Suicides: Who Do They Tell (Before doing it)

From a post today over on LinkedIn by Battalion Chief Dena Ali:

Less than 5% disclosed their thoughts of suicide to a clinician, less than 21% disclosed to anybody. This is why the problem surrounding suicide is “everyone’s business,” and why asking is so important…. But more importantly, this is why safe firearm storage is critical.

Dena’s comment was based on posted this article, Who Do Service Members and Veterans Tell? Patterns of Disclosing Suicidal Thoughts Prior to Firearm Suicide Death.

That article was posted by Keita Franklin, Ph.D., with the following comments:

I want to make sure that everyone working in the field of military and veteran suicide prevention saw this new research out of Rutgers University.

The study, published this month in Crisis: The Journal of Crisis Intervention and Suicide Prevention, examined 28,600 veterans and service members who died by firearm suicide between 2013 and 2021.

The major finding: only 21 percent communicated suicidal thoughts or plans to anyone in the month before their death. Nearly four out of five told no one.
And among those who did share their thoughts, 42 percent confided in a spouse or partner and 31 percent told another family member.

Fewer than 5 percent told a health care provider.

This is exactly why public health approaches to suicide prevention are so important. We cannot rely on waiting until someone shows up in our offices between Monday and Friday, 8 to 5, and tells us they are at risk. By then it is often too late. And we cannot rely on hospital based or clinical interventions alone.

Two important takeaways.
First, if people rarely volunteer their pain or their struggles, then direct, caring outreach with compassionate approaches and evidence based screening questions used outside of hospital systems becomes even more important. This reinforces the case for putting tools like the Columbia Protocol in the hands of spouses, parents, battle buddies, coaches, clergy, and coworkers. The people most likely to hear a disclosure are the people closest to home. They deserve to be equipped.

Second, we have to build safety for the service member or veteran who never says a word. That means secure firearm storage, lethal means safety education, and community environments that protect people through their darkest moments even when no one knows they are struggling.

Asking saves lives and means safety saves lives. Two evidence based strategies that should be part of a comprehensive public health model, tailored to the specific population you serve, that surrounds people with connection, employment that brings them mission/purpose, reduces risk in the environment, and reaches them long before a crisis begins.

Digging into research at this granular level and learning these nuances is so important. Good work to the Rutgers team for pushing it out. Now it is up to us to move it into implementation and practice. 

I pulled the information for the following graphics from Everytown for Gun Safety in America: