Changing the face of suicide

July 27, 2017 | By John William Howard

By empowering the public, Washington County aims to support people in the throes of a mental health crisis.

Typically, no one wants to talk about suicide.

It’s not dinner conversation. Suicide is a topic filled with faux pas and misnomers, and is a difficult topic to discuss because of the pain, fear and confusion surrounding it.

A growing group of people in Washington County are fighting to change that narrative and open crucial communication lines, hoping to cut down on the number of countywide suicides. Along with deconstructing the stigma around suicide, the county is also hatching initiatives to change the way suicide is discussed.

And the approach is a bold one.

“If you have a family member or a friend, and you think something is up or someone is in need of help, it’s OK to talk about it,” said Andy Cartmill, a facilitator for the county’s mental health and suicide awareness trainings. “We want people to ask the question directly about suicide — ‘Are you considering suicide?’ — instead of ‘hurting yourself’ or doing something ‘stupid’ or ‘silly.'”

Cartmill said it helps to be clear and get to the point. If someone is considering death, they may not see another choice. Often, suicide is less about death and more about pain and how to escape it, a sentiment echoed by Laureen Conti, a Peer Support Specialist at Washington County’s new Hawthorn Walk-In Center.

Conti, like all the Peer Support Specialists at the Hillsboro mental health and addiction center, is on her own road to recovery from a past crisis.

Conti grew up in California, part of a family in which mental health was dinner conversation. She lives with type-one bipolar disorder. Seven years ago a concerned friend called a crisis line and she was taken to a Portland hospital by Washington County Sheriff’s deputies. A few weeks later, the sheriff’s office transported her to Providence St. Vincent Medical Center in Portland following a manic episode.

In the years following the two interventions, Conti said she’s made a steady climb upward thanks to the treatment she received: the right medication, the right therapist, the right support group and the right people surrounding her.

“I needed hope,” she said. “The biggest thing I needed was hope. When somebody is suicidal, and I’ll just speak for myself, it’s not that they want to die, it’s that they want the pain to go away.

Finding some hope that it’s going to get better, that what you’re going through is a temporary situation and it can get better, that makes all the difference.”

Conti is at the forefront of recovery for patients at the Hawthorn Walk-In Center, and a poster child for the county’s efforts to respond to mental health crises.

In 2013, the county established the Suicide Prevention Council, a group of first responders, mental health professionals, doctors and others with the goal of addressing a spike in certain demographics — most notably Vietnam War and Korean War veterans.

Amanda Garcia-Snell, the Washington County Public Health Program Supervisor, said the council was tasked with “the idea of figuring out upstream strategies” to prevent suicides down the road.

The program was moved to the Public Health division in 2014, and won a five-year federal grant in 2015 to hire a full-time coordinator.

Cartmill is one of the council’s more visible public arms, leading suicide awareness trainings with various groups — law enforcement, foster care, domestic violence groups, schools, church groups — around the county. His aim is to re-teach people about some of the early indicators and help connect concerned family members or friends to available resources.

He comes across plenty of common myths regarding suicide, including that talking about suicide can spur suicidal thoughts.

Having suicidal thoughts doesn’t always mean suicidal intent, Cartmill said, and the best approach is to listen — just listen.

“What we teach is to be honest and say, ‘Look, if you’re hearing these things, I’m always here for you,” Cartmill said. “‘I’ll help you as much as I can, but the professionals can help even more. Would you consider talking to someone else in addition to me?’ Get buy-in from the individual and formulate a safety plan.”

Conti said the direct approach helps to combat fears about discussing suicide.

“It felt a little awkward in the beginning asking somebody if they were suicidal, and I think the only way through it is to just name it and not be afraid of the word,” she said. “What I have found is by asking it and getting it out in the open, people are relieved to be able to say, ‘yeah, I am having those feelings,’ and nobody freaks out.”

But what actually happens when someone calls the Washington County crisis line?

Conti said it’s not what people are typically afraid of: the lights and sirens. Instead, it’s a dialogue and a handful of questions to provide the caller with the next step or help the person in crisis get help.

Workers will go out to see someone in need, but the Hawthorn Center typically tries to have patients come in to the center, even calling a cab — paid for by the center — to help someone actually get there.

But before center staff can spring into action, they need community members to intervene if they see something out of place. The county provides free training to recognize signs of someone who may be experiencing mental health crisis.

“Often, people turn to loved ones before they turn to professionals for help,” said Rich Roell, the coordinator for the Washington County Crisis Team. “That person is essentially the first point of contact, and that’s where the conversation is changing in the community. We have excellent crisis services in the county, but it can’t be up to us.

“The whole community can be empowered to respond to suicide.”

The county’s suggestions are simple. Listen. Take talk of suicide seriously, and stay calm. Remain with the person. Ask about their intentions directly, and make a plan if the answer is yes. Keep the crisis line — 503-291-9111 — fastened to the refrigerator, or in your contacts.

But most of all, don’t be afraid to talk. Conti said she’s seen a shift in how suicide is viewed, and sees firsthand what happens when someone has the bravery to speak up.

“I think it is less hush-hush to talk about somebody who has died by suicide,” Conti said. “I see a lot more compassion now.”