Rachel Hudson is a clinical provider and licensed master social worker with Burrell Behavioral Health. As KSMU looks at the drop in life expectancy in Missouri, suicide is one factor to consider. According to the American Foundation for Suicide Prevention, suicide is the third leading cause of death for ages 10-24 and the third leading cause of death for ages 25-34. Suicide is the fourth leading cause of death for ages 35 to 44 and the fifth leading cause of death for ages 45-54. It is the 11th leading cause of death in Missouri.
Tell me what you do at Burrell and who you work with.
"I am a clinical provider so, I do provide outpatient therapy to both adults and youth. I also co-facilitate our Survivors of Suicide Loss support group with another practitioner, and I am the chair of Burrell's Zero Suicide Committee."
What does that committee do?
"That committee makes sure that we are using the most up to date evidence-based practices to make sure we are doing everything we can on every level to reduce the number of suicides within our communities."
Let's start out by talking about what suicide is. What is suicide?
"Suicide is when someone takes their life by their own means."
And what are some of the warning signs? What should people watch for?
"There are a lot of warning signs. And what I have learned through this, through a deep dive into this subject, is it's very complex. You're going to see different things in different populations and different personality types. Any kind of — when someone has a major loss in their life, whether that's a breakup, whether that's a death in the family or a loved one or friend, especially if by suicide — so, when someone is impacted themselves by the loss of a suicide, that can put them at greater risk. Changes, significant changes in mood — if you know someone that's usually very outgoing, bubbly, and then all of a sudden they're very withdrawn and isolated, that would be something I would pay attention to. And then also the opposite. If you know someone that's usually very reserved and quiet and all of a sudden they're kind of coming out of their shell, I would just pay attention to that."
Are there certain segments of the population that are at higher risk for suicide?
"There are. And so, in Missouri specifically, it kind of goes from white male, Black male and then white female as the the statistically significant populations. They did a survey within Missouri that 75% of trans college students endure significant thoughts of suicide with 50% of other members of the LGBTQ community. So, college students — very high risk age."
And with all the legislation that's targeting transgender folks, that has to even create a bigger problem, I would imagine, for transgender people.
"Feeling like you don't matter or you don't fit in, feeling rejected, feeling unaccepted from family, friends, community members has a huge impact on individuals."
Why do people attempt suicide?
"From my experience, I'll just point this out. In 2020, there were 1.2 million attempts. 12 million people actually thought about it. 1.2 attempted, and then 47,000 approximately actually died by suicide. And so, a lot of times it has to do with just wanting everything to stop, whether that's the stress that's going on, whether that's the emotional pain, Chronic physical pain can also be a factor. And I think if there's no perceived hope, if there's no perceived that things will get better, that's a very significant place that creates those thoughts that suicide would be a solution to the problem."
Is suicide related to impulsiveness?
"I have done some research and in talking to people that there are some personalities and different age groups that impulsivity can be a factor. Someone that is able to endure a significant amount of physical pain and that maybe they engage in more extreme sports type of activities, they can also be at a heightened risk for follow through with an actual attempt."
What are some of the barriers to seeking help?
"There was a study done with college students, specifically in Missouri, and the number one barrier identified was not feeling that they needed the assistance. And so, I think that a lot of times we feel like we can handle something and we may have the answers. And so, just that resistance to being open to other ideas could be part of that. Feeling shame was second in line. And so, the shame that the judgment that may come from that or just feeling like what you're feeling and thinking isn't okay and and feeling shameful because of that."
And how can we overcome those barriers?
"I think the more people talk about them. For me personally, when I heard someone else talk about it, it made me feel okay to talk about it, especially if I saw that person has come through and is on that other side. They've gotten help and they are able to to live a fulfilling life despite the thoughts and feelings and tragedies that happened in their life. So, keeping that in mind, being willing to share, sometimes you are helping someone else just by your vulnerability and transparency in that."
And it sounds like Burrell has several programs to offer and help available for people who are having suicidal thoughts.
"Absolutely."
How can someone find out about the programs and counseling available through Burrell?
"So, we have the website that is available. So, anyone that has access to internet can Google Burrell Behavioral Health. And there are virtual options. And so you don't have to be physically in the same area that you're receiving the service. So, if transportation is a barrier, as long as you have access to internet, you could attend a virtual appointment. If you call 988, they can give you very specific steps to take. So, when you're in a crisis, sometimes it's really hard to know, like to follow steps and know what to do. But those three numbers, 988, if you call that there's going to be someone on the other end that is going to be able to know where you're at and where to direct you to get the help you need."
Tell me about the Behavioral Crisis Centerhere in Springfield. It's at 800 S. Park. Who can get help there?
"So, anybody that is experiencing a mental health crisis, they may be thinking of suicide and having some suicidal thoughts or it may not be to that level yet. They can walk in and they will be able to receive an evaluation and potentially start treatment that day. And it is a 24/7 facility. So, holidays, it's open. Middle of the night, it's open. So, with the Behavioral Crisis Center, it also helps alleviate some of the stress from our emergency departments because, instead of everyone going to the emergency department, they can be diverted to a more specified mental health treatment that can free up the emergency departments for maybe more emergent situations. I do also want to share about our One Movement. Our network's engaged — something I had a phenomenal opportunity to be involved in and help grow to the level where we're engaging businesses, community members to really get on board with receiving education on suicide prevention and also becoming educators themselves and providing education to their colleagues, to their employees, to their families. And so that's been a really neat experience to see the interest that everyone has in being a part of that."
