>> I ONCE ASKED A PARENT OF A CHILD WHO HAD COMMITTED SUICIDE, WHAT THEY WOULD HAVE DONE DIFFERENTLY.

AND SHE SAID ACT SOONER.

STAY WITH US AS WE TALK WITH PSYCHIATRIST Dr. ALI A. FAROOQUI ABOUT THE CAUSES, SIGNS AND CONSEQUENCES OF SUICIDE, NEXT ON "KENTUCKY HEALTH."

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.

8 IF EIGHT BOEING 747 AIRLINES FILLED WITH PASSENGERS CRASHED EACH MONTH, WE WOULD SHUT DOWN OUR AIR TOURIST INDUSTRY UNTIL THE PROBLEM WAS FULLY RECTIFIED.

FORTUNATELY FOR THOSE TRAVELING BY AIR, THIS IS NOT HAPPENING BUT IT DOES REPRESENT THE NUMBER OF PEOPLE WHO DIE FROM SUICIDE EACH MONTH IN THE UNITED STATES.

THE INCIDENTS OF SUICIDE IS INCREASING WITH ALL AGE, ETHNIC, RACIAL AND SOCIAL GROUPS AT RISK.

UNFORTUNATELY, SOME GROUPS BASED ON GENDER IDENTIFICATION, WHERE THEY LIVE AND OCCUPATION, HAVE HIGHER RATES OF SUICIDE THAN OTHERS ONE RESPONSE TO THE INCREASE IN SUICIDE IS THE 988 CRISIS LIFELINE.

A NETWORK OF MORE THAN 200 LOCAL STATE AND LOCAL CALL CENTERS SUPPORTED BY HEALTH AND HUMAN SERVICES THROUGH THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION.

WHILE THIS IS A GOOD START, THERE IS MUCH MORE THAT NEEDS TO BE DONE IN THE AREAS OF PREVENGSZ, RECOGNITION PREVENTION AND TREATMENT OF UNDERLYING DISORDERS THAT MAY LEAD TO SUICIDE ATTEMPTS.

TO HELP US GET A BETTER UNDERSTANDING OF THE COMPLEXITIES OF SUICIDE, WE HAVE AS OUR GUEST Dr. ALI A. FAROOQUI, Dr. FAROOQUI EARNED A MEDICAL DEGREE FROM THE UNIVERSITY OF KENTUCKY.

DID RESIDENCY TRAINING IN NEUROLOGICAL SURGERY AT THE UNIVERSITY OF MISSOURI AND THEN COMPLETED A RESIDENCY IN PSYCHIATRY AT THE UNIVERSITY OF LOUISVILLE.

Dr. FAROOQUI CURRENTLY PRACTICES WITH INTEGRATED PSYCHIATRY IN KENTUCKY AND DEPARTMENT OF PSYCHIATRY AT THE UNIVERSITY OF LOUISVILLE.

THANK YOU FOR BEING WITH US TODAY.

>> THANK YOU FOR HAVING ME TODAY.

>> I WISH WE WERE TALKING ABOUT A LIGHTER SUBJECT, BUT, BOY, SUICIDE.

IT'S A SIGNIFICANT PROBLEM IN OUR COMMUNITY NOW ISN'T IT?

>> YES, ITS THE PREVALENCE, UNFORTUNATELY, IS GROWING.

AND I AGREE WITH YOU.

IT'S AN HONOR TO BE HERE AND A PLEASURE TO TALK ABOUT MENTAL HEALTH WITH YOU BECAUSE I THINK THE PREVALENCE OF MENTAL HEALTH ILLNESSES IN GENERAL IS INCREASING.

AND SUICIDE ALONG WITH IT.

>> SO HELP US ALONG.

WHAT IS SUICIDE AND WHAT IS THE DIFFERENCE BETWEEN A SUICIDE AND SUICIDE ATTEMPT?

>> THAT'S A GREAT QUESTION.

SO SUICIDE IS AN ACT OF INJURY TO SELF THAT RESULTS IN DEATH.

WITHIN THE MENTAL ILLNESS DIASPORA, SUICIDE IS ACTUALLY ONE OF THE ONLY DIRECT MORTALITIES THAT WE SEE IN PSYCHIATRIC PRACTICES.

SUICIDE ATTEMPT IS WHEN AN INDIVIDUAL ATTEMPTS TO KILL THEMSELVES, BUT DOES NOT.

BUT THAT DOES NOT RESULT IN DEATH.

>> DOES THAT COMPOUND THE PROBLEM?

IF SOMEONE HAS ATTEMPTED SUICIDE ONCE, ARE THEY LIKELY TO GO BACK AND TRY IT AGAIN?

>> IT REALLY DEPENDS.

