The entire country mourns when a celebrity or public figure ends his or her life, but in Los Angeles it can seem even more impactful because the entertainment industry is based here, and more often than not, they had a connection here. The grief feels personal because of the influence such people (musicians, actors, artists) had on our lives and the world, even if we didn’t know them. The recent losses of designer Kate Spade and chef/world traveler Anthony Bourdain in the same week have brought the problem to the forefront, but this isn’t a famous-people issue. Many struggle with depression and feelings of hopelessness, especially in this city. As suicide rates in L.A. continue to climb, we feel it is especially important to talk about prevention and awareness. For those who live with this darkness and even for those who don’t, understanding the psychology pertaining to suicide is the first step to ending or at least curbing the problem. Please take the time to read and share these words from a crisis line counselor and other mental health professionals. There is always another way. — L.A. Weekly

We need to talk about suicide.

Whenever a high-profile person ends their life, there seem to be three completely natural responses from the public: 1. “Why did he do this? He had it all!” 2. “Why did she do this? She had a family and kids; how selfish!” 3. “Why did they do this? I bet it was drugs or a divorce or a secret.” All of these thoughts — whether applied to Chris Cornell, Chester Bennington, Kate Spade or Anthony Bourdain — are typical when a celebrity, or anyone — your friend, your friend’s son, or your own daughter, wife or husband — makes a choice and takes an action that ends their life.

In media, suicide is often used as a dramatic trope, something that is seeded by an event like a rape, that takes hold through a lack of support and understanding, and is attempted or completed as either a revenge mechanism or a last resort. The Netflix series 13 Reasons Why sparked incredible outrage from mental health professionals for “glamorizing” suicide and offering no educational resources. With its current season, the network now provides those resources, but professionals question if it’s enough. Suicide in the news and in the media can often spark a tragic contagion.

Liz Eddy, communications director for the Crisis Text Line, notes, “We saw a 116 percent increase in volume the weekend after Kate Spade and Anthony Bourdain's deaths compared to the weekend before,” she says of texts to the national crisis text line. “The rate of texters age 25 to 54 rose from a typical 23 percent to 32 percent.”

Indeed, a study published by the National Academy of Sciences in 2013 concluded that news reporting and entertainment content about suicide and exposure to suicidal behavior in peers can contribute to increased attempts and completions. After news coverage following the deaths of Spade and Bourdain violated carefully developed, evidence-driven media guidelines about how to cover suicide, the Annenberg Public Policy Center published a media advisory on June 8 that encouraged less focus on means of death. “This is a proven source of risk for those who might be in a suicide crisis because it provides information about a lethal method of killing oneself,” explains Dan Romer, the policy center’s research director. “Some thought that Spade learned her method from the coverage of [comedian] Robin Williams' death, which also featured this method.”

While the data is spotily updated, it is clear that suicide rates across the country and in Los Angeles County are on the rise. Alarmingly on the rise. According to the American Foundation for Suicide Prevention, suicide is the 10th leading cause of death in the United States, with 44,965 deaths per year. The Los Angeles County Department of Public Health, Injury & Violence Prevention Program reported more than 3,600 completed suicides between 2005 and 2009. Men die by suicide more than women, and white men are most at risk. The rate is highest for middle-aged people.

Many Los Angeles residents are in another at-risk category: creatives. Studies by the U.K.’s Office for National Statistics and Sweden’s Karolinska Institute showed that people working in the arts are 25 to 50 percent more likely to die by suicide. “We have written about the ways in which journalists ignore the role of contagion in their reporting and how that can be a source of further risk for those who are vulnerable,” Romer says. “Those in the creative community who are currently in a crisis moment may be especially vulnerable because of their greater ability to empathize and identify with the deaths of celebrities” such as Spade.

So what do these trends and statistics mean? They mean we need to talk about suicide, especially in L.A.

Stigma is a dangerous barrier to learning more about and preventing suicide. When compassion and support replace shame and criticism, the opportunities for life-saving increase. Suicide often can be preventable.

