Public Health Advisory: Increased Suicide Risk
November 18, 2020
Background
Since August of 2020, there have been four student suicides in Snohomish County reported to public health. These tragedies appear to be unrelated to one another and are an increase from recent months and from the same time period last year. Local data and disaster research suggest that suicide rates throughout our population may rise as the COVID-19 pandemic continues.
The purpose of this health advisory is to highlight best practices and support the community in promoting well-being and safety. The COVID pandemic and civil unrest in our country has increased uncertainty for all of us, including our youth, and we cannot underestimate the impact. Physical and social distancing, increased isolation as cold weather approaches, school concerns, changes in relationships, and worries for family and friend’s health and the future of our country all contribute toward increased anxiety and despair. We must work to mitigate this to prevent further tragedy. This health advisory addresses the increased behavioral health challenges during this disillusionment phase of disaster response and provides resources.
This is a difficult time for everyone. The on-going pandemic and the corresponding exhaustion and emotional fatigue that we are feeling continues, combined with seasonal changes and more difficulty connecting with the people and supports that typically help us cope. Young people may be even more at risk due to less access to their typical social networks. Please review or re-review the following guidance:
Actions Requested
For the community:
- Review the Washington State Department of Health’s behavioral health impact timeline and warning signs of potential suicide risk.
- Talk with each other about emotional health and coping with stress. Ask explicitly about suicide risk, particularly with adolescents, elders, and household members experiencing difficulties.
- Secure all firearms and medications in the home as a precautionary measure. If someone in the household is at risk of suicide, removing firearms or medications from the home temporarily may be the most effective course of action.
- Reach out to make positive connections with friends, family, coworkers, and others. Connectedness is a key protective factor against suicide and making connections is important to maintaining well-being.
For clinicians:
- Review the behavioral health impact timeline and warning signs of potential suicide risk.
- Ask patients and clients about risk factors, including recent loss or trauma, unsecured firearms or medications in the home, social isolation, and thoughts of suicide, death, or that life may be too much to bear.
- Assess suicide risk in greater depth with patients receiving related behavioral health care, leaving inpatient treatment, or with a history of suicidal behaviors or attempts.
Additional Recommendations for Prevention
- Restrict access to lethal means. Lock up all prescription and over-the-counter medications. Lock up firearms and store the ammunition separately. Youth almost always know where a firearm is located.
- Know the warning signs of when someone may need help. These include changes in eating and sleeping, increased self-isolation, impulsivity, agitation, sensitivity, boredom and laziness, and reduced interest in typical activities.
- Know what questions to ask. A simple screening tool, such as the C-SSRS (Columbia Suicide Severity Rating Scale), can help determine a youth’s risk, and it should be used by health and mental health care providers, school systems, and police. As a lay person or family member, it is always ok to ask if someone is considering suicide.
- Prevent adverse long-term impact of this moment. Incorporate recommendations from the Adverse Childhood Experiences Study (ACES) into prevention and practice.
Resources:
- National Suicide Prevention Lifeline: 800-273-8255
- 24 Hour Care Crisis Line (VOA) 800-584-3578
- Care Crisis Chat 24/7 www.imhurting.org
- Catholic Community Services (mental health) 425-257-2111
- Domestic Violence Services of Snohomish County 425-252-2873
- Crisis Text Line: Text HOME to 741741
- Crisis Connections: 866-427-4747
- The Trevor Project: 1-866-488-7386 www.thetrevorproject.org
- WA Listens (crisis line for stress related to COVID-19): 1-833-681-0211
We cannot overstate the impact of stress, grief, loneliness, trauma, fear, anxiety and hopelessness that most of us have experienced at some time during this pandemic, nor can we say enough about the disproportionate burden that some segments of our society bear throughout this crisis and beyond. Please remember that our youth feel this, too. We must acknowledge the profound impact this experience has on each of us, be patient with ourselves and others, work to embrace each other, and cultivate our desires and create space for creativity, generativity, and hope.
Contributed by Wendy Burchill, Healthy Communities Specialist, Child Death Review Coordinator and Injury Prevention, Snohomish Health District