IT'S A FRUSTRATING ANSWER TO SAY IT DEPENDS BUT WITH MENTAL ILLNESS, IT REALLY DOES DEPEND BECAUSE YOU HAVE THE PRESENTATION OF ILLNESS AND DISORDER IS REALLY AN INTERSECTION OF ENVIRONMENTAL FACTORS AND GENETIC PREDISPOSITIONS OR PATHOLOGY THAT IS ORGANIC OR, YOU KNOW, WITHIN A PERSON'S BRAIN AND BODY, WHETHER IT'S GENETIC OR OTHERWISE.

SO THE FACTORS THAT CAN BE CONTROLLED ARE USUALLY FACTORS THAT ARE ENVIRONMENTAL AND TREATMENT.

SO IF AN INDIVIDUAL, WHO TRIES TO DIE BY SUICIDE, IF THEY RECEIVE THE APPROPRIATE TREATMENT AND THE FACTORS THAT WE CAN ADDRESS: THE ILLNESSES AND DISORDERS THAT WE CAN TREAT; AND THE ACCESS TO CARE THAT WE CAN PROVIDE THEM, THEN YOU ACTUALLY DO CHANGE THE TRAJECTORY OF THAT INDIVIDUAL'S GENERAL HEALTH AND MENTAL HEALTH AND YOU CAN PREVENT ANOTHER SUICIDE ATTEMPT IN THE FUTURE.

SO IT'S NOT ALL BLEAK.

BUT THERE IS-- BUT THERE IS A HIGHER RISK OF ATTEMPTING SUICIDE AGAIN IF YOU HAVE HAD A PRIOR ATTEMPT.

>> THERE IS THE OLD, I GUESS, WIVES TALE SAYING THAT SUICIDE IS A CALL FOR HELP.

IS THAT CORRECT?

>> YES AND NO.

YOU KNOW, IT'S NOT A NORMAL PHENOMENON.

IT IS PATHOLOGICAL AND IT IS A RESULT OF A MENTAL ILLNESS TO WANT TO TAKE ONE'S LIFE OR END ONE'S LIFE.

THERE IS NO ILLNESS WHERE THAT IS AN APPROPRIATE RESPONSE.

SO THE WAY THAT WE LOOK AT THIS, IS, YOU KNOW, AN ATTEMPT TO END ONE'S LIFE IS A MANIFESTATION OF THEIR MENTAL ILLNESS.

>> GOTCHA.

>> SO IN THAT SENSE, YES, IT IS A CALL FOR HELP BECAUSE WHAT IT DOES, IT SHOWCASES THE NEED FOR TREATMENT IN THAT INDIVIDUAL TO THEIR LOVED ONES.

>> WHO IS THE PERSON THAT IS GOING TO COMMIT SUICIDE?

IS THERE A PARTICULAR-- LET'S TALK ABOUT-- IS THERE A PARTICULAR TYPE OF MENTAL ILLNESS THAT IS GOING TO DO THAT AND THEN WE WILL TALK ABOUT POPULATION GROUPS.

>> NO, THAT'S ALWAYS A GREAT QUESTION.

SO THE DEPRESSION IS THE MAIN ILLNESS, RIGHT?

THERE ARE OTHER TYPES OF MENTAL ILLNESS THAT IF YOU ARE SUFFERING FROM THAT ILLNESS, AND DON'T HAVE THE APPROPRIATE TREATMENT, THEN YOU ARE AT INCREASED RISK.

BUT IF YOU LOOK AT MENTAL ILLNESS INHERENTLY, THEN DEPRESSION STANDS OUT.

IN TERMS OF INDIVIDUALS, AND THE RISK FACTORS WHAT I'M GUESSING WHAT YOU ARE ASKING, THE RISK FACTORS ASSOCIATED WITH SUICIDE.

WHEN YOU LOOK AT THE RISK FACTORS, WE REALLY DIVIDE THEM INTO A COUPLE DIFFERENT CATEGORIES.

WE DIVIDE THEM INTO THE CATEGORY OF STATIC FACTORS MEANING FACTORS THAT ARE NOT REALLY SUBJECT TO CHANGE.

AND THEN WE LOOK AT DYNAMIC FACTORS OR FACTORS THAT WE ARE ABLE TO ADDRESS TO CHANGE THE TRAJECTORY OF AN INDIVIDUAL WHO IS CONTEMPLATING ENDING THEIR LIFE.

AND THIS 1.7 MILLION AMERICANS THINK ABOUT ENDING THEIR LIFE ON AN AN ANNUAL BASIS.

>> 1.7 MILLION.

>> THINK ABOUT IT.

NOT ONLY THINK ABOUT IT BUT ATTEMPT TO END THEIR LIFE.

BUT THERE ARE 1.7 MILLION SUICIDE ATTEMPTS IN THE UNITED STATES.

