I wasn't a novice clinician when I started working at the Crisis Line some years ago. And yet, when the individual calling would inform me of their plan, the how and intent to kill themselves and end their life, it jolted, and quite honestly, terrified me. I didn't know what to do or say; I knew I could not make their lives better with a single phone call, and that I had to work fast. Very fast. The stories shared with me were as varied as snowflakes, but for two similarities: all of the callers experiencing suicidal ideation shared their sense of profound disconnection and loneliness, and loss of hope that things would ever change.
Suicide is the 10th leading cause of death for our people, according to the Center for Disease Control (CDC), and is even higher for certain populations (e.g., suicide is the 2nd leading cause of death for young people between the ages of 10-34). No one single factor causes suicide, with the research literature points to contributing factors such as mental health (and particularly depression), difficult life events (including loss of loved ones and other losses of connection), substance abuse, poor adaptability, and identifying as being part of minority populations, to mention a few. While loneliness is its own risk factor, it also loads up (in other words, contributes to) other risk factors such as mental illness/depression in the general population, and even more so in already vulnerable risk-groups such as veterans and LGBTIQ youth.
Enter COVID - halting the best laid plans, robbing individuals of those very things they love - a person, a milestone, the ability to function the way they always had. Couple that with uncertainty about the future, and one can understand the loss of hope that many talk of in these times. The guidelines on social distancing/isolation and, in some cases, quarantine, have pushed many to feel like an island drifting without context. COVID and its stressors, presses on all the buttons we know increasing the risk of suicide, and not the least, isolation and despair.
While we can't control COVID, we can take an active and participatory role in how we deal with it-
- Maintain a present focus - focus on what you can do now that is both healthy and helps you move in the direction of your future goals.
- Take care of your physical body - exercise, get outside, eat well, and sleep adequately.
- Limit external burdens - draw stop signs around excessive media consumption, toxic and negative people, as well as unprescribed substances.
- Actively seek the positive - healthy and positive people, activities and things that make you happy and are healthy for you.
- Stay safe - adhere to the guidelines of regular and frequent hand-washing, maintaining social distancing, wearing a mask indoors, limiting unnecessary travel etc.
- Increase connection using technology - it's not the same as in-person, but it counts.
- Get help and support - online support groups, Lifeline, a mental health provider, or if you have concerns about a loved one, or even yourself, go to your nearest emergency department.
Back in my days at the Crisis Line, I could feel the dramatic shift when a suicidal individual was able to identify at least one thing in their life that was worth living and having hope for. They could see the future and felt enough of a connection that they expressed interest in a follow-up call. While this wasn't the solution to all their problems, it meant that they would stick around long enough so that they had a fighting chance.