September is Suicide Awareness Month as designated by the National Alliance on Mental Illness (NAMI), and it is the time of year where the number of people who died by suicide in the last year is emphasized (48,344 Americans). It is also a time to teach people how to recognize the signs and symptoms as well as what to do in a crisis.
In addition to this worthy list of awareness building information, and risk factors, it is helpful to look at the protective factors that help to prevent suicidal thoughts initially. Protective factors are defined by the American Psychological Association as “a clearly defined behavior or constitutional (e.g., genetic), psychological, environmental, or other characteristic that is associated with a decreased probability that a particular disease or disorder will develop in an individual.” Experts agree that individuals with higher levels of these characteristics are less likely to engage in suicidal thoughts and actions.
Protective Factors
Greater emphasis has been placed on protective factors in recent research. Most notably, resilience has been widely recognized as helping to reduce suicide in the general population, as well as reducing suicidal behavior among individuals with psychiatric disorders. Resilience is described as the capacity of adaptively overcoming stress and adversity while maintaining normal psychological and physical functioning” (Sher, 2019).
One aspect of resilience, according to Dr. Saundra Jain, that is particularly helpful in reducing suicidal thoughts and actions is social connectedness. However, building and maintaining social connections is especially hard for people dealing with feelings of hopelessness and sadness. Starting with more internal skill building may be a more tolerable first step in developing resilience.
Building Resilience
Dr. Wendy Suzuki lays out a 6-step process for building resilience and mental strength.
- Visualize positive Outcomes
Take time at the beginning and end of each day and visualize any uncertain situations you are going through. Imagine the best possible outcome-really see things working out well in your mind. - Turn anxiety into progress
Take a step back and reassess the situation in a calm manner. Try to reframe the circumstances in a more positive light. - Try something new
Push your brain and body to try something you never would have considered before. Take an online class or explore a new city. - Reach out
Don’t be afraid to ask for help. Talking or visiting with friends and family can help you feel supported and reinforces the sense that you are not alone. - Practice positive self-tweeting
Send yourself positive and upbeat messages daily. You don’t have to write yourself a note, although you could. Boost yourself up with positive and optimistic statements. - Immerse yourself in nature
Time in nature has been shown to improve mental health and wellbeing. Even if it’s just a walk in the yard, get outside often. Take in the sights, sounds, and smells of the outdoors.Prevention
Clearly, preventing suicide from becoming an option for those struggling is preferable, but if you or a loved one is in crisis – there is help. Mental health experts suggest that we spend time really listening to those around us so that they feel heard. It is OK to ask questions too. Asking if someone is feeling suicidal will not somehow give them that idea. Validating what your loved one is going through in a non-judgmental manner also helps them feel heard. Stay away from clichés like, “Everything happens for a reason”, or other platitudes that might seem like you are minimizing their feelings. Most of all, show up and be positive and supportive. By letting someone know they are not alone, you can make a difference in the lives of those you care about.
Doing our Part
Rose Hill Center provides a safe and secure place for our residents to build these resiliency skills. Participation in a variety of therapeutic and social interactions helps our residents develop social connectedness and build self-esteem which are both protective factors. Given the increased risk for suicide among individuals with serious mental illness, Rose Hill Center completes the Columbia Suicide Severity Rating Scale (C-SSRS), an assessment designed to identify whether someone is at risk for suicide and assess the severity of that risk, on a regular basis.
Another building block of Rose Hill’s therapy is Cognitive Behavioral Therapy (CBT). CBT may improve resilient personality features and is a part of every resident’s treatment plan. Basically, CBT is present oriented psychotherapy that can be used to enhance wellbeing, optimism and problem-solving. Using CBT to help individuals change maladaptive thinking, much like the steps described above, Rose Hill residents may modify their perceptions to include feelings of capability and control and hope for a brighter future.