AND SO THE STATIC FACTORS, MEANING FACTORS THAT WE, AS PHYSICIANS OR OTHER PRACTITIONERS, THAT PROVIDE MENTAL HEALTH CARE CANNOT CONTROL FOR ARE AGE.

OLDER INDIVIDUALS ARE MORE LIKELY TO ATTEMPT SUICIDE THAN YOUNGER INDIVIDUALS.

SPECIFICALLY OVER THE AGE OF 85.

THE SECOND FACTOR IS GENDER.

SO INDIVIDUALS THAT ARE MALE TEND TO ATTEMPT SUICIDE MORE OFTEN THAN INDIVIDUALS THAT ARE FEMALE.

AND THEN ALSO BY RACE.

SO WHITE, PEOPLE WHO IDENTIFY AS WHITE CAUCASIANS TEND TO HAVE A HIGHER RISK OF ATTEMPTING SUICIDE THAN OTHER ETHNIC GROUPS.

A PREVIOUS HISTORY OF SUICIDE ATTEMPT IS ACTUALLY A RISK FACTOR.

SO IF YOU HAVE ATTEMPTED TO END YOUR LIFE BEFORE, THERE IS A HIGHER CHANCE OF YOU DOING THAT IN THE FUTURE, OR HAVING A SUICIDE ATTEMPT IN THE FUTURE.

AND THEN IT USED TO BE CALLED FAMILY HISTORY OF SUICIDE.

SO IN YOUR DIRECT RELATIVES, IF YOU KNOW OF SOMEONE WHO HAS DIED BY SUICIDE, THEN YOU ARE MORE LIKELY TO STATISTICALLY, TO ATTEMPT SUICIDE.

THAT'S EXPANDED A LITTLE BIT TO TALK ABOUT FAMILY AND CLOSE RELATIVES OR CLOSE LOVED ONES AS WELL.

>> WHY THE 85-YEAR-OLD AND ABOVE?

>> I THINK THAT HAS TO DO-- AND THERE IS NO CLEAR CUT ANSWER TO IT BECAUSE WE ARE LOOKING AT HISTORICAL STATISTICS OF INDIVIDUALS THAT HAVE ATTEMPTED OR DIED BY SUICIDE.

BUT IT HAS TO DO WITH THE DYNAMIC RISK FACTORS.

THINGS THAT WE CAN CHANGE.

NUMBER ONE IS ACCESS TO MEANS OF KILLING ONE'S SELF.

SO IF YOU DON'T HAVE AN ABILITY TO OBTAIN WHAT IS NEEDED TO END YOUR LIFE, THEN YOU ARE LESS LIKELY TO DO IT.

CHRONIC ILLNESSES IN GENERAL: CANCER, PAIN, EVEN PAIN AND OTHER CHRONIC ILLNESSES ARE A RISK FACTOR; WHICH CAN BE, YOU KNOW,-- WHICH ARE DYNAMIC BECAUSE YOU CAN TREAT CERTAIN ILLNESSES, YOU CAN TREAT SYMPTOMS OF THAN UNTREATABLE CHRONIC ILLNESSES BUT IT STILL EXISTS.

MENTAL ILLNESS AND SUBSTANCE ABUSE IS A RISK FACTOR.

SUBSTANCE ABUSE INCREASES THE CHANCES OF AN INDIVIDUAL BEING IMPULSIVE AND ACTING ON AN IMPULSE, YOU KNOW, A THOUGHT THAT MIGHT COME IN TO END THEIR LIFE.

AND THEN, YOU KNOW, DEATH OR OTHERWISE LOSING FAMILY MEMBERS OR FRIENDS.

SO LOSS, SOCIAL LOSS IS ASSOCIATED WITH THAT AS WELL.

>> I MAY BE THROWING YOU A CURVEBALL AND I APOLOGIZE FOR THIS.

YOU MENTIONED CANCER AND CHRONIC PAIN.

WHEN A PERSON HAS A TERMINAL DISEASE AND IS CONSIDERING EUTHANASIA, IS THAT SUICIDE OR IS THAT A DIFFERENT, YOU KNOW THING?

>> IT'S A DIFFERENT BALL GAME.

AND THIS IS A HOTLY DEBATED TOPIC.

SO THERE IS NO CLEAR CUT ANSWER TO THIS.

YOU HAVE ONE GROUP OF INDIVIDUALS AND PROFESSIONALS STAT STATE THAT THE WANTING THE AGENCY TO END YOUR LIFE AS A RESULT OF A CHRONIC ILLNESS, LIKE CANCER, IS A MANIFESTATION OF DEPRESSION OR OTHER MENTAL ILLNESS ASSOCIATED WITH THAT DIAGNOSIS, WHICH IS NOT UNCOMMON.

