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Training trails busy year for suicides in Jacksonville, Onslow

Daily News (Jacksonville, NC) - 11/7/2015

Nov. 07--Asking whether someone is pondering suicide does not plant ideas of suicide -- despite lasting beliefs of the contrary.

This year has been busy with suicides in Jacksonville, which tallied seven so far, according to Jacksonville Police Department.

The year's total almost exceeds the city's suicides -- a total of eight -- the last three years.

Jacksonville Fire and Emergency Services is familiar with the sensititivies required to respond to suicide -- and attempted suicide -- scenes.

For emergency responders, the approach is similar to other calls but requires added compassion, Battalion Chief Jon Crazy Bear told The Daily News.

"The main difference is that there is a sense or a stigma that the underlying cause of the incident is a deeper mental issue," Crazy Bear said. "We learned that a little bit of compassion goes a long way in such instances."

Crazy Bear added that the city's responders must have many tools to recognize signs of suicide attempts.

"The signs and symptoms of suicide patients are not always very apparent," he said.

For law enforcement, the scene of a suicide has some similarities to a crime scene, Patrol Division Sgt. Christopher Funcke said.

"Although law enforcement approaches such a call as a crime scene, it is different for us when interacting with the witnesses and family members," Funcke said. "It can be very stressful to investigate the crime while being mindful of the loss the that the victim's family and friends are experiencing."

The first priority for all responders, he added, is the preservation of life, "however we can."

The toolkit for first responders is important in Jacksonville, which had more attempted suicides -- 47 -- this year than in 2014. There were 45 attempts in 2014, according to Jacksonville Police Department.

A similar trend has prevailed in Onslow County.

"Suicide is almost like a common occurrence for us," Maj. Chris Thomas told The Daily News. "Most of the time it's an adult. Most frequently, it's a self-inflicted gunshot. Tied for second would be overdoses and hanging, possibly with hanging more common than overdoses."

Onslow County has had 17 suicides this year and 25 in 2014, Thomas said.

The latest data available from Centers for Disease and Control total 41,149 suicides throughout the United States in 2013. That is almost double the nation's homicide total that year.

In 2013, more than half of suicides were by firearm.

In Onslow County, firearms also are the most common in suicides, according to Onslow County Sheriff's Office.

Few people are comfortable talking about the nation's 10th leading cause of death.

- But talking about suicide is one form of its prevention.

"That is staggering to me," said Barry Feldman, a psychologist who specializes in suicide intervention and prevention. He spent this week teaching suicide-prevention tactics to Jacksonville and Onslow County first responders, including police officers and deputies.

"Suicide is an attempt to solve a problem of intense emotional pain with impaired problem-solving skills," Feldman said. "There is an intense emotional pain. I have heard patients say they feel like their brain is broken. They want the pain to stop. They aren't open to alternatives. It is a constricted way of thinking."

For Jacksonville police officers, Feldman's course complements mandatory 40 hours of crisis-intervention training. The courses were provided this week at Jacksonville Center for Public Safety.

Crazy Bear said the training instilled a "consciousness that the community has members dealing with life issues greater than which they are able to cope.

"We were given signs to look for and questions to ask, when responding, that may expose a person who is dealing with suicidal issues," Crazy Bear said. "Our responders are often the first opportunity for someone in dire need to make contact with the help offered through the medical community."

Funcke said suicide is "much more prevalent than the public is aware.

"Still a taboo subject, it is important to bring awareness and education," Funcke added.

Onslow County Sheriff Hans Miller said suicide requires specific training for officers.

He said suicide investigations include three elements:

Prevention, such as observation of signals that could represent an attempt.

* Intervention, such as an action by law enforcement that defrays the crisis.

* "Post-vention," Miller said, referring to actions to support the swath of people affected. Those include grieving families, relatives and first responders dispatched to the scenes of suicides.

Feldman reminds the community that talking about suicide is part of a necessary, complex solution.

"No, you're not planting any seeds if you talk about suicide," Feldman said. "Research supports that. We need to be able to talk about suicide like other problems, such as addiction."

That is part of Feldman's mission: to dispel lingering myths about the tragedy that leaves many loved ones stricken by complex, profound grief.

"What people don't realize is suicide is 100-percent preventable," Feldman said.

But it is not preventable by "one thing," he added.

Suicide is too complex for simple solutions.

- Law enforcement officers or EMTs may arrive to a home for reports of an injury that could have been a suicide attempt.

"Responders may go to a home where someone has a broken arm," he said. "They can ask 'Where'd you get hurt? Show me where you got hurt.' They might see a strap in a rafter and they can probe a little further."

Responders, he added, "must be more aware that what you see might not be what you get."

And the totals are understated for suicide in the United States.

"Unless intent was known, it is not ruled suicide," Feldman said. "That number is understated 10 to 30 percent."

Suicide is not the result of a weakness, he added.

"That's what people think, but that's not what going on," Feldman said. "Ninety to 95 percent of suicides had a diagnosable mental health disorder."

And suicide spans all sectors of society. Even famous people, such as Robin Williams, have committed suicide.

Although adult suicides dominate national totals, suicide is the third leading cause of death among adolescents, Feldman said.

There are factors -- not causes -- that are apparent among suicides.

Men, who dominate suicide totals, seek mental-health assistance less frequently than women, Feldman said.

"Males complete most often," Feldman said. "Females attempt most often."

And rural areas have higher suicide rates than urban locales.

Getting involved

Feldman coaches suicide prevention by mapping signals that may present beforehand. He provided an example in cases of children and young adults.

First, find out how someone is feeling, he said.

"Feelings of despair, helplessness, hopelessness, sadness, anxiety," Feldman said.

And beware of certain actions "seeking access to means" to commit suicide, he added.

Stockpiling pills or reckless behavior, for example.

Opiates -- such as pain pills -- often appear in intentional overdosings, Thomas said.

And any changes in behavior also can be indicators that suicide is under consideration, Feldman said.

"Changes in academic performance, appearance," he added. "If someone's appearance starts deteriorating. If an active kid is withdrawn or cutting class."

Thematic content of students' essays and artwork also could signal feelings of complete despair.

"Sometimes, the signs are specific," Feldman said. "Sometimes, the signs are vague."

Situations also could contribute to mounting problems in a person's life.

"Watch out for stressors at home, at school," Feldman said, adding that many stressors are inherent during adolescence.

- "Losses, relationship changes, a lack of hope for the future," he said, may signal more profound emotional conditions. "Those should be considered red lights and we need to stop and pay attention when those appear.

For more information, visit American Foundation for Suicide Prevention at AFSP.org or Centers for Disease and Control at CDC.gov.

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