybe ask some questions or talk to Mom and dad or whatever.

Yeah.

So there's definitely signs that you can look for.

There's verbal signs.

So if you're hearing a young person talk about having unbearable pain, feeling hopeless or feeling alone or just straight up saying, I'm having thoughts of wishing I was dead right, those are really things you want to keep listening for and ask questions about, right asking.

Tell me more about that.

You know, I heard you say that and that kind of concern me like, can you can you say more about that so that I can understand also behavioral signs.

So things like withdrawing socially, maybe not.

being as involved in things that they once were involved in, not having as much, passion or love for something like a sport or a community group that they once were really involved in, maybe giving away possessions or engaging in risky behavior like substance use or running away.

Yeah, that with withdrawing a little bit.

All those things to me kind of fall into the category of withdrawing into your own little hole.

Yeah, absolutely.

And then we link it back right to feeling loneliness, to feeling that loneliness, not feeling like we have anybody in our corner that we could talk to about this.

And you've heard this a thousand times.

We all have the mom and dad on television talking about.

We had no idea.

Yeah, she was so or she was very high achieving 4.2 GPA.

Captain of this, queen of that.

And they're gone.

That's that's a scary one.

It's really scary.

And that's why I always say we're not going to know.

We're not the experts.

We're not going to know what's going on for sure in other people's lives.

And that's why we just have to ask, right?

Even if we have young people that seem like they're doing fantastically, they're high achievers, they're they're busy, right?

They're involved making that time to check in with a young person regularly and genuinely being curious about how they're doing is going to be the biggest protective factor that you can implement in a young person's life.

Last 30s here as we wrap up this segment, shameless plug for you.

How do people, get in touch?

with resources and what resources are out there?

Yeah, I think the best resource out there right now in Pierce County is Kids Mental Health.

Pierce County, that's a community coalition that Mary Bridge Children's serves as the backbone organization for.

So it's a group of community members that are dedicated to improving the behavioral health system for school aged youth.

So you can go to kids mental health.

Pierce county.org, and they have an entire resource hub for Pierce County on parental supports, crisis supports, outpatient therapy, you name it, they have it.

Claire, thanks so much for coming to northwest now.

Yeah, thank you for having me.

Firearms are used at half the approximately 1000 annual suicides in Washington state.

For more on that, Doctor Jeffrey Sun, who's a board certified psychiatrist and an assistant professor at the UW center for Suicide Prevention and Recovery.

Doctor song, thanks so much for coming to northwest now.

Great to have a discussion with you about, you know, a troubling problem, you know, suicide and, all the ramifications of it.

I wanted to start with one of your areas of research.

You you look at firearms from a public health perspective.

49% of the Washington suicides involve a firearm.

what what are values on both sides of that equation when it comes to the Second Amendment, you think both sides can kind of come together on and and think Preventatively right.

Yeah.

It's a it's a great question and it's a great topic in the field.

So you talked about 49% of the suicides involve self-directed firearm use.

What we'll add is that among all of the firearm fatalities.

So a gun death in Washington, the number is going to look like around 75% of all of the gun deaths are suicides.

So a big proportion of the suicide issue involves firearm use.

And then a big proportion of firearm fatalities will involve, suicide.

So it's a super important topic.

And so we in Washington came together in 2016 and 2017 under the leadership of Representative Tina Orwell, who has been a great champion of this work.

And we formed a Safer Homes task force.

And so the Safer Homes Task Force was a continuation of some work, an approach that began in New Hampshire in 2009.

And that was, what we'll call a gun shop project.

So what happened in 2009 was there was a spate of three suicides.

They were all within one week, and then they were all recent purchases of a firearm from a single gun shop.

And so the public health officials thought, we really have nothing to lose.

So let's just approach the owner.

And so they went to, Ralph Tamiko at Riley's Gun Shop in New Hampshire and talked to him about this and said, did you know this was happening?

And Ralph had no idea.

He said, this is terrible, and we have to work together.

And so that was the beginning of looking at these shared values of safety, protection, responsibility, freedom, community, something that we can all agree on.

So we're in Washington.

So to continue that work.

And so our Safer Homes Task Force when it was formed, was co-chaired by representatives from the University of Washington and also from the Second Amendment Foundation.

So we ended up with red flag laws.

We just have an assault rifle, restrictions on that in the state.

Have those panned out or do they have they have the potential to panned out, to have a good result when it comes to suicide, do you think?

Well, I think that the so our finding and looking at the research around firearm use and suicide prevention is that the, the suicides that occur are typically happening with someone with what we'll call long standing preexisting and legal firearm ownership.

And so the firearms are occurring among responsible gun owners.

And so from that standpoint, the extreme risk protection laws and then banning certain categories, of weapons, I would say that those are important tools and an overall approach, because those approaches are looking at focused, high risk parts of the problem.

We I don't know that we would ask them to have an effect on overall suicides.

Right.

So they're an important tool for these extreme risk situations.

But it seems like what you're gesturing at is that a lot of the suicides are by long standing gun owners.

And it kind of comes out of nowhere.

It's a it's just the fact that they have access to them maybe is the problem.

Yeah.

So I so I'll refrain from nodding at the comes out of nowhere.

I would say that suicide is complex and builds over time.

And the so the finding is that gun owners are not necessarily at higher risk of having mental health problems, having suicidal thoughts.