WE KNOW INDIVIDUALS SUFFERING FROM CANCER HAVE HIGHER RATES OF DEPRESSION AND ANXIETY AND THINGS LIKE THAT.

THERE IS ANOTHER GROUP THAT STATES THAT IF AN INDIVIDUAL KNOWS WHAT THE END OUTCOME OF THAT CHRONIC ILLNESS IS, THEN, YOU KNOW, THEY SHOULD HAVE THAT AGENCY.

IT'S SUCH A DEBATED TOPIC THAT THERE IS 2340 CLEAR CUT ANSWER IN THAT AREA.

>> WHAT ABOUT EXPERIENCES IN TERMS OF THE YOUNG PERSON?

TRAUMA?

OTHER STRESSES THAT MAY OCCUR.

ALSO I WOULD WANT TO INCLUDE THE INDIVIDUAL WHO IS MILITARY OR OTHERWISE POST TRAUMATIC INJURIES.

IS THAT A FACTOR, TOO?

>> YES.

AND THAT IS A FACTOR BECAUSE IT CHANGES A-- THOSE ARE ENVIRONMENTAL FACTORS THAT MIGHT UNMASK MENTAL ILLNESS.

THE NUMBER ONE FACTOR HERE IS UNTREATED MENTAL ILLNESS, RIGHT?

SO IF YOU THINK ABOUT TRAUMA AND PREPONDERANCE OF THE EVIDENCE, YOU KNOW-- AND PTSD, SOME INDIVIDUALS ARE GENETICALLY PROTECTED IN A WAY THAT AN EXPERIENCE THAT THEY HAVE CANNOT CAUSE-- DOES NOT CAUSE SYMPTOMS.

OTHER INDIVIDUALS ARE GENETICALLY VULNERABLE, WHERE, YOU KNOW, AN EXPERIENCE THEY MIGHT HAVE, DOES CAUSE SYMPTOMS.

AND I LIKEN ILL IT WHEN PATIENTS ASK THIS QUESTION, TO HEART DISEASE OR SUN EXPOSURE.

I AM DARKER SKINNED, SO I HAVE LESS RISK... >> YOU LOOK PRETTY LIGHT TO ME, BUT OKAY.

[LAUGHTER] >> SO INDIVIDUALS FROM THE INDIAN SUBCONTINENT, A LITTLE MORE MEDICAL MELINON SO THE SUN RISK EXPOSURE IS DIFFERENT FOR ME THAN SAY AN INDIVIDUAL WHO SUFFERS FROM ABL-- ALBINISM.

BUT I MAY HAVE GENETIC VULNERABILITIES THAT I COULD STILL GET IT.

THE SAME THING WITH MENTAL ILLNESS.

I MEAN THIS IS-- MENTAL ILLNESS IS A NUR LOGICAL DISORDER THAT HAS BEHAVIORAL AND EMOTIONAL MANIFESTATIONS SO WE ARE TREATING THE BRAIN.

SO CERTAIN EXPERIENCES AN INDIVIDUAL GOES THROUGH MIGHT RESULT IN THE MANIFESTATION OF SYMPTOMS THAT ARE THE SYMPTOMS OF PTSD OR PSYCHOSIS OR MANIA.

IF THOSE SYMPTOMS GO UNTREATED, THEN YOU HAVE UNTREATED MENTAL ILLNESS AND YOUR RISK OF DYING FROM SUICIDE INCREASES OVER TIME.

>> THERE IS AN OLD SAYING, PHYSICIAN HEAL THIGHSELF CLEARLY WE KNOW THAT A PERSON WHO HAS THEMSELVES FOR A PATIENT IS A LOUSY DOCTOR.

FORTUNATELY OR UNFORTUNATELY, ONE OF YOUR AREAS OF SPECIALTY IS TAKING CARE OF PHYSICIANS WHO HAVE MENTAL ILLNESS.

ARE WE SEEING AN INCREASED INCIDENT OF SUICIDE IN HEALTHCARE WORKERS AND WHY?

>> YES, WE ARE.

YOU KNOW, THE STATISTICS ON THIS VARY.

SO NUMBERS, DIFFERENT STUDIES THAT YOU READ, HAVE NUMBERS AS LOW AS 120 PER YEAR UP TO ONE SUICIDE A DAY ON AVERAGE.

SO LIKE 300 TO 400 PHYSICIANS DIE BY SUICIDE IN A YEAR.

SO IF YOU THINK ABOUT WHAT THAT MEANS, THAT'S AN ENTIRE MED SCHOOL CLASS.

WHEN I WENT TO MED SCHOOL, WE HAD 100 SOME PEOPLE IN OUR CLASS.

SO WE LOSE THAT MANY PHYSICIANS TO SUICIDE ANNUALLY.

AND, YOU KNOW, ARE WE SEEING AN INCREASE?

