Palo Alto Weekly

Spectrum - April 23, 2010

Guest Opinion: How the U.S. Air Force fought suicide, and we can, too

by Anat Admati

As a parent of three, including a Gunn student and a Terman student, I shared the sense of grief, concern and helplessness many adults and teens felt last spring when we were confronted with two tragic deaths, the first of several.

Seeking to understand better how to deal with this situation, I started educating myself on the subject. I soon realized that a lot is actually known and that there are things that can be done to prevent most such tragedies.

I and others became involved in various efforts, but I also came to realize that these efforts cannot fully succeed unless more people in the community become better aware of this information and thus empowered to act.

I am writing this to share some of what I learned and to call on everyone in this community, organizations and individuals, to respond to this challenge.

The main lesson I have learned is that we should not feel helpless, and that if we work together we can prevent tragedies and improve our community's well-being.

A lot of myth, stigma, fear and misunderstanding surround suicide. Many find it incomprehensible. Some believe no one can stop a person who plans to end his or her life.

In fact, while suicide is the result of complex biological, physical and circumstantial conditions, there is overwhelming evidence that most suicides can be prevented. And everyone, organizations as well as individuals, can do something to help in prevention