That's so important to raise the awareness and, you know, get more people knowing what to do if they notice someone who may be having suicidal thoughts. So, how can someone find out more about that?
How important is it to make sure a person who has had suicidal thoughts doesn't have access to anything they could use to harm themselves, such as firearms?
"So, there are resources that actually provide lock boxes, trigger locks pertaining to actual firearms. And so there are ways to put those out of range of people that may be at risk. There are facilities, pawnshops, whatever community you're in, there are usually resources where people will hold firearms temporarily. So it's not that you would have to let go of them permanently, but just temporarily while that that crisis is occurring. And then you have other means such as medications. If someone has an abundance of medications, you have the opportunity to use the safe disposal sites where you can dispense, destroy medications in a safe manner and then just helping people be able to do that. If you have an elderly relative or you have a friend that takes a lot of medications, being able to say, 'okay, these medications are not being used anymore, why don't we do something with them?' so they only have the doses that they need."
What should someone do if they if they suspect somebody is having suicidal thoughts or maybe they've attempted to take their life in the past? What should they do? What kind of help is available?
"So, one thing that I really feel like is important is to put our phones down and not try to multitask when we're talking to someone, especially if we know that person has been in a vulnerable spot where they may be experiencing any kind of thoughts of self-harm or suicide. So, Burrell Behavioral health, obviously we have services, multiple areas across the state and outside of the state. We also do have the Survivors of Suicide Loss group that provides support to those individuals that have lost somebody, which, as I mentioned earlier, puts someone at a greater risk. And we have several locations with Burrell that they can just walk in and immediately get something scheduled or walk in and start talking to someone that day."
What are some evidence-based treatments for helping those who have had thoughts of suicide?
"It is really important to engage in safety planning that is shown to be able to reduce the risk of suicide."
And what do you mean by that?
"So, that is where you would identify someone's warning signs, like what does it look like when they start to not do well? What thoughts do they have when they start to not do well? What does their environment look like when they start to not do well? Then you're looking at, okay, what are things, resources, protective factors that they have? Who are the people in their lives? What skills and talents and interests do they have that can maybe come into play? And then identifying who to call. We like to make sure there are natural supports, people that are in someone's life that can be accessible, because a lot of times we're going to talk to people we know before we're going to reach out to a professional. And so, really important to identify those people in someone's life that they feel comfortable talking with and then making sure they have the crisis line, the 988, all that information in front of them. And there's an app, there's actually a safety plan app that I encourage everyone to actually download."
How can they do that?
"Go to the App Store, andthere's an Apple version and an Android version, and it is called Suicide Safety plan."
What would you say to someone listening who is having suicidal thoughts?
"I would say that you are not alone. It might feel like you're alone, especially if you haven't been able to share with anyone else that you are thinking and feeling this way. And I would encourage identifying one person that you feel like is safe to talk to. If you don't have someone in your life to speak to about this, I would absolutely call 988, text 988 and just start a conversation."
And that's the Suicide in Crisis Lifeline that connects someone with support and help 24/7.
"And also going back to the treatment and the evidence-based services, cognitive behavioral therapy is really important when — so, you have a crisis, you have an immediate suicidal crisis and you do the safety planning. But ongoing treatment is really important to explore. Where do those thoughts come from and different ways of maybe coming up with solutions to manage stress and manage the things that are happening in someone's life."
And there is hope. There's a lot of attempts each year that are not successful. People get help. So, what would you say to someone to let them know that there is hope and there is help?
"I think that knowing that whatever situation we're in, I like to say like, this too shall pass. If I know that the situation I'm currently in, there's another side to it, to me that helps me get through a moment. I personally have had thoughts of suicide. There was a time in my life where I felt like that was what I would rather be is no longer here versus living the life I was living. And what it really took was being willing to share that with someone. Once I opened my mouth and shared, that is when other people were able to help me. It's odd because I would have — I was walking around thinking and feeling this way, but I wouldn't say anything, and therefore I couldn't get the help I needed. And then it was like this perpetual cycle because I'm like, 'well, I can't get help. There's no help.' But once I actually said the words and talked to someone, I was able to make changes in my life and and get through the things I needed to get through."
Thanks for sharing that. I really appreciate that. And again, the Suicide and Crisis Lifeline is 988. Anyone in a suicidal crisis or emotional distress can call 988 any time of the day or night to get confidential support.
Is there anything else you would like people to know?
"I would definitely recommend in a day that we are connected constantly to our cellular devices when we are engaging with someone that is in our physical presence to put that down and really be present and listen to the words that someone is saying and their body language. Because a lot of times if someone is experiencing suicidal thoughts, they're going to come out and clues. It's not going to maybe be a direct I'm thinking about suicide. I want to die. It may be something like, I just want out. I'm just I feel like a burden to everyone. Comments like that need clarification. And that's where if someone is listening, they can maybe cue in on something like that and discuss that further."