YES, UNFORTUNATELY WE ARE.

AND THAT'S A MULTIFACTORIAL QUESTION JUST LIKE A LOT OF THINGS IN MENTAL ILLNESS ARE MULTIFACTORIAL.

THERE IS NO, UNFORTUNATELY, CLEAR CUT ANSWER THAT I CAN POINT TO AND SAY AHA, THAT IS WHAT IT IS!

BUT WITH PHYSICIANS AND HEALTHCARE WORKERS IN GENERAL, WE ARE LESS LIKELY TO SEEK TREATMENT.

WE HAVE AN INTERNAL BIAS AND PERHAPS IT'S CULTURAL, LIKE YOU SAID.

THERE WAS THE OLD WIVES TALE AND THE SAYING, HEAL THYSELF.

SO THERE IS A STIGMA IF I SEEK TREATMENT FOR MENTAL ILLNESS WHETHER IT'S DEPRESSION, SUBSTANCE USE, ANYTHING ELSE, THEN I'M SOMEHOW FALLING SHORT OF THE EXPECTATIONS THAT SOCIETY HAS PLACED UPON ME.

AND THAT'S JUST OBJECTIVELY NOT TRUE.

BUT UNFORTUNATELY WE STILL SEE IT IN THAT WAY.

AND THE RATES ARE INCREASING.

PART EVER THAT HAS TO DO WITH THE CHANGE OF THE ROLE OF THE PHYSICIAN IN THE HEALTHCARE SYSTEM AND THIS IS A TREND THAT WE SEE WITH WE TALK TO OTHER PHYSICIANS ACROSS THE BOARD ADMINISTRATIVE BURDENS INCREASE, JOB SATISFACTION IS DECREASING.

BUT IT'S NOT-- WHEN I SPEAK WITH PHYSICIANS THAT I TREAT, IT'S NOT THAT THEY DON'T LIKE BEING PHYSICIANS.

THEY LOVE SEEING PATIENTS.

THEY LOVE TREATING PATIENTS.

THEY LOVE THE PRACTICE OF MEDICINE.

IT'S ALL THE OTHER STUFF THAT TENDS TO WEAR DOWN AND CAUSE PHYSICIAN BURNOUT.

SO I'M CAREFUL TO CATEGORIZE BURNOUT AND MORAL INJURY DIFFERENT.

A LOT OF PHYSICIANS I SPEAK WITH AND THAT I TREAT, THEY FEEL LIKE THEIR VALUES DON'T NECESSARILY ALIGN WITH THE VALUES OF THE HEALTHCARE SYSTEM AND AS A RESULT OF THAT, THEY FEEL TRAPPED AND THAT, HOPE NESNESS IS ONE OF THE KEY SYMPTOMS WITHIN THE DEPRESSIVE, WITHIN THE SPECTRUM OF DEPRESSIVE SYMPTOMS THAT IS LINKED WITH SELF HARM.

>> DOES FATIGUE COME INTO PLAY WITH THIS ALSO.

>> PHYSICAL FATIGUE OR EMOTIONAL?

>> I WAS THINKING PHYSICAL FATIGUE BUT I GUESS YOU ARE RIGHT.

I IMAGINE EMOTIONAL FATIGUE, WE JUST CAME OUT OF THE BUSINESS WITH COVID AND THAT HAD TO WEAR NURSING STAFF, ALLIED HEALTH AND PHYSICIANS.

>> ABSOLUTELY.

I THINK IT DOES.

ULTIMATELY SPEAKING, IT CULLS DOWN TO WHETHER OR NOT AN INDIVIDUAL FEELS LIKE THEY HAVE AGENCY AND WHETHER THEY HAVE THE WORK THEY'RE DOING IS MEANINGFUL, PURPOSEFUL.

A LOSS OF A SENSE OF PURPOSE IS QUITE A POTENT NEGATIVE FACTOR IN SOMEONE'S LIFE.

INDEPENDENT OF WHETHER THAT PERSON HAS IDEATIONS OF ENDING THEIR LIFE OR NOT, JUST IN TERMS OF QUALITY OF LIFE, LOSS OF PURPOSE IS QUITE POTENT.

AND, YOU KNOW OVER TYPE, ESPECIALLY AFTER THE PANDEMIC, WITH THE, YOU KNOW, CHALLENGES THAT SCIENCE IN GENERAL IS FACING ACROSS THE BOARD, I THINK WE ARE SEEING HEALTHCARE PROFESSIONALS GET JADED A LITTLE BIT FASTER THAN WE USED TO.

>> WHAT ABOUT IN THE COMMUNITY?

NON-PHYSICIANS?