The issue is that firearms, because they have such high lethality when someone goes through that suicidal crisis, that having immediate access for that small period of time can turn that crisis deadly.

Gotcha.

I want to speak briefly to on some of the research that you've done.

When it comes to physicians, you have trained and coached physicians.

I was interested to learn that a lot of physicians kind of tend to miss the the suicidal ideation piece that their patients are giving them.

How do you train for that?

And, you've said too, that it has a very devastating impact as I would imagine it would on physicians.

Talk a little bit about that, right?

Yeah.

The, so the finding in health care settings is that suicide risk is definitely an issue that we want to address.

So what we'll find is that about just under half of people who have died by suicide have probably seen their primary care doctor within the past month.

And so we want to make sure that health care is a setting where we might be able to address suicide risk, the finding that suicide, suicidal thinking or suicide risk may have been missed by the physician, that that might be an artifact of suicide itself, and that so I'm referring to a study that was recently or a report that was recently produced through the United Kingdom.

And so the finding was that about 27% of people who died by suicide had been in mental health treatment.

And so then we can go back in the record and look, did that mental health practitioner know that this person was at risk?

And so the finding was that about 84% of these trained mental health practitioners thought that the suicide risk at their last contact was low risk or no risk.

And so so we do the best we can.

We do the best we can.

There's some room for improvement there.

There's some room for improvement there.

Right.

you talk about, the media as well, you know, people in my industry, too much energy being spent on guilt, remorse, horror.

And who's to blame?

again, the research really has not yielded any direct causal relationships cause and effect when it comes to suicide.

So talk about the idea that you brought up that I think is very interesting in our previous conversations prior to this interview about mastering the crisis, what does what is the media's role in that?

And, what is it exactly?

What's that concept.

Right.

Yeah.

So the idea of media reporting and suicide.

So this is actually an area where the research is reasonably established.

So it looks like media reporting on suicide can actually have an effect.

And so what you mentioned media reports that focus on the horror of suicide.

Specific ways that people died by suicide are oversimplifying it to this event.

Cause the suicide.

So we find that all of those can be harmful.

And so this research to suggest that different categories of talking about suicide.

So stories of hope and recovery.

So talking about people who have gone through a very difficult time, maybe thought about suicide and then found a way through it, oftentimes with support and then that category that you brought up, mastery of crisis is so important.

It's the same sort of media reporting.

And so focusing a story on someone who has gone through a difficult time, found a way through, did not engage in suicidal behavior.

You also talked about, faith communities and the role they can play and you're another phrase that you have delivered that I, that I like.

It's a little comical, but I think it's effective is that people need to be trained or have help with how to suffer better.

Nobody wants to suffer.

But we're apparently we should be able to suffer better, right?

That, So that phrase caught my attention.

So I'm referring to, a book about the role of faith communities in suicide prevention.

So it's written by an author, Karen Mason, who has done some work, in this area.

And so she has a list of different ways that faith leaders and faith communities can support suicide prevention.

So it's a broad list.

And I think the one that caught my attention was faith leaders helping people learn how to understand and manage suffering better.

And so the idea that we have done all of the problem solving that we can we have found more community and then somehow at the core, there is this irreducible aspect of suffering through it, and that some problems really do not have immediate or any solution.

And so you have to pass through it, you must pass through it and pass through it in a way that involves finding some sense of connection and community, meaning and purpose for your pain.

Gratitude for what you have, some courage and some hope through it.

Last 90s here you talk about, you know, we all want a magic sauce, a secret secret sauce, and a magic bullet.

But you're talking about, really addressing this from a comprehensive approach.

And I know in a minute, 20 that's not a long to talk comprehensively, but what is, I guess, lay out the outline of what a comprehensive approach looks like right here.

So, the, the metaphor that will sometimes use is the idea of the upstream midstream downstream approach.

And so the upstream approaches are trying to support the health of the entire group of people.

And so that might be looking at events that form informal social settings so that people can have stronger connections.

Midstream approaches are focused on people who might be starting to develop some risk.

So this might be problems with drugs, alcohol, mental health issues.

But it could be things like finances, transportation, legal issues.

And then downstream approaches are what we might think of of what we'll call suicide care.

So helping people who have already had suicidal thoughts or behavior.

And so we want to have upstream midstream and downstream approaches last 15 seconds for you.

Shameless plug.

If people want to learn more about your research.

And there's it's interesting stuff.

where can they learn more?

Where would you like to direct people?

Sure.

So there's two organizations.

One is Forefront suicide prevention at the University of Washington.

And so you can go to in the forefront, dawg.

And then the center for suicide Prevention and Recovery.

You can go to U-dub Seaspiracy spar talk to learn more there.

Doctor, thanks so much for coming to northwest now.

Thank you.

I really recommend learning more about the scope of the problem and possible solutions at the CDC website.

cdc.gov.

Here in Washington, the State Department of Health, at just about every health care system and county health department also have lots of information online.

The bottom line if you or somebody you know is in a crisis, call or text the new suicide Crisis Lifeline at 988.

Once again, text or call 988.

I hope this program got you thinking and talking.

You can find this program on the web at kbtc.org, stream it through the PBS app or listen on Spotify and Apple Podcasts.

That's going to do it for this.

Mind Matters edition of northwest.

Now until next time, I'm Tom Layson.

Thanks for watching.

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