“My family and friends … My family and friends …”
Sixteen-year-old Levi Baehr, in dark despair, repeated the words he’d loaded into a suicide prevention app on his smartphone weeks before, ready at his fingertips, fearing moments like this would come.
“… My family and friends …”
This was one of his survival plans in a growing national and Missouri crusade called Zero Suicide.
It is intensifying training among the professionals who people in despair encounter and compelling more action to take away the means people use for suicide.
These are desperate times for efforts to stop self-inflicted deaths. So many strategies have been deployed to stir awareness and shed the stigma that chokes depression and mental health.
“But nothing has worked,” said Bill Geiss, a Zero Suicide specialist and clinical assistant professor in psychiatry at the University of Missouri-Kansas City. “We are failing miserably.”
Missouri, with the 17th-ranked suicide rate in the nation, has seen suicides increase by 9.6 percent since 2013. Kansas, ranked 20th, increased by 12 percent. The nation has increased by 7.4 percent.
In 2015 alone there were 44,193 completed suicides nationwide — 1,052 of them in Missouri and 477 in Kansas.
The notion of achieving “zero suicide,” in the wake of these trends, may seem audacious, said Scott Perkins with the Missouri chapter of the National Alliance on Mental Illness.
“We’re changing the culture,” Perkins said. “You wouldn’t want an airline to say they hope to prevent crashes but they can’t prevent them all. With suicide, the goal should be zero.”
Baehr lives in that changing culture. He believes Zero Suicide support is helping him.
The words on his phone were one of the survival strategies the Lee’s Summit teenager built as part of ReDiscover’s Show Me Zero Youth Suicide program.
With quick taps on a specially designed app, he can instantly call up a link to three people he can reach for help, or tap into hotline resources, or call up pictures and reaffirming thoughts he authored when he felt strong — reasons to stay alive.
Some of the people in the Show Me Zero Youth Suicide program write elaborately, or call up memorable verses in preparing their phone pages, said Kirsti Olson, ReDiscover’s suicide prevention liaison.
But Baehr kept his words concise. It’s what he needed, he said.
On that winter day earlier this year, he first called the words up on his phone at school, then retreated to a friend’s house, in the end found shelter alone in a back bedroom until sleep overtook him.
“I read them over and over again,” Baehr said. “I stared at it for hours … thinking about what they mean to me — how I didn’t want to hurt them.”
“…My family and friends … My family and friends … My family and friends …”
The idea of Zero Suicide feels impossible here in an Overland Park community center.
Bonnie and Mickey Swade’s Suicide Awareness Survivor Support group gathered 24 people for a regular Tuesday night meeting in the middle of winter.
They are parents, siblings, wives and husbands who know how they tried to stop suicide.
Bob and RoseAnn Brostoski’s son was a physician. He sought out counseling, they said. He was seeing a psychiatrist. Was on a watch list.
“People who kill themselves truly believe everyone will be better off,” RoseAnn Brostoski said.
What chance does a safety plan have, she wonders. She knows the people who surrounded her son, and all the time they spent, “all the hours,” trying to ease his pain.
The Brostoskis want Zero Suicide to work. They want to see lives saved by the safety plans and by healing images and words.
“But you have to accept — we had to accept — the person we love couldn’t access that script for himself,” RoseAnn Brostoski said. “It overwhelmed the damn script.”
A pervasive negative view of mental health care poisons the work, said Geiss, who is training staff at Truman Behavioral Health and Wyandot, Inc., in Zero Suicide.
People with depression — even if it comes from past abuse or neglect that should make them angry — too often carry shame, he said.
Abbye Putterman in the Overland Park support group went there to help her live with her twin brother’s suicide.
The thing is, she had thought she was going to kill herself when she was stunned by her brother’s death. She still feared for herself. But she didn’t tell this when she was answering grief counselors’ questions.
“I faked two psych evaluations,” she said. “I was afraid they’d lock me up.”
“Suicide hides,” Geiss said. Studies show that most people who completed or attempted suicide, when they had last been asked, said they were not suicidal.
“They won’t tell you because they don’t want to lose control of their suicide plan,” he said.
The Zero Suicide training not only tries to give vulnerable people their own safety plans that they control. It also targets hospital staff and clinicians.
Suicide “scares clinicians to death,” Geiss said. “We hospitalize and push it along. We treat for depression, but that does not treat suicide.” It’s too passive. It’s too much just a sentinel. “We want a clinician who is active.”
The name Zero Suicide came from work starting a decade ago in the Henry Ford Health System in Detroit under C. Edward Coffey, who’s now president and CEO of the Menninger Clinic in Houston.
The most important strategy, he said, is taking away the means someone has contemplated to kill him- or herself.
Consider highway safety, he said. The death rates on highways have declined significantly over the past 40 years.
It’s not because we have become such better drivers, he said.
“We re-engineered cars,” he said. Airbags, collapsible steering columns, rapid-pulsing brakes and other innovations reduced the death threat.
Family members, clinicians and friends can take the same approach with depression, learning how someone has contemplated killing themselves, then sweeping away the firearms, or taking the car keys, or removing the ladder or the rope.
You buy time, Coffey said. The impulse goes.
“They could buy another rope, of course,” Coffey said, “but research shows they don’t. If you can interrupt the idea, it makes a difference.”
Gotta own it
Baehr sat with Kelley Smith, the great aunt who raised Baehr since he was 18 months old and whom he calls mother.
“I’m glad he has somebody,” Smith said. She meant the counselor at his school, and Olson at ReDiscover, in whose office they were gathered.
An aching gap hangs between people with depression and the Zero Suicide help waiting on the other side.
The phones are the big shift, Olson said. Counselors have dedicated phones they can use to check in the way youth do — texting — as well as calling.
They build their strategies and they prepare the communication lines. Baehr links in the music that soothes him.
“If I could sit and hold their hand and whisper into their ear all weekend long, I would,” Olson said. “But I can’t. They have to own it.”
But what Baehr came to understand, which he didn’t know he could do, was he had to take that step into his high school nurse’s office that first time.
His mother had told him he should consider it. She knew he was this quiet teenager, like so many, not himself anymore.
“I don’t like being open with people that much,” Baehr said. “I’m a person who bottles up emotions and keeps them to myself.”
He had to step toward help.
“I could barely speak,” he said. “I had tears. I was shaking so much. … It was hard to understand me.”
But he knew he was seizing a new chance and it was OK. It was good.