ARE YOU SEEING SIMILAR THINGS WHERE PEOPLE MAY FEEL UNAPPRECIATED OR DENIGRATED OR TREATED AS LESS THAN, DO THEY HAVE THESE SAME IMPACTS?

>> YEAH, SO SOCIAL CONNECTIVENESS, YEAH, ABSOLUTELY.

>> THAT'S A BETTER WAY OF SAYING IT.

>> SOCIAL CONNECTEDNESS IS SO IMPORTANT.

LIKE THERE ARE RISK FACTORS FOR SUICIDE, THERE ARE ALSO PROTECTIVE FACTORS.

THERE ARE FACTORS THAT WE CAN EVALUATE FOR THAT REDUCE THE RISK OF SOMEONE INFLICTING HARM TO THEMSELVES IN A WAY THAT ENDS THEIR LIFE.

ONE OF THOSE IS HAVING A STRONG SOCIAL STRUCTURE, STRONG CULTURAL IDENTITY.

HAVING A STRONG RELIGIOUS OR SPIRITUAL IDENTITY WHERE THAT IS SOMETHING THAT IS NOT MORALLY ALIGNED WITH THEIR VALUES.

HAVING ACCESS TO HEALTHCARE AND ONGOING ACCESS TO SPECIFICALLY MENTAL HEALTH CARE IS A PROTECTIVE FACTORS.

THOSE INDIVIDUALS ARE LESS LIKELY TO TRY TO END THEIR LIFE AS WE LOOK BACK BECAUSE I GUESS SOMETIMES IT'S DIFFICULT TO PREDICT WHO IS AND WHO IS NOT.

WHAT ARE SOME OF THE COMMON THINGS THAT STAND OUT WHEN WE THINK ABOUT SOMEBODY WHO MAY COMMIT SUICIDE?

>> SO THIS IS SOMETHING THAT WE TRAIN OUR RESIDENTS TO PICK UP ON AND SOMETHING THAT WE TALK TO OUR PATIENTS ABOUT QUITE A BIT IN TERMS OF WHAT ARE THE WARNING SIGNS THAT, IF YOUR LOVED ONE DOES HAVE SUICIDAL IDEATIONS OR HAS ATTEMPTED SUICIDE IN THE PAST, WHAT WARNING SIGNS TO LOOK OUT FOR IN TERMS OF SYMPTOMS OR THINGS THAT PEOPLE ARE EXPERIENCING, A SENSE OF BEING TRAPPED OR A SENSE OF HOPELESSNESS IS QUITE POAT POTENT.

THAT COMES OUT ABOVE THE REST, ABOVE APPETITE PROBLEMS OR SLEEP PROBLEMSES OR CONCENTRATION PROBLEMS THAT MIGHT BE ASSOCIATED WITH DEPRESSION: HOPELESSNESS IS VERY, VERY-- IT INCREASES AN INDIVIDUAL'S LIKELIHOOD OF ATTEMPTING TO END THEIR LIFE THERE ARE OTHER SIGNS AS WELL.

MOSTLY THE SIGNS REVOLVE AROUND CHANGE.

SO IF AN INDIVIDUAL HAS OVERT AND DRAMATIC CHANGE IN THEIR BEHAVIOR, THEN THAT IS SOMETHING TO BE COGNIZANT OF OR AWARE OF, WHETHER IT'S DRINKING TOO MUCH OR ALL OF A SUDDEN THEIR PATTERN OF SUBSTANCE USE OR DRINKING HAS CHANGED WHETHER IT'S ANGER OR, YOU KNOW, FEELINGS OF WANTING TO TAKE REVENGE OR FEELINGS OF BEING A BURDEN, COMMUNICATION OF BEING A BURDEN OR NOT WANTING TO BE ALIVE.

WHETHER IT'S, YOU KNOW WE TAKE IF SOMEONE MENTIONS SUICIDE IN JEST, I TAKE THAT VERY SERIOUSLY AS WELL.

SO THOSE TYPES OF BEHAVIORS PARADOXICALLY, A SUDDEN SENSE OF LIGHTNESS AFTER BEING DEPRESSED FOR A LONG PERIOD OF TIME IS ALSO A WARNING SIGN.

IF SOMEONE, YOU KNOW IT'S NOT AN UNCOMMONE IF 234078 NON.

IN FACT, I WAS SPEAKING TO ONE OF THE THERAPISTS IN MY OFFICE AND I WAS TELLING HER I WAS COMING TO TALK TO YOU TODAY AND THAT IS SOMETHING SHE ALSO MENTIONED, YOU KNOW, WE HAVE SEEN INDIVIDUALS AND IT'S DOCUMENTED IN THE MEDICAL LITERATURE THAT IF THEY HAVE BEEN DEPRESSED FOR A LONG PERIOD OF TIME AND THEN THEY SUDDENLY TURN THE CORNER, THEN THE FAMILY MEMBERS MIGHT THINK THAT THEY'RE TURNING THE CORNER, THEY'RE COMING AROUND, BUT IT MIGHT ACTUALLY BE A WARNING SIGN FOR SOMEONE WHO HAS MADE A DECISION TO END THEIR LIFE.

