My Suicide Prevention Opinion in the Cordova Times

I spent about 3 years living in a small town in Alaska, the birthplace of my father. Cordova, Alaska is within the traditional territory of the Aleut and Eyak people. The local tribe, Native Village of Eyak, owns the paper.

Since 1999, suicide in the U.S. has increased by about 26%. It continues to increase in Alaska. One fact we don't know is whether our current programs are working. I don't believe they are. Just the fact that we report the incidence of suicide on an annual number per 100,000 people is an indication of how we think about suicide and suicide prevention.

I think differently. To me, suicide can be thought of as the consequence of a complex system. ACE's explain a link between trauma and suicide. When we attempt to influence a system, we need to understand why something like suicide happens. Whether the suicide rate goes up or down on an annual basis gives us information, but not enough to act upon. It may be that the changes are random. But what we want to believe is that what we do is making a difference. So we seize upon a decrease as a reason for celebration. It makes us feel good until it increases again. We need to say we are successful in order to keep the grants coming, and we need to show considerable harm to try and increase the amount of funding going into suicide prevention.

Statistical analysis should actually look at movement of the numbers over time, within what is referred to as a control chart. Using a control chart for suicide is difficult because of the small numbers. It takes a long time for trends to show up. If there are 3 or 4 successive time periods of increase or decrease, then we can hypothesize that something is working and try to understand and replicate it.

Fishermen know that they need to fish where the fish are. Maybe this is a crude analogy for suicide prevention, but the reason I wrote my opinion letter and submitted it to the Cordova Times [LINK HERE] is to encourage a different way of thinking. It is Divergent Thinking [LINK HERE]. It stated with thinking that ACE's might be a causal factor, adding information about the link between deficits for certain nutrients and suicide, looking at the gender and age ranges where suicides are most frequently completed and examining healing modalities from many sources. 

Convergent Thinking [LINK HERE] is what encouraged me to respond with my letter to the Cordova Times. In recognition of Suicide Prevention Month (September), Governor Bill Walker sent a message with traditional suicide messages (Convergent Thinking) [LINK HERE]. The traditional message is simple. Using your judgment, ask people if they are feeling tired or hopeless enough to consider ending their life and refer them to the experts.

My message is that a majority of suicides are completed by men in the age range from 14 to 34 (80%) and predominantly by men or women with 5+ ACE's (about 6% of the ACE Study population). So let's find a system where we can find them, then have the conversation started by the discover of facts that indicate a higher risk of suicide ideation, attempts or completions. I don't believe we lost anything by giving this a try. We know a lot of places that serve people with 5+ ACE's. And if you are not comfortable with 5+, 4+ is fine as well. 12.5% of the Kaiser Permanente patients studied has 4+ Ace's. It still allows us to narrow our range of inquiry and find those who have a higher risk. And if we find them at the ideation stage of suicide, then we have done our job and identified a risk we can address before something actually happens.

Thank you for reading this far. It's tough being a divergent thinker in a convergent thinking world. When I tried to introduce this to a suicide prevention task force, I was quickly shouted down, almost in unison by the rest of the 20 or so people in the room. 

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