Recent suicides prompt efforts for prevention

Eleven suicides reportedly have occurred in Washington County this year, including three in Lubec since April and one in Edmunds. In half a year, the county's rate has been three times the national average rate for an entire year. There have also been a number of attempted suicides, including a recent attempt in Lubec and in the Passamaquoddy communities at Pleasant Point and Indian Township.
"It's just tragic," Washington County Sheriff Donnie Smith comments. "It's horrible on communities. It's all they talk about."
Denise Altvater of Pleasant Point, the director of the Wabanaki Program of the American Friends Service Committee, notes that the family of someone who commits suicide suffers a great deal of pain. "That's a huge trauma to family and siblings."
The impact on families and communities is significant, agrees Ashley Pesek, a therapist consultant to the emergency services team with the Atlantic Mental Health Center (AMHC) office in Machias. She observes, "It is grief, but it's a grief that only people who have experienced the same type of loss can truly understand." Concerning the effect on a community, Pesek notes, "People are left with questions of why without an understanding of how someone came to make that choice."
Smith says a community may begin to feel responsible and come together to prevent any more. That is the case in Lubec and Pleasant Point. In response to the three recent suicides in Lubec, a suicide intervention team from AMHC held a meeting on July 19 at the Christian Temple Church's Pike Hall. The meeting included a critical incident stress debriefing to limit the development of post-traumatic stress for those affected by a suicide, along with a group conversation and a meeting with parents to explain risk factors and resources available. At Pleasant Point, a Native group called the RezHeadz, who use lyrical healing and hip-hop music, are coming on July 22 and 23 to present workshops on suicide prevention, bullying and other topics.
Smith, who had worked as a school resource officer and would give a PowerPoint presentation about parents and teachers about warning signs that they should watch for, recalls a string of teen suicides that took place in the Camden area in 2001. "We don't know what triggers a rash of suicides," he says, speculating that some people may be very depressed and anxious and overwhelmed with life in general. For young people, the problems may range from the breakup of a relationship, underage drinking to losing a best friend. Living in a depressed area "may play into it," says Smith, but he adds that was not the situation in Camden.
Concerning the reasons for a person's decision to commit suicide, Pesek says, "Suicide is a very personal decision. Most of the time there is not a known reason."
Risk factors can include being a white male over the age of 60, recent losses of a family member or friend, or of a relationship or a job. Other indicators of a person being at risk can include substance abuse, past attempts and changes in behavior. Evaluating mood changes depends upon what the person's normal behavior has been. Pesek also notes that those affected by a suicide are at a higher risk of attempting suicide themselves.
"Postvention is prevention, if there is a completed suicide," Pesek says, pointing out that the providing of education about risk factor awareness can help prevent suicides in the future.
Altvater agrees that there are many reasons for why someone may consider suicide. "Although untreated trauma, depression, anxiety, PTSD [post-traumatic stress disorder] and substance abuse all contribute to the possibility of suicide, they do not cause suicide. The exact reason behind a suicide often remains a mystery." She notes that childhood trauma such as abuse can end up resulting in generational cycles of problems. "If attention is not paid to it immediately, it gets buried deeper and deeper, and you may turn to drugs and alcohol. But if you reach it early, you can help, so the cycles don't continue."
She observes, "Things happen to kids who are not properly parented." Youth also may suffer abuse, which they hold inside, and if they drink or take drugs and get depressed, "that's a perfect mixture for suicide." The attempted suicides may be a cry for help, and people who consider suicide may want to hurt someone else and not fully realize that it's permanent. Altvater, who coordinates a youth group for Natives and non-Natives, says some youths have told her that they need someone they can talk to who they can trust, who knows what they're going through and will respect confidentiality.
Having been sexually abused and tortured and raped at a foster home when she was a young girl, Altvater has been diagnosed with PTSD. She recalls, "When I started drinking and drugging, I started thinking about suicide." Sometimes an event would trigger a reaction in her, which "when it's bad I end up in the hospital or I tough it out." She adds, "The last few years are the first time I felt joy or happiness or was able to feel love."
Altvater says, "In the past I have been in a mental state where suicide is the only thing that makes sense and one more moment of emotional pain is too unbearable. I cannot connect with what is going on around me and any little issue becomes too overwhelming. When I am in that place, life just doesn't make sense."
Someone who has decided to commit suicide may feel a relief, that a weight's been lifted because it's all going to end.
Altvater notes that there are not a great many resources in Washington County for helping with depression and for those who are considering suicide. "You have to go to Bangor for psychiatric care. That isolation is another big issue -- you feel stuck and that there's no way out."
She observes, "Daily life on the reservation can be hard. Here we struggle with many of the same problems as the rest of Washington County such as lack of resources to treat trauma, depression and substance abuse, but some of the social problems that increase the rate of suicide are significantly higher on the reservation, such as our incarceration rate, unemployment rate and widespread poverty, which means many more families do not have health insurance or transportation."
For Native youths without a sense of their own culture and history and who have "untreated generational and historical trauma, feelings of hopelessness and lack of support, suicide becomes a viable way out and an acceptable option."
Research has shown that mental and substance abuse disorders are significant risk factors for suicide, so many prevention programs focus on these disorders. Psychotherapy has also been shown to reduce the rate of repeated suicide attempts.
In this area, resources that are available include AMHC's emergency services specialists, who can provide mobile crisis response at a home or hospital. Pesek points out that they are available 24/7 by calling the help line at 1-888-568-1112.
Crisis stabilization services are offered to provide short-term intervention, and medical centers and hospitals in the county provide substance abuse and outpatient services.