Lifting the Veil of Silence on Suicide

September is Suicide Prevention and Awareness Month. The time to talk about this once-taboo topic is now. If there was a silver lining to 2020, it may be that the suicide rate in the United States fell by 5.6%, according to data from the Centers for Disease Control and Prevention. As it turns out, the pandemic may be one of the most significant reasons for that decline.

“During global crises, there is more focus on the external world than on internal turmoil,” explains Peter Bolo, MD, a psychiatrist, interim medical director for Atlantic Behavioral Health, and the resiliency advocate for Atlantic Health System. “There was so much pain and suffering during the pandemic, some people felt more understood and less isolated in their internal feelings about suicide.”

Additionally, though there was a lot of focus around anxiety and depression related to the pandemic, there also was a lot of support. “This decreased the stigma around mental health, so people were more likely to seek help,” adds Dr. Bolo. These factors, in tandem with better accessibility to services (in part due to the expanded use of telehealth), likely combined to reduce the suicide rate.

Awareness Is Crucial

Although last year’s downturn in suicide is encouraging, suicide remains a concern. This is particularly true for those with known risk factors, including mental illness, family history (this may be linked to genetic factors that contribute to mental illness), substance abuse, stressful life events, and access to firearms. Dr. Bolo makes the distinction, however, that “risk factors for suicide do not necessarily translate to suicidal behavior.”

Spot the Signs … And Speak Up

Warning signs that a person may be having suicidal thoughts include changes in behavior, isolation or withdrawal, depression, or the use of drugs or alcohol. “If you are having suicidal thoughts, it’s crucial to seek help,” Dr. Bolo stresses. “If you are seeing warning signs in someone, have a conversation to let that person know you’re concerned. Ask, ‘Have you thought about harming yourself? Have you thought about suicide?’ This opens the door for a person to be open about their thoughts. Otherwise, those thoughts fester and may overflow into behavior.”

A Better Model: Collaborative Care

One vehicle for reaching those in need of help is Collaborative Care, whereby a behavioral health clinician is embedded in a primary care office. If a patient needs medication or therapy, this can be addressed on-site. Managing mental health in a primary care setting without having to refer people out is both efficient and effective, and Atlantic Health System is at the forefront of this model of care. “Atlantic Health System was the first in New Jersey to begin providing Collaborative Care and has the largest network, including six primary care practices and a pediatrics component, the latter being one of the few in the country,” says Thomas Zaubler, MD, chair of psychiatry for Morristown Medical Center.

Those practices include:

• Morristown Medical Center Family Medicine Adult and Pediatric
• Internal Medicine Faculty Associates, Suites 210 and 350, Morristown
• Madison Pediatrics
• AMG Primary Care of Union
• Chatham Family Medicine

“As a society, we’re getting better at addressing mental health,” says Dr. Bolo. “For too long, suicide was something people didn’t speak about – it was considered too unfathomable and scary. But people are talking about it now. It’s a positive reflection on the world.”