Op-Ed

Kentucky can do more to prevent suicides. It will take resources and a plan.

According to the Centers for Disease Control and Prevention, 47,000 Americans died by suicide in 2017.
According to the Centers for Disease Control and Prevention, 47,000 Americans died by suicide in 2017. Getty Images

Earlier this month, the Winburn Middle School community of students, families, teachers and administrators faced the unimaginable: a suicide death of a 12-year-old girl. It is a heartbreaking circumstance shared by thousands of parents, families and schools across the United States this past year. 

Nationally, 517 children 10-14 years of age died by suicide. 

A letter sent out to families by interim principal Mike Hale sensitively characterized their predicament: “On behalf of the staff of Winburn Middle School, I hope that each of you have an opportunity to enjoy time with family over the three-day weekend. The events of this week are a reminder that such time is precious.”

In a recent Herald Leader article, public health and medical professionals provided insight into what can be done: do something if you notice a change in behavior or your child appears irritable, talk to your children, have family time, eat dinner together, put away electronics.

 What is left unsaid is, despite the proliferation of warning signs, the only thing that seems to predict whether someone will die by suicide is a suicide attempt. 

Parents are understandably flummoxed by these recommendations. What if they are already doing the things recommended by the professionals? Must they wait until a child attempts suicide before they seek treatment? What if they need professional services that target specific concerns and behaviors? Access to resources, mental health services competent to address problematic, suicide-related behavior in children and adolescents, is also scarce.

The worry around these child deaths is, unfortunately, not limited to the deaths themselves. Our research demonstrates that for every individual who dies by suicide there are about 135 individuals who are exposed to the death. 

About 30 percent of those — or 48 individuals —may be significantly impacted by the death to the point of also needing help. These could be family members, but they could just as easily be best friends, classmates, teammates, teachers, school counselors and virtually any relationship. These impacted people have higher levels of depression, anxiety, suicidal ideation and attempt just because they knew and were impacted by another person’s suicide.

When the Fayette County coroner signals that “we should be very worried” in the wake of the five deaths of children 14 years of age or younger that have occurred in the past year, he may not have guessed how accurate he was. This is a tragic scenario that may become even more so without any serious community planning, targeted specific interventions and public conversations.

Suicide is sheathed in myth and stigma. In an effort to address the dearth of training around suicide, well-intentioned policy makers have imposed mandates on providers and also on school districts for suicide-related training without any assurance of quality or any policing of compliance. As long as the box is ticked on the school training — or the CE is provided for the behavioral health provider’s licensure renewal — then school and providers alike feel like they have done their due diligence. There is, however, no connection to practice.

Nationwide Children’s Hospital in Columbus, Ohio has developed a model for addressing child and adolescent suicide that should be followed in Kentucky. This integrated approach combines the best practice of suicide prevention and postvention services combined with data collection that constantly monitors outcomes. 

School-based personnel are provided with real training, not check-the-box training. Referrals to hospital-based and community providers who are trained in suicide-focused treatments are a part of this system of care.

If Kentucky is ever to address the problem of child and adolescent suicide, it will require investments in the creation of these types of networks. Currently, Band-Aids are being used to cover huge gaping wounds and children, adolescents and adults alike are still dying every day. Last year, 770 Kentuckians died of suicide. 

We need to have a more comprehensive plan to detect people who might be suicidal, refer them to good treatment providers and provide community support and postvention after a suicide occurs.

Melinda Moore is an assistant professor in the Department of Psychology at Eastern Kentucky University and the clinical division director of the American Association of Suicidology. Julie Cerel is a professor and licensed psychologist in the College of Social Work at the University of Kentucky and president of the American Association of Suicidology.

If you are anyone you know is having thoughts of suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK).

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