Suicide Prevention and Awareness

We have written a lot about mental health this year. Suicide is a leading cause of death in the United States. Each year over 45,000 people in America kill themselves — a rate that has increased 41% since 1999. Mental health conditions are often seen as the cause of suicide, but 54% of those who commit suicide do not have a known mental illness. 

Suicide is rarely caused by a single factor, and is also affected by personal relationships, substance use, physical health, and stress from jobs, money, legal issues, and/or housing. In addition to September being Suicide Prevention Month, the week surrounding World Suicide Prevention Day is National Suicide Prevention Week. Awareness is important to end the stigma of suicidal feelings and help more people access life-saving help in dark times.

 

Anyone can have suicidal thoughts, but it is important to know they are not permanent. Having suicidal thoughts is not a sign of weakness or failure, but is a symptom of profound distress. Suicidal thoughts and behaviors can be very damaging and dangerous, and should be considered a psychiatric emergency. 

Other than mental illness, there are a number of risk factors for suicide:

Photo by Ahmed Hasan

  • A family history of suicide
  • Substance abuse — using drugs and alcohol results in mental/emotional highs and lows that can exacerbate suicidal thoughts
  • Intoxication — more than a third of people who die from suicide are under the influence at the time
  • Access to firearms
  • A serious or chronic medical illness
  • A history of trauma or abuse
  • Prolonged stress
  • Isolation
  • A recent tragedy or loss
  • Agitation and sleep deprivation

Certain populations can be more at risk than others. Suicide rates have been shown to be higher in rural areas, particularly in counties with small populations and lower incomes. Women are more likely to attempt suicide, but men are more likely to die from it. LGBTQIA people are at a higher risk for attempting suicide than heterosexual/cisgender individuals, especially among those who experience rejection from their families. People of color, immigrants, and other underrepresented communities also face unique factors affecting their mental health that can lead to tragic outcomes.

 

There are warning signs to watch for if you are afraid someone you know may be having suicidal thoughts:

  • Suicidal ideation — threats or comments about killing themselves that may appear harmless but can become overt and dangerous
  • Increased alcohol or drug use
  • Aggressive behavior and/or dramatic mood swings
  • Social withdrawal from friends, family, and community
  • Talking, writing, or thinking about death
  • Impulsive or reckless behaviors

The more serious signs include:

  • Putting affairs in order
  • Giving away meaningful possessions
  • Saying goodbye to friends and family
  • Mood shifts from despair to calm
  • Planning, possibly by looking around to buy, steal, or borrow the tools they need to complete suicide, such as a firearm or prescription medication

 

Photo by Jon Tyson

If you know someone who might be thinking about suicide, you can help by offering to listen. Listening to someone can show that they are cared for, give them a greater feeling of control, and help them feel connected to another person. It is important to remain calm and vigilant of their feelings.

After listening for a time, ask the person if they have thought about suicide. Asking can be scary and difficult, but the answer will give more information than watching for warning signs. If they answer “No,” keep listening; don’t tell them you are glad or relieved, as they may be less likely to be honest if their answer changes. If their answer is “Yes,” it is important to stay calm and not show signs of fear or anger; keep listening, let them know you care, and ask questions about any further thoughts or plans to commit suicide. Get the person help, even if they have not agreed to it. Telling a professional about your concerns can save their life.

 

Beyond the emotional toll suicide takes on all those it affects, there is a financial cost. The average cost of one suicide is estimated at $1,329,553. More than 97% of this cost is due to lost productivity; the remaining 3% are costs associated with healthcare costs. The total cost of suicides and suicide attempts is estimated at $93.5 billion. Every $1 spent on psychotherapeutic interventions and interventions that strengthened linkages among different care providers saved $2.50 in the cost of suicides

NeedyMeds has information for over 5,000 free, low-cost, or sliding-scale clinics throughout the country that offer counseling or mental health services for those in need. Search your ZIP Code for mental health clinics near you, or call our toll-free helpline for information at 1-800-503-6897 (open Monday through Friday, 9am to 5pm ET).

 

We encourage everyone to educate themselves, strive to understand the difficulties people around us live with, and to replace stigma with hope and support. If you or someone you know is thinking about suicide, it is important to know that no one is alone in their struggle. Call for assistance, whether help is needed immediately or long-term.

