People are often surprised when someone attempts or dies by suicide. Our family was shocked the first time our son Jim overdosed, trying to obey voices in his head. Jim has schizo-affective disorder. According to the National Center for Health Statistics, 5 percent of people with schizophrenia commit suicide, five times the rate of the general population.
Even though we were surprised, Jim fit the profile of those highest at risk, according to Dr. E. Fuller Torrey. Jim knew he was sick, unlike many people with schizophrenia, but he wasn’t responding well to the few psych meds he agreed to take. He was socially isolated and hopeless about his future. To complete the suicide-risk profile, our son had a gross discrepancy between
his earlier achievements in life and his current level of function. If family and friends have done what they could to help, Dr. Torrey says, they should not blame themselves.
But had we done what we could? This question haunts families when there is a suicide or attempt. Had we tried hard enough to get him back in the hospital? It is harder to meet hospitals’ strict admission standards if the person isn’t voluntary. Jim’s delusion advised him not to trust anyone, least of all his parents who were surely imposters.
During this month of increased suicide awareness, there is much news urging people who are feeling suicidal to seek help. Tell someone. Call a suicide hot line. Family and friends need to be educated about signs of mental illness. According to the National Alliance on Mental Illness
(NAMI) more than 90% of people who die by suicide show symptoms of a mental health condition. Be willing to talk to people who you think need help. Don’t assume that if you bring up your concern you will drive them to suicide. This advice works and should be continued.
We should also be aware that it doesn’t work for everyone. In the depths of our son’s illness, he becomes paranoid about those trying to , and he would never call a hotline. The sicker he is the less he accepts help. Rarely has he sought help himself.
This year the state legislature passed a law allowing earlier help for people who have a track record of serious mental illness but who lack insight to accept care. I hope this can cut into our state’s usually sound concept of person-centered care, but one that too often blocks families and mental health workers from being able to help when the person is extremely ill. It is harder for people with mental illness to get help in a hospital than it is to get into jail.
Jim’s most recent suicide attempt came after he was jailed for a property crime committed while he was psychotic and high. Instead of getting immediate help as he would have if he had been accepted for one of the rare slots in mental health court, he was sent to criminal court where he waited months to even be assigned a probation officer. During that long wait, he again tried to end what he termed his miserable life.
Another life-saving measure would be to better fund mental health courts. We could also ensure that people with mental illness have housing and employment so they don’t have to live in despair. Let’s start using every tool we have to stop suicides, including those that work best for people with serious mental illness.