From the frontlines: Thoughts from a therapist on Suicide Prevention Awareness Month during a pandemic
by Dr. Rebecca Levy, LMFTA
September is National Suicide Prevention Awareness Month. In the past year and a half, we have experienced a great deal of tragedy, especially when considering the impact of this pandemic on mental health. Prior to the pandemic, researchers reported that approximately 50% of people who attempted to kill themselves went to their primary care doctor a week before their suicide attempt. With the impact of this pandemic, there was about a 50% increase in the use of a suicide hotline. As demonstrated by recent studies, COVID-19 has had a profound impact on mental health due to our increased isolation, stress, and fear of illness.
As a mental health provider, I am left with many thoughts; but here is my take on some of the major considerations of dealing with mental health issues during an international health crisis.
Telehealth
Helping people who struggle with suicidal ideation has been different this year for many reasons. As a mental health provider, I have had to provide therapy to patients over the phone or over video more than in person. Teletherapy can feel different, disconnected, or even scary, especially with a high-safety-concern patient. What if they are in a different city or even a different state? Before the pandemic, this geographic difference was almost unheard of.
Managing my own stress in conjunction with the increase of patients presenting with suicidal ideation over telehealth has been challenging. This increase in mental health concerns, combined with the physical distance between patients and providers, has been a recipe for mental illness to rear its head. Yet, there are some positives to telehealth for patients struggling with suicidality. Having a virtual option for patients we might not have typically reached has allowed for more access to those populations in need. There is also something to be said about having an emotionally charged conversation with your therapist in the comfort of your own home.
The Secondary Pandemic
As a society, mental health is something we have struggled to address. There is stigma attached to each diagnosis, as well as barriers to getting care. Historically, the importance of mental health has not been viewed as on par with physical health; however, suicidality is the pinnacle of illness because it can result in death. Dare I say that this pandemic has a brought a necessary focus to addressing poor mental health as the crisis it is?
This pandemic may have caused great distress and loss, but maybe it brought us where we need to be in recognizing the importance of taking care of our mental health. The biggest question is, what we do in times like this to help ourselves and our loved ones?
What To Do
What has mattered to people in helping them through a tough time, such as struggling with suicidality?
Normalize. A lot of us do not talk about having thoughts about not wanting to be here, but they are more common than we think. Having that de-stigmatizing perspective, and reminding people that those thoughts and feelings are normal when we are feeling very low, is helpful when talking to people who are having thoughts of suicide.
Ask. As mental health providers, and as friends and family of loved ones, we are doing a disservice by not asking the hard question: Have you had thoughts of hurting yourself in some way? By asking this question, we are normalizing the fact that we can talk about suicide and allowing space for those who are in that place to talk about it.
Listen. During this tough time, it should be everyone’s responsibility to check in on each other and their loved ones. Go ahead and ask that tough question or the easy question, ”How are you?” But take the time to be patient and wait for a real answer, and then truly listen.
Acknowledge – This pandemic is life-changing. The COVID-19 pandemic is overwhelming. Our worlds have been turned upside down. I think one of the most invalidating things I have seen done to people who are struggling with suicidality is telling them that they “need to be grateful” in some form or another. It is more helpful to validate them in their pain (i.e., “It sounds like you are having some really scary thoughts”) or risk emotionally isolating them further.
Get help. There is help if you, or a loved one, is struggling with mental health. Therapy, it can do wonders! A lot of therapy offices have walk-in hours to help patients in crisis. There are also a lot of medication options (e.g., antidepressants) you can discuss with your primary care provider that can bring relief from symptoms of feeling down or hopeless. If you are worried about a loved one, there are options available to help them. Your area may have a Mobile Crisis group that will go to a person’s home and assess for safety, or work collaboratively with the police department to complete a welfare check (which can be requested anonymously if you are nervous to do so!). In addition, you can research your local behavioral health crisis centers to see what services are available. And finally, the Emergency Department of your local hospital is available in cases of severe crises.
It has been a difficult, but enlightening time, supporting patients, providers, and families with mental health and substance use needs throughout the pandemic. When it comes to awareness about suicide prevention, please remember that it is okay to directly ask the hard questions, and there is help available.
If you or someone you know needs help, call: 1-800-273-8255 or Text HOME to 741741
Please call 911 if you sense immediate danger.
Dr. Rebecca Levy is a Medical Family Therapist and the Director of Behavioral Medicine at Cone Family Medicine. She holds a bachelor’s degree in Psychology, a master’s degree in Couple and Family Therapy, a doctorate in Medical Family Therapy, and an associate license in Couple and Family Therapy (LMFTA). Her areas of expertise are suicide assessment, integrated behavioral health care, cultural humility, and family medicine resident wellness. She sees her role in clinical practice, research, and education to advocate for underserved populations and health equality.