By Dr. Nicholas Abid
Recently, a dear friend of mine received the phone call every parent dreads. His son “Joe,” a young man in his 40s, had committed suicide, leaving behind three young children and a fiancée.*
Joe had been struggling with depression for years. He recently suffered a number of stressors: his young daughter had been diagnosed with leukemia; his wife had been diagnosed with osteosarcoma and passed away within the last year; and, his mother had recently died of Alzheimer’s.
With the help of family and friends, Joe seemed to manage life as a single father. His children were doing well and living a fairly normal life given the trauma around them. Joe had returned to work, and even decided to run for office, but midway through the campaign, he withdrew. His depression had returned.
While Joe sought treatment from the best healthcare providers in his area, he was never able to get a handle on his illness, and on that fateful night, Joe took his life.
A Public Health Problem
Tragically, Joe’s suicide is not as rare as one might think.
Suicide is a major public health problem and a leading cause of death in the United States. According to the Centers for Disease Control and Prevention (CDC), suicide is the tenth leading cause of death in the United States, and in 2017, men died by suicide 3.5 times more often than women.
Mental illness, Gender and Suicide
According to the American Academy of Suicidology, about two-thirds of people who commit suicide are depressed at the time of their death, and the risk of suicide is about 20 times greater among people with major depression.
Gender is a significant factor in the way mental illness is experienced.
Men with depression, for example, typically express their illness through “masculine” behaviors. While some psychologists reason women with depression tend to “act in” through emotions like worthlessness, helplessness and guilt, men are more likely to “act out,” through expressions of anger, poor impulse control and alcohol abuse.
Risk Factors for Suicide
Each suicidal person is different and the reasons for attempting suicide are many. In general, here are some common risk factors:
- Depression, other mental disorders or substance abuse disorder
- Chronic pain
- Family history of a mental disorder, substance abuse or suicide
- Family violence, including physical or sexual abuse
What Can We Do?
As a health plan, we can, and should, raise awareness of suicide as a major public health issue. We can encourage our provider partners to screen for suicidal thoughts and mental health conditions, and when one is identified, treat it aggressively. If an actively suicidal individual is identified, we should treat it as a medical emergency and help them access mental health services immediately.
There are also a number of agencies available to assist in helping those with a mental illness.
For general information on mental health and to locate treatment services, call the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Referral Helpline at 1-800-662-HELP (4357), or for access to trained counselors, 24 hours a day, 7 days a week, call the National Suicide Prevention Lifeline, 1-800-273-TALK (8255).
Nicholas Abid, D.O., FACN, is Behavioral Health Medical Director for WellCare of Florida.
*All names changed for privacy