We don’t know enough about suicide, but we know enough to change the persistent dialogue. There are common risk factors, most prominently depression and alcohol/substance abuse. Additional factors include mental illness, prolonged physical illness, unemployment, loneliness/isolation and a family history of suicide. Often, these factors occur together

Dr. Kita S. Curry is the president and CEO of Didi Hirsch Mental Health Services, home of the Suicide Prevention Center — the nation’s first — with locations throughout the Greater Los Angeles area. Dr. Curry explains, “Depression is an illness of the mind that affects your thinking. It’s unimaginable, unless you’ve been in that state and know how dark it is. You only see your failures and loneliness; you’re thinking nobody loves you and you’re a burden. You can’t see how the future will change,” Curry says. “The depression is usually compounded by a life experience that is overwhelming. You lost your job, your mate just died, your house got foreclosed on — something that you can’t see a way out of. In that moment, it feels like there’s nothing you can do that will change it, except die. You don’t want to die, but that’s a way of ending pain.”

Many people show warning signs. They can be subtle and slow, such as declining social invitations, erratic moods, increased fixation on the negative. Other signs can be jarring, including volatile mood swings, preparing for death (giving away belongings), and reckless or even dangerous behavior.

While middle-aged white men are most likely to complete suicide, anyone of any age, race, social standing, faith, education and location is at risk. People considering suicide (“ideation”) don’t always create a plan, acquire the means, decide on a time and take the action. At any point in that process, suicide can be prevented.

“Suicide is most preventable when someone is willing to discuss their wanting to end their life (suicide ideation) and/or having a plan to terminate life,” explains Dr. Bob Connolly, who treats patients with mental health and substance abuse issues including depression in his private practices across Los Angeles.

“People going through such turmoil in their lives need to be supported without judgment. They will need help in making changes in their life that will reflect what's best for them. There may be people close to them who aren't comfortable with those changes,” Connolly continues. “I think of people in powerful positions whose work has a significant impact on others … perhaps they need to step away from their current responsibilities in order to receive the help they need. That should be encouraged in order to prevent something disastrous.”

If you are thinking about suicide, it’s usually not easy to reach out and ask for help. The depressed mind clutters logical thought. In any calm moment of clarity, finding a safe, trusted support source is possible. If necessary, calling 911 or going to the doctor or ER is just as valid when one’s life is at stake. For some, the hospital can be the right place to start a recovery program.

The key to prevention, however, is held by the rest of us. We need to be the safe support. If someone you know shows any of the risk factors, or is in a tough situation and trying to smile through it, reach out. Ask if they are OK, if there’s anything they need, and let them know you’ve got their back.

Talking about suicide with someone does not compel them to attempt suicide. On the contrary, it is preventative. “Are you thinking about harming yourself?” is a question we need to start asking. And then we need to listen, without judgment and with empathy. “When someone is in that dark and hopeless place, hope has to come from the outside from people who say, 'I am sorry you are in so much pain. I want to help you. We’re going to get through this together,'” Curry says.

Sometimes, just knowing there is one person who cares can be the difference between life and death. Reminders of reasons to stay alive can be helpful. Let them remember and share those things. Keeping them physically safe — taking away car keys, removing guns, pills, knives, etc. — is important. Providing access to medical care systems can provide hope. And again, 911 may be an uncomfortable choice but it’s better than receiving that tragic call.

This is an emotionally exhausting challenge for the people with suicidal ideation as well as those who care about them. It’s scary, confusing, frustrating and sad. Self-care is important for all involved. Whatever that can look like, whether it’s an ice cream binge or a walk along the Santa Monica Pier, grabbing some peace is crucial to not perpetuating a cycle of depression, and refueling the empathy tank to take care of one another.

We can change the statistics, and we can change lives, by talking about suicide.

If you are thinking about self-harm or suicide, or know someone who may be at risk, please contact any of the following resources for care and support, or call 911:

NATIONAL SUICIDE PREVENTION LIFELINE
suicidepreventionlifeline.org
1-800-273-8255

CRISIS TEXT LINE
crisistextline.org
Text CONNECT to 741741

IN L.A.: THE DIDI HIRSCH SUICIDE PREVENTION CENTER
didihirsch.org
877-727-4747
(also offers support for suicide attempt survivors and survivors after suicide)

Deborah Brosseau is a communications consultant, writer, recovery coach and counselor on the Crisis Text Line.

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