Community-Based Prevention

by Emily Vickerman, Family Mental Health Navigator

September is Suicide Prevention Month, and we wanted to share about community-based prevention. This is the idea that the actions, attitudes, and structures within our community can promote mental health and wellbeing and support the navigation of resources for those in crisis. Suicide affects entire communities. Community prevention requires collaboration and a collective effort by local organizations, schools, providers, and individuals to create a supportive environment. This column discusses what you as an individual can do to support our community in suicide prevention.

Know the Risk Factors: 

Risk factors don’t cause or predict a suicide attempt but can make it more likely that someone will consider, attempt, or die by suicide. These include:

• Having a mental health disorder
• Previous suicide attempts
• Family history of suicide
• Substance use challenges
• History of trauma or abuse
• Recent loss or tragedy
• Lack of social support/sense of isolation
• Local clusters of suicide
• Easy access to lethal means
• A chronic/serious medical condition

Specific populations are also at greater risk. These groups are youth ages 10-24, LGBTQ+ youth and adults, survivors of suicide loss, veterans, people living in rural areas, and Indigenous adults.

Recognize the Warning Signs: 

Suicide risk is greater if a behavior is new or has increased, and if it seems related to a painful event or loss.

      Youth warning signs:

• Talking about or making plans for suicide
• Expressing hopelessness about the future
• Overwhelming emotional pain
• Withdrawal from social connections
• Sleep changes
• Uncharacteristic anger or hostility
• Recent increased irritability

      Adult warning signs:

• Talking about or making plans for suicide
• Reckless behavior
• Talking about being a burden to others
• Talking about feeling trapped or in unbearable pain
• Increased substance use
• Expressing having no reason to live
• Showing rage or talking about seeking revenge
• Extreme mood swings

What to do: 

If you suspect someone is considering suicide, it’s important to ask them directly if they’re thinking about killing themselves. This does not increase their risk. Instead, it can provide an opportunity for them to share how they’re feeling and get help. Offer support and encourage them to seek professional support. To feel better prepared to talk to someone considering suicide, take a QPR (Question, Persuade, Refer) Training. The Health Department is offering several of these in the upcoming months.

Who to call and when:

If you or someone you know is experiencing a mental health crisis, it can be tricky to know who to call for professional support. Here’s a quick breakdown of who is best suited to respond to which circumstances and what to expect when you call them:

988: 988 is available by phone, text, or web chat 24/7/365. When you contact 988, a trained crisis counselor listens, provides support, and shares resources. The average wait time is 40 seconds. 988 counselors are trained to help reduce the intensity of the situation for the person seeking help and connect them to additional local resources for ongoing support. Less than 2% of 988 calls require the counselor to activate 911 and this only occurs when there is imminent risk to someone’s life that cannot be reduced during the call.

988 is the best choice in a situation where a person experiencing suicidal ideation is capable of listening and responding to someone over the phone and is not actively putting themselves or someone else in danger. 

Mobile Crisis Units: RHA Behavioral Health Services provides Mobile Crisis Management (1-888-573-1006) in Western NC 24/7/365. Mobile Crisis services provide on-site response, stabilization, and intervention for people experiencing a mental health, developmental disability, or substance use crisis. When you call Mobile Crisis, a trained counselor provides phone support while you wait for the mobile team to arrive on-site. Average wait time in WNC is 2 hours for adults.

Mobile Crisis is the best choice in a situation where a person is NOT capable of listening and responding to someone over the phone and is NOT actively putting themselves or someone else in danger.

911: 911 dispatches emergency police, medical, and fire services 24/7/365. When you call 911, a dispatcher will ask you for your location and ask questions to determine the type of services required for your emergency. The 911 dispatcher will stay on the line until responders arrive at your location and may continue to gather information to help prepare the team arriving.

911 is the best choice in a situation where a person is actively making a suicide attempt or is putting someone else in imminent danger. When you call 911 in this scenario, ask for a CIT (crisis intervention team) officer. These officers receive specialized training for responding to calls where someone is experiencing a behavioral health crisis.

The presence of a strong, supportive community can discourage isolation, encourage the seeking of help, and provide accessible resources for those in need. We can all prevent suicide.

Emily Vickerman is the Family Mental Health Navigator at the Children and Family Resource Center.  The Family Mental Health Navigator connects families with children who have mental or behavioral health needs to services and the larger service delivery system, to better manage any mental illness, improve the children’s overall health, and avoid preventable hospital encounters. Caregivers can book a free consultation by calling 828-698-0674 ext. 158 or by scheduling online at childrenandfamily.org/mental-health. Community providers may also refer families to this program by calling or childrenandfamily.org/program-referral.