>> ON THE OTHER HAND, I REMEMBER THIS GOES BACK TO WHEN GALEN WAS WALKING THE EARTH AND TREATING PATIENTS, I SEEM TO RECALL WHEN THE PERSON IS DEPRESSED, THEY'RE TOO DEPRESSED TO DO ANYTHING BUT IF THEY COME OUT OF THE DEPRESSION, THEY'RE GETTING MORE ENERGY AND THEY MAY ACT UPON NOW SUICIDE IDEATIONS.

>> THAT'S NOT FULLY TRUE BECAUSE THERE ARE TREATMENT FOR MENTAL ILLNESS REDUCES SUICIDE ATTEMPTS, REDUCES THE RISK OF SUICIDE BY AND LARGE.

SO AND THAT'S WHERE PROPER EDUCATION TO THE PATIENTS AND PROPER SETTING THE EXPECTATIONS TO THE PATIENT OF WHAT IS GOING ON IS HELPFUL.

AS SOMEONE IS BEING TREAT AND THEIR DEPRESSION IS BEING LIFTED.

THAT IS A SIGN OF HOPE AND A POSITIVITY IN THAT INDIVIDUAL'S LIFE.

I TELL MY PATIENTS I'M SURE I CAN GET YOU BETTER.

I'M JUST NOT SURE I CAN DO THAT IN THE FIRST TRY.

BECAUSE THINGS LIKE DEPRESSION, THEY'RE SUFT A HETEROGENEOUS GROUP OF PROBLEMS IN THE BRAIN PATHOLOGY THAT CAN CAUSE THE SYMPTOMS OF DEPRESSION, AND SO, YOU KNOW, I THINK THAT IT'S TREATMENT FOR MENTAL ILLNESS IS NOT A RISK FACTOR.

>> ALSO NOT FOR THE LIGHT HEARTED.

IT'S A HARD THING TO TAKE CARE OF.

>> ABSOLUTELY.

>> I'M A FAMILY MEMBER, AND I SEE SOME OF THESE THINGS THAT YOU JUST SAID ARE CHANGES, MOOD HAS CHANGED, DRINKING MAYBE HAS CHANGED.

ANGER.

HOW DO I INTERVENE?

AND IF I INTERVENE, AM I GOING TO DRIVE THAT PERSON FURTHER DOWN THE PATH.

>> >> DATA SUGGESTS THAT NO.

DATA SUGGESTS THAT INTERVENTION DOES NOT INCREASE THE RISK OR DRIVE THAT PERSON DOWN THAT PATHWAY.

AND IT'S ACTUALLY AN EYE OPENING EXPERIENCE FOR A LOT OF MEDICAL STUDENTS WITH HOW FRANKLY WE DISCUSS THOUGHTS OF SUICIDE WITH OUR PATIENTS BECAUSE WE OFTEN TIMES HAVE TO.

WE HAVE TO BE SPECIFIC ABOUT WHAT TYPES OF PLANS FOR SUICIDE WHAT THEIR LEVEL OF INTENT FOR SUICIDE IS.

IF, YOU KNOW, THE INTERVENTIONS CAN BE CATEGORIZED IN A COUPLE OF DIFFERENT WAYS.

THE MAIN ONE IS REMOVAL OF ACCESS.

SO IF AN INDIVIDUAL HAS WEAPONS AT HOME, IF THEY HAVE A HISTORY OF ATTEMPTING SUICIDE BY A SPECIFIC WEAPON OR A SPECIFIC METHODOLOGY, THEN TRY TO MITIGATE AND CONTROL THE FACTORS BY REMOVING THE ACCESS TO THAT IS QUITE BENEFICIAL AND ACCESS TO HEALTHCARE.

IF THEY DO HAVE A HEALTHCARE PROVIDER WHETHER IT'S A PCP, PSYCHIATRIST, THERAPIST, WHOMEVER, THEN ADVOCATING FOR THAT INDIVIDUAL TO GO AND TALK TO THEIR PROFESSIONALS ABOUT SEEKING TREATMENT IS, YOU KNOW, CAN HELP QUITE A BIT AND MOST OF ALL, IT'S THE CHANGE OF THE CONVERSATION AROUND MENTAL ILLNESS.

YOU KNOW, MENTAL ILLNESS IS A NEUROLOGICAL PROBLEM.

IT'S NOT-- YOU ARE NOT SEEKING HELP.

YOU ARE SEEKING TREATMENT AND THERE IS A DIFFERENCE BETWEEN THOSE TWO THINGS.

