Suicide prevention is a complicated endeavor requiring support networks and treatment to work effectively. It is also an endeavor that is a crisis away from collapsing, as suicide is an individual choice outside the control of others.
Even with a strong support network and proper treatment, some people choose to take their own lives.
There are signs, methods of treatment and avenues people can use to help minimize the risk of suicide, along with mental health institutions designed to assist those in need.
Mental health services
Like many other illnesses, depression and suicidal thoughts are treated via short-term and long-term care plans. A person in crisis needs immediate treatment and assistance through crisis services, and both Southwest Behavioral and Mohave Mental Health provide that to the community.
"One of our big roles is education, along with access to services," said Lauren Lauder, vice president of Southwest Behavioral for Northern Arizona. "One of the important things is when a member is seeking services because of depression or crisis, they are able to access those services.
"Sometimes there are barriers or time restrictions. They often don't know who to go to or where to call, or there's a delay in services. We work hard to get people into services as quickly as possible, especially when someone's struggling with depression."
Her organization works more with the outpatient side of mental health, seeing patients over a longer period of time and working on developing strategies to help them improve functionality in their life.
An organization like Mohave Mental Health works with more inpatient cases that focus on dealing with the crisis as it's happening, then looking at organizations to continue the patient's care.
"Our mission is short-term stabilization," said Tim Davis, director of inpatient services at Mohave Mental Health. "We bring in a person and assess their needs, and it's not a one size fits all. We provide a comprehensive assessment and, in the case of suicide, we look at plans, intent, and means. How are they going to do it and if they tried to do it. We react on that.
"We also look at risk factors: age, gender, previous attempts, family health, substance abuse. It can elevate a risk. Men tend to use more lethal means. We factor all of that in."
Signs of trouble
Both Davis and Lauder agree on what the warning signs of suicide and depression are, and encourage people to look for behavior that seems erratic or out of place.
"The individuals that are contemplating harm, they don't recognize or don't want to tell anyone," said Davis. "There's the classic, 'I'm much better today, and I want to give everything away.' Look for an overnight change of behavior. Something that's shifted or seems funny.
"You also don't want to be afraid to approach the individual. You will experience anger or frustration or fear. They can be defensive. It's a normal reaction to be angry. My feeling is, I would rather have someone angry than dead."
Davis encouraged friends and family, an individual's support network, to reach out and be available to them. Watch them, and trust your gut feeling if something feels out of place.
With any mental illness, getting a person functioning again is the main goal. For an outpatient facility like Southwest Behavioral, that comes with a combination of therapy and a strong support network.
"People can absolutely be participating in treatment, in therapy, and be very high-functioning. There are other people that have depression that is debilitating to them, but it doesn't mean that without treatment they can't be functioning," said Lauder.
Her goal at Southwest Behavioral is to improve a patient's functionality in their community, whether that be at home or at work or elsewhere. They use therapy, social support skills and living skills training to improve their situation.
Just as important, if not the most important, is getting a person's support network involved.
"Family and friends are encouraged to participate in services with them. It creates a support network outside of us. That's something they can do to be a part of the process," said Lauder.
Medication has its role in mental health services, too. For Davis and his team, in the event of a crisis, medication is brought on board pretty quickly if it's needed in a behavioral health issue.
"We don't see medications as the long-term solution in most cases. Some cases require that. We like to take a more pragmatic approach, stabilize the acute systems, and get you past the crisis event," said Davis.
With medications, a wide range exists to help treat a variety of mental health issues, with multiple medications available for a given illness.
Medications don't work the same for every individual, and part of getting medication during a crisis event is understanding that what works for one person might have a different effect on another.
When taking medications, Davis stressed that clients should question their doctors and have a dialogue with them about what's going on and share their experiences.
"There's no magic pill or equation that will cure you. It doesn't work that way in behavioral health," said Davis.
Lauder and Southwest Behavioral see medication as support for the outpatient care they provide.
"Our opinion, and our practice, is that medication complements treatment. A person receives it in addition to therapy. They go hand in hand," she said. "We want people to have the coping skills necessary, and we want them to develop those skills. We don't believe medication gives them the ability to do that."
Both organizations also look at addiction issues and a history of medication abuse before prescribing medications. A person may suggest a medication they had success with in the past, but justification before prescription is necessary. In some cases, requiring doses to be taken at the health facility or prescribing smaller amounts of medication ensure that medication abuse is kept to a minimum.
Even with a strong support network, therapy and medication, suicide is ultimately an individual choice.
"There are some individuals so consumed with the pain they feel that they aren't able to overcome that, despite what providers and family members do. There are situations that sometimes, after multiple interventions and attempts to intervene, are not successful in improving that person's function," said Lauder.
"The biggest message is for people to really understand that they are not alone, and to ask for help."
For Davis and his team at Mohave Mental Health, they are constantly getting data to help supplement their programs, and one of their focuses is helping coach individuals to help one another in a time of crisis. A family can do everything right, follow every step to help an individual, but still suffer when someone chooses suicide.
"We intervene as much as we can, but an individual has the right to take their own life if they wish. We don't want to have that happen, and we do everything we can to not have that happen. We do understand that, as professionals, we can't control everything," he said.
Mohave Mental Health's crisis line is (888) 757-8111.
Southwest Behavioral's crisis line is (877) 756-4090.