Samaritans 24/7 Crisis Services via call or text: (877) 870-HOPE (4673)

The Trevor Project (LGBTQIA crisis support): 1-866-488-7386 or Text “Trevor” to 1-202-304-1200

Trans Lifeline (transgender crisis support): (877) 565-8860

The Steve Fund Crisis Text Line (crisis support for people of color): Text STEVE to 741741

Be Healthy Going Back To School

It is the time of year when people of all ages are returning to classrooms. They will be exposed to new experiences and ideas but also higher risk of exposure to viruses/illness and stress. Here are some tips for students of all ages to ensure a healthy and successful time in school:

  • Vaccinations are the best course for preventing illness. In addition to the vaccines recommended by your doctor, the Center for Disease Control and Prevention recommends an annual flu vaccine for everyone over 6 months of age.
  • Sleep is essential to keep children (and adults) focused throughout the day. Adults need about eight hours of sleep, while young children often need more. It’s important to set a bedtime that ensures everyone gets enough sleep and to keep a consistent schedule.
  • To avoid getting sick and to prevent children from bringing germs home, it’s important to teach children to wash their hands after using the restroom or before eating.
  • A healthy diet can help children grow and learn more effectively, as well as keep everyone’s immune systems primed to fight off illness. Avoid junk food and soft drinks, and consider packing children’s lunches with healthy snacks.
  • Going back to school is stressful for both parents and students of all ages; for some children, it may be a new sensation. Help manage stress by talking to children (or encouraging adult students to talk to someone) about anything bothering them and take care not to overload anyone’s schedule. Schoolwork is important, but it is essential for mental health to relax, play, and spend time with family.
    • A significant new stress for students and teachers returning to school is the atmosphere of fear that has emerged in the wake of mass shootings at schools and other venues throughout the United States. Simulated active shooter drills have been shown to contribute to trauma rather than relieve fears, and policies of harsher discipline and armed school staff increase the likelihood that people are exposed to violence
    • It is imperative that children feel they can trust the adults in their lives and be connected as a community. An authoritative approach of structure, oversight, consequences, and support can help children learn responsibility for their behavior and how to reconnect with others; as opposed to an authoritarian environment of punishment, control, and containment which hardens a school instead of making it a better place with less violence and fewer problems.
  • Student backpacks should never weigh more than 10-20% of a student’s body weight, and should be adjusted properly to the bottom of the pack so it sits at their waist.  Encourage students to use both shoulder straps; slinging a backpack over one shoulder can strain muscles and hurt their back.
  • If your student has a chronic health condition, ensure that the school nursing staff is aware and carefully go over any emergency plans with your child and school health personnel.

 

Students of different ages may have different experiences in school, but these tips are a good foundation to staying healthy while learning and growing. If you are having trouble accessing vaccination or other services, NeedyMeds has a database of over 18,000 free, low-cost, and sliding-scale clinics all over the country

The NeedyMeds Drug Discount Card can be of help for prescribed medicines, even over-the-counter medications if written as a prescription. The free discount card is also available as an iPhone and Android app. For children affected by a chronic health condition, there may be academic scholarships or extracurricular camps and retreats available

For more information, visit the website or call our toll-free helpline at 1-800-503-6897 Monday through Friday, 9am to 5pm Eastern Time.

Planned Parenthood Forgoes Title X After Gag Rule

This week, Planned Parenthood withdrew from federal Title X funding rather than comply with the Trump administration’s “gag rule” prohibiting Title X grantees from providing or referring patients for abortion services. Title X funding is mandated to focus on family planning and related preventive health services for patients who are low-income or uninsured. Two-thirds of patients who benefit from Title X funding are at or below the federal poverty line. Providers have already been forbidden from using federal funds to pay for abortions since 1976.

Planned Parenthood has been a controversial organization to many Americans since its beginnings in 1916. Planned Parenthood began their work when information about family planning and contraception were considered “obscene.” The founders of the first birth control clinic were arrested and convicted for disseminating contraception information. In the 1960s, family planning became a central element of the War on Poverty. Today family planning services include everything from couples counseling to reproductive health screenings, pregnancy tests and prenatal services to contraception or pregnancy termination. Some Planned Parenthood clinic locations are able to provide a full range of family practice services. Planned Parenthood’s mission has always been to provide services for those in need regardless of income, national origin, or any other criteria.

 

Planned Parenthood has served up to 40% of Title X recipients, providing contraceptive care, cancer and sexually transmitted infection (STI) screenings, prenatal care, and other crucial health services. According to their 2017-2018 Annual Report Planned Parenthood was able to provide 296,310 breast exams and 274,145 pap tests, detecting cancer in 70,193 women as well as diagnosing 240,489 STIs after providing over 4 million screenings to men and women. Contrary to the claim that Planned Parenthood is an “industry of abortion,” the report states only 3.4% of the services provided in 2017 were abortion procedures

After losing Title X funding, many patients are likely to lose access to services Planned Parenthood provides. For now, Planned Parenthood says it has “emergency funds” to cover services that were formerly paid for by Title X and the organization will fundraise to make sure that care does not suffer. However, low-income women who have relied on Planned Parenthood for screenings, birth control, and more, may face more limited options in the months ahead. Planned Parenthood has been the only Title X provider in Utah, and served up to 90% of Title X patients in Minnesota. It will be nearly impossible for other health centers to fill the gap being created, with patients in underserved states seeing longer wait times for appointments or going without care. Men and women seeking affordable family planning services might be forced to drive hundreds of miles for reproductive care. Abortion services will be largely unaffected by the change.