BECAUSE THIS IS NOT-- WHEN AN INDIVIDUAL HAS THOUGHTS OF SUICIDE, THAT IS PATHOLOGY.

THAT IS AN ILLNESS.

WE KNOW THAT THAT IS A CAUSE OF MENTAL ILLNESS AND THE REASON WE KNOW THAT IS BECAUSE WHEN WE TREAT THOSE INDIVIDUALS, THOSE THOUGHTS GO AWAY THEY DON'T REMAIN SO WE KNOW THAT TREATMENT CHANGES THOSE THOUGHTS AND MAKES THEM GO AWAY.

SO THIS IS TREATMENT AND UNDERSTANDING THAT FOR AN INDIVIDUAL WHO IS EXPERIENCING THOSE THOUGHTS TO UNDERSTAND THAT BECOMES IMPORTANT, TOO BECAUSE IT'S PSYCHIATRY AND SUICIDE SPECIFICALLY IS ONE OF THE FEW, IF NOT ONLY MELODIES ORDERS WHERE WE ARE FIGHTING AGAINST THE PATIENT'S WISHES.

MOST OF THE TIMES WHEN WE TREAT PATIENTS WE ARE TRYING TO SAVE THEIR LIVES AND THE PATIENT THEMSELVES WANT TO HAVE THEIR LIVES SAVED.

WHEN WE ARE TREATING MENTAL ILLNESS, SPECIFICALLY DEPRESSION AND SPECIFICALLY SUICIDE, WE ARE FIGHTING AGAINST THE PATIENT SO THEY BELIEVE THAT THIS IS THE NEXT STEP FOR THEM AND THEY WANT TO TAKE THEIR LIFE BUT IF WE CAN ESTABLISH A CULTURE OR AT LEAST, YOU KNOW, WHEN THE PATIENT IS NOT IN THE DEPTHS OF DEPRESSION IF WE ARE ABLE TO EDUCATE THEM ON THE FACT THAT IF THOSE THOUGHTS OCCUR, THEN WE NEED TO ADDRESS THEM.

WE NEED TO TREAT THEM.

>> AS WE COME TO A CLOSE, IT'S IMPORTANT.

HELP VERSUS TREATMENT.

I NEVER HEARD ANYBODY SAY I'M GOING TO HELP A DIABETIC.

WE ARE GOING TO TREAT DIABETES.

SAME THING WITH MENTAL ILLNESS.

GIVE ME THE QUICK YES OR NO ANSWER.

20 SECONDS.

>> DO WE HAVE ENOUGH HEALTHCARE PROVIDERS TO TAKE CARE OF MENTAL HEALTH ORDERS.

>> I DON'T NEED YOU TO FINISH THE QUESTION.

THE ANSWER IS NO.

>> WE NEED TO DO MORE.

>> YES.

>> THANK YOU VERY MUCH FOR BEING WITH US.

YOU HAVE BOTH SCARED ME AND ALSO GIVEN ME GREAT CONFIDENCE IN KNOWING THAT THERE ARE STILL THINGS OUT THERE.

LET ME FIRST SAY THAT IF YOU, A LOVED ONE OR FRIEND IS THINKING ABOUT OR CONCERNED THAT YOU OR THEY MAY COMMIT SUICIDE, PLEASE DIAL 988.

THIS IS THE NUMBER TO THE SUICIDE AND CRISIS LIFELINE.

I HOPE THAT YOU ARE NOW BETTER EQUIPPED TO RECOGNIZE THE RISK FOR SUICIDE AND REALIZE THAT THERE IS NO SHAME IN GETTING HELP.

IF YOU WISH TO WATCH THIS SHOW AGAIN OR WATCH AN ARCHIVED VERSION OF PAST SHOWS, PLEASE GO TO WWW.ket.org/HEALTH.

IF YOU HAVE A QUESTION OR COMMENT ABOUT THIS OR OTHER SHOWS, WE CAN BE REACHED AT KYHEALTH@ket.org.

I LOOK FORWARD TO SEEING YOU ON THE NEXT "KENTUCKY HEALTH" AND LET ME JUST ADD SOMETHING THAT Dr. FAROOQUI SAID.

SOMETIMES WHEN WE RECOGNIZE PEOPLE IN TROUBLE, LET'S REMOVE SOME OF THE INSTRUMENTS THAT MAY CONTRIBUTE TO THEIR OWN DESTRUCTION.

IF WE HAVE WEAPONS IN THE HOUSE, I'M NOT ASKING YOU TO TAKE THEM AWAY.

JUST LOCK THEM UP.

KEEP THEM SAFE, KEEP US ALL SAFE AND KEEP YOU SAFE UNTIL NEXT WEEK.

SEE YOU THEN.

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.

BAIFORTD RICK