The number of suicides in Tennessee reached an all-time high in 2016 at 1,110, a rate of 16.2 suicides per 100,000 Tennessee residents.
The increase comes after suicide was ranked the No. 10 cause of death among all age groups in the state in 2015, one of the three leading causes for ages 10-34 and fourth for ages 35-54.
One of the biggest battles the Tennessee Suicide Prevention Network faces in trying to bring those numbers down is stigma about suicide and mental health in general, Amy Dolinky, East Tennessee regional coordinator for TSPN, said.
“I think that is the underlying component of everything we do as an agency,” Dolinky said. “... Breaking down those walls and barriers is very important.”
A major problem is the myth that talking about suicide increases the likelihood someone will make an attempt, which Dolinky said simply isn’t true.
“I think the biggest thing is just to be there and be present and listen,” Dolinky said. “Listening is really a key piece to suicide prevention. As a society we kind of get caught up in how busy our lives are. … So really making that effort to be present and listen and be nonjudgmental are kind of the keys to that. Then not being afraid to ask someone, ‘Are you considering suicide?’ … Just that willingness to have that conversation and not assume that someone is reacting to a situation a certain way.
“Find out what are their feelings,” she added. “Risk and protective factors really all boil down to pain and loss, whereas protective factors all boil down to connections. ... Sometimes that’s even about making that connection between what the person is experiencing and suicide. If I think somebody is thinking about suicide I want to have that willingness to ask. Even if I don’t know what the next step is … we can have that conversation. We don’t want this to be something that is painful and stigmatized.”
When deciding to ask someone if they’re considering harming themselves, it’s important to approach that conversation by letting the person know it comes from a place of caring and concern, Parinda Khatri, chief clinical officer for Cherokee Health Systems, said.
“I think the most important thing is to No. 1, share that you care about that person and that this is coming from a place of caring,” Khatri said. “Secondly, if you can understand what is important to them and how this mental health problem may be impacting their life then you may want to point it out in that way.”
One of the biggest warning signs is change in mood or behavior. If somebody suddenly starts acting reckless or stops taking part in activities they enjoy, that could be an indicator, Khatri said.
Positive mood swings could also be a sign something is wrong. Any drastic changes in mood — not just in a negative way — can be warning signs, Dolinky said.
Noticing changes and approaching the individual are good steps toward helping, but it’s important to know positive changes may not happen right away.
“Understand that this is a process,” Khatri said. “Many people are resistant to treatment. … You have to stick with them, talk to them and know that this is important. Building motivation for somebody to get treatment and change takes time. Continue to let them know you care about them and highlight their life and the impact on their life and what you’re noticing now.”
Sometimes, mental health problems that may lead to suicide or self-harm aren’t easy to see — even for the individual battling those problems — but there are signals.
“No. 1, are you feeling sad more often than not? If you’re noticing that you’ve been feeling sad more often than not every day for two weeks or more, that’s one,” Khatri said. “Another is are you able to enjoy things you used to enjoy. Many times people who have mental health problems are not able to enjoy things they used to enjoy. Are you noticing you’re drinking alcohol or misusing drugs? ... Those are main indicators that you may need to get some help.”
When help is needed, it’s important to know where to look. There are talk and text lines for people who might be considering suicide. The talk hotline is 1-800-273-8255. The text line can be reached by texting “TN” to 741741.
If someone believes they are ready to hurt themselves and doesn’t know where to turn, they should go to the emergency room, Khatri said.
“If you have thoughts of hurting yourself, plans to hurt yourself or intent that, ‘yes, I am going to hurt myself,’ you should go to the emergency room,” she said. “Make sure you don’t have access to anything you can use to hurt yourself and make sure you have someone you trust with you that can help keep you safe.”
And take away the means for committing suicide — especially guns, which is the most commonly used tool in the state, according to TSPN.
“Even though in Tennessee we don’t like to talk about firearms, access to firearms leads to a higher rate of suicides,” Dolinky said. “Many people like to argue that if they don’t have access to firearms they’ll find another way, but the research shows that’s not the case. Some of those people will find another way, but many will not.”
Help is out there for anyone who needs it, whether someone is thinking of harming themselves or believes a loved one may be considering suicide, Dolinky said.