Education, more resources key factors in suicide prevention

Washington State Department of Health employees Neetha Mony and Douglas Wagoner contributed to this story.

After Cal Beyer’s friend, Jeff, died by suicide in February 2015, Beyer learned that he had missed the warning signs of a person in crisis. Beyer hired Jeff in 2004 and provided Jeff support when he struggled. Beyer, however, didn’t realize the full extent of the pain that Jeff hid from others.

“I could have been bolder,” Beyer said. “If I had known, I would have gone to his home and gotten him help. None of us knew the depths to which he had fallen.”

Beyer’s story about loss is not unique. In 2017, at least three Washingtonians died by suicide every day. Washington’s suicide rate has increased steadily since 2006. Disproportionately affected populations include American Indian and Alaska Natives, people living in rural communities, males (especially older males), veterans and members of the armed forces and their families.

Legislators and Gov. Jay Inslee have honed in on suicide prevention efforts as a key priority. In 2016, the state Department of Health developed its 2016 Washington State Suicide Prevention Plan which helps guide prevention efforts with partners across the state. Last December, Inslee proposed additional funding for suicide prevention strategies that include paying for improvements to the crisis hotline, connecting K-12 students to mental health community services, and implementing clinical best practice tools to help people who experience suicidal thoughts.

Volunteers placed white, yellow and red headstones on the Capitol Campus lawn for the 2019’s Suicide Prevention Education Event on March 6. The headstones represent the number of people who died by suicide in 2017: 1,292 individuals in Washington. Backpacks rested against 84 headstones for individuals aged 19 years and younger. The headstone colors symbolize how someone died: red means a firearm, yellow means suffocation, white means poisoning, blue means a fall or a jump, and green is designated as ‘other.’

First lady Trudi Inslee attended the event, which was organized by Forefront Suicide Prevention from the University of Washington. A large part of the event focused on how suicide prevention must be at the forefront of integrating the state’s health and mental health systems. Attendees were encouraged to advocate the Legislature for more suicide prevention funding.

“We know so much more today than ever before about how to help people in crisis and prevent these tragic deaths,” Trudi Inslee said. “We need to reduce suicide across all groups and educate communities so people who need help can find it.”

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Cal Beyer, right, stands for a photo with Kevin Hines (known worldwide for his suicide prevention work). Beyer spoke about suicide prevention efforts at the United State Department of Health and Human Services in Washington D.C. earlier that day (Photo courtesy of Cal Beyer)

At Jeff’s memorial service, Beyer said his family spoke openly about his lifelong struggle with depression. Jeff’s wife thanked Beyer for his friendship and encouraged him that if he “ever had a chance to make his voice a little louder,” he could help other families recognize the signs of an at-risk individual.

As a result, Beyer said he “declared war on suicide” and advocated more boldly for suicide prevention. He helped form the Construction Industry Alliance for Suicide Prevention, which promotes suicide prevention in an industry that holds the №2 spot for industry suicide rates. In 2016, Engineering News-Record recognized him as a “Top 25 Newsmaker” for his work.

Like Beyer, funding crisis hotlines is an investment that Dipti Chrastka, clinical director at Crisis Connections, believes in. One the most popular Crisis Connections programs is the 24-hour crisis line. It also hosts Teen Link, a youth peer support line that is open every day in the evening hours. Teens volunteer on the phones and monitor online chats for Teen Link because at-risk youth are often more comfortable talking to other teens, according to Chrastka. Callers can range from feeling lonely, bullied or depressed, to having suicidal thoughts.

“Suicide doesn’t have any boundaries,” said Sarah Brock, former crisis counselor and now lifeline division coordinator for Volunteers of America. “No population or group is safe from the effects of suicide.”

When someone dies by suicide, Brock said a ripple effect usually takes place — even if the person who died was a celebrity or not personally connected to someone’s circle. Unfortunately, there aren’t enough resources for people who need help. Brock said people who use crisis lines — like the crisis line where she works — sometimes experience long wait times, which means the proposed funding will reduce these wait times and improve the level of services offered.

“There needs to be some funding or resources provided to youth before they reach that at-risk level, for sure,” Brock said. “It would also be helpful if students have more mental health resources that they can easily access in school.”

When an at-risk kid calls the crisis line, they want to talk to somebody who can help them and won’t get them into trouble. Near the end of the call, the operator often suggests resources for the teenager, like talking to a school counselor. But Brock said some teens are scared to talk to the help available at school because they are worried their parents will be informed or they will somehow get in trouble.

The governor’s proposal would add more call center staff to the network, expand services to Eastern Washington, help manage higher call volumes and improve the state’s crisis response services, according to the Washington State Department of Health.

The crisis line recently collaborated with the National Suicide Prevention Lifeline call center to coordinate both the state and national crisis lines to improve performance and the resources that are available to callers. Despite a 40 percent increase in the number of calls, the in-state answer rate improved from 43 to 78 percent with this collaboration. But we still have unanswered calls — — Washington’s in-state answer rate could get closer to 100 percent answer rate with more funding for better call center resources.

Everyone plays a role in suicide prevention, Beyer said. Helping people talk about it in the workplace is crucial — it could have helped Jeff, he said.

“You think of all the impact of anxiety and depression at work — — it has to be a workplace issue,” Beyer said. “It’s a personal issue, it’s a family issue, it’s a community issue and a society issue. Why don’t we talk about it in the workplace?”

Construction and public safety are industries that many veterans enter after they leave active military service. The stress experienced by veterans as they transition to the civilian workforce can be challenging, and the following doesn’t help: Beyer said the construction industry has a tolerant culture of alcohol and substance use. The industry also has the highest use of prescription opioids. And, according to the Centers for Disease Control, construction has the highest rate of suicide among all industries.

“Anytime you have a male-dominated industry it becomes high risk for suicide because they’re a tough guy pull-yourself-up-by-your-boot-straps culture,” Beyer said.

That’s what his work with the construction industry alliance helped him to do: destigmatize it, talk about it and share resources. Building a caring culture in the workplace and educating people about warning signs provide a framework to give people help.

“It’s how we’re going to save lives,” he said. “Inslee’s budget to invest in suicide prevention is definitely visionary. This is the time to strike — when people are ready to have this type of solution.”

To connect with someone anonymously, call the National Suicide Prevention Lifeline at 1–800–273–8255, chat or text “HEAL” to 741741 to text with a trained crisis counselor.

Forefront provides resources to help people identify the signs of suicide risk and know how to help.

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