 

NeedyMeds has information on nearly 500 Planned Parenthood clinics. Search your zip code for locations in your area. Cancer screenings and STI testing assistance can be found in our Diagnosis-Based Assistance database by searching for conditions that affect the men and women in our lives, as well as many that offer various forms of assistance for women seeking an abortion. For more resources, check our website at Needymeds.org or call our toll-free helpline at 1-800-503-6897 9am to 5pm Eastern Time Monday through Friday.

National Immunization Awareness Month 2019

August is National Immunization Awareness Month (NIAM) in the United States. This is the time of year when children and teenagers are heading back to school, toddlers are entering preschools or daycare programs, and many adults are heading into college or continuing their careers. Regardless of the situation, it is important to be aware of the need for getting vaccinated year round.

 

Vaccines are a vital part of healthcare at all stages of life and offers the best protection available against many potentially devastating illnesses. The Center for Disease Control and Prevention (CDC) encourages parents to follow an immunization schedule for babies and young children, protecting them from 14 life-affecting diseases. Pre-teens and teenagers should begin to innoculate against meningococcal diseases (meningitis or septicemia) and HPV (Human Papillomavirus, which can lead to cancer). Adults should continue to protect themselves with a yearly flu shot, tetanus updates, and later in life the shingles vaccine.

 

An important element of immunization awareness is to protect our populations through “herd immunity” — when a high percentage of a population is vaccinated they protect individuals who have not developed an immunity. Babies are protected by their mother’s immune system at birth and continue to be passed antibodies from their mother’s breast milk; however, surrounding infants with people who have been vaccinated further protects them from serious diseases. Some individuals may be allergic to certain vaccines, leaving them without the benefit of immunization and largely depending on herd immunity from the surrounding populations throughout their lives. Lastly, there are children and adults who are immunocompromised and shouldn’t be vaccinated.

No medicine can be considered 100% effective; the measles vaccine is 93-97% effective with one or two doses, respectively. Measles is so highly infectious that 90% of unvaccinated people who come close to an infected person will contract the virus. Being unvaccinated for infectious diseases is not only putting oneself in danger of serious illness and possibly death, but also the community at large.

Measles was declared eliminated from the United States in 2000, but that did not stop more than 1000 diagnoses being recorded in the first half of 2019  — the greatest number since 1992. The sharp rise in outbreaks is due to falling vaccination rates caused by the mass spread of misinformation, historical amnesia, and individualistic attitudes that encourage people to reject expert advice or only follow it selectively. The prevailing myth has been that vaccines cause autism and other developmental conditions, sparked by a 1998 paper by a doctor who has since been discredited and stripped of his clinical license. There have been dozens of studies that refute the association between vaccines and autism, but they have done little to quiet those who repeat lies and misinformation.

 

For those in need of assistance, our database of free, low-cost, and sliding-scale clinics has information on over 7500 clinics that offer immunization services. Search your ZIP code to find medical clinics near you that may offer free or low-cost immunizations. Pharmaceutical companies also offer Patient Assistance Programs (PAPs) such as Vaccine Patient Assistance Program. Call our toll-free helpline for more information at 1-800-503-6897 Monday through Friday 9am through 5pm Eastern Time.

Minority Mental Health Month

July has been Minority Mental Health Month since 2008. Back in May we addressed mental health awareness, but there are factors affecting mental health that are particular to minority communities. People of color, immigrants and their families, LGBTQIA people, and other underrepresented groups face unique struggles in regard to mental illness in the United States.

 

Everyone has stress and difficult emotions on occasion, and this is completely normal. Mental illness, however, is any condition that makes it difficult to function in daily life. It can affect relationships or job performance, and is caused by any number of complex interactions within the human brain. Mental illness can range from anxiety or mood disorders like depression, psychotic disorders like schizophrenia, eating disorders, or addictive behaviors. Minority communities are disproportionately affected and experience different levels of care compared to heterosexual/cisgender/white populations. Discrimination and implicit bias from healthcare providers is associated with higher rates of psychiatric disorders, substance abuse, and suicide in patients of color.

 

LGBTQIA (lesbian, gay, bisexual, transgender, queer, intersex, and asexual) individuals often experience body dysmorphia, physical or emotional abuse, or feeling unsafe at school or work. There are many areas of the United States where finding sympathetic and appropriate help can be prohibitively difficult. Over 27% of transgender people in the U.S. report being denied healthcare. Recent studies have found that LGBTQIA people are 29% more likely to experience memory problems as compared to peers with similar characteristics such as age, gender, race and ethnicity, marital status, and income. Other studies have found that 71% of LGBTQIA people reported feeling sad or hopeless for at least two weeks within the past year, 39% have contemplated suicide, and 20% have attempted suicide.

 

People of color are less likely to use psychiatric medications or administer them to a child in their care, even when they have equal access. Aside from a lack of diversity, experts say that this is possibly due to a lack of cultural competence in the fields of healthcare and psychiatry. This can be exacerbated by the media depicting police shootings, immigrants being detained, and racial profilings having PTSD-like effects on young people of color — to say nothing of one’s individual experiences of racism, isolation, being silenced or stripped from their sense of belonging. Mental health services can also be more expensive: over 30% of medical expenses faced by communities of color can be associated with health inequities.

Immigrants, their families, and many people of color have been facing increased pressure even in the midst of Minority Mental Health Month. For much of July, there has been media coverage of overtly racist messages from President Trump and his supporters. Trump telling rival women of immigrant families holding elected office to “go back to where [they] came from” has deeply rooted origins of discriminating against people who do not appear “American” enough (i.e., European-descended white) and characterizing communities of color as “infested” has a disgraceful history going back to American slavery. There have been raids targeting immigrant families in recent weeks, which have included the arrest of U.S. citizens who had been racially profiled and held for weeks in concentration camp conditions. Witnessing these exchanges and events brought by people in positions of power can be intensely harmful to those who have experienced similar bigotry.

 

Thousands of immigrant children have been separated from their parents/families under the Trump administration’s “zero tolerance” policy, and face an increased risk of profound physical and mental health problems. Psychologists who have visited detention centers worry that the conditions in these prison camps will add to the trauma families have already endured, though the impact is difficult to predict as no research has been done on children who have been forcibly separated from their families due to the inherent ethical concerns. The observable realities are tragic: parents have committed suicide after being told they’ll never see their children again; children have been abused, neglected, and denied sanitary conditions or healthcare; dozens of people have died, including five children so far in 2019. The U.S. Immigration and Customs Enforcement (ICE) is ill-equipped to screen or treat mental illnesses from anxiety to schizophrenia. Just reading of events such as these can be the cause of real mental and emotional anguish for countless people in America, with and without citizenship.

There are many ways one can support immigrant families in detention. The most commonly available method is to call your elected representatives in Congress and local governments to tell them not to support the inhuman treatment happening at the Southern border, and register to vote.

 

If you are looking for a LGBTQIA-friendly medical center, the Human Rights Campaign (HRC) has an interactive map with locations of over 1600 healthcare facilities in the United States. The HRC also has information on finding insurance for transgender-related healthcare, which can be a challenge for many transgender people even after the ACA. Beyond these resources, there are questions any underrepresented person can ask their healthcare or mental health providers to get an idea as to how well they can help and understand you:

  • Have you treated other LGBTQIA people/people of color/immigrants/refugees?
  • Have you received training in gender/cultural competence or on LGBTQIA/people of color/immigrant/refugee mental health?
  • How do you see our sexualities/gender identities/cultural backgrounds influencing our communication and my treatment?
  • How do you plan to integrate my sexuality/identity/culture/beliefs and practices into my treatment?

Your mental health provider will play an important role in your treatment, so make sure you can work with this person and that you communicate well together. Mention your beliefs, experiences, values, and cultural characteristics. Make sure that they understand them so that they can be considered in the course of your treatment.

NeedyMeds has Diagnosis Assistance Programs listed for various forms of mental illness. We also have information for over 5,000 free, low-cost, or sliding-scale clinics throughout the country that offer counseling or mental health services. Search your ZIP Code for mental health clinics near you, or call our toll-free helpline for information at 1-800-503-6897 (open Monday through Friday, 9am to 5pm ET).

 

We encourage everyone to educate themselves, strive to understand the difficulties people around us live with, and to replace stigma and bias with hope and support. If you or someone you know is suffering from a mental health condition, it is important to know that no one is alone in their struggle. Call for assistance, whether help is needed immediately or long-term.

 

Samaritans 24/7 Crisis Services via call or text: (877) 870-HOPE (4673)

The Trevor Project (LGBTQIA crisis support): 1-866-488-7386 or Text “Trevor” to 1-202-304-1200

Trans Lifeline (transgender crisis support): (877) 565-8860

The Steve Fund Crisis Text Line (crisis support for people of color): Text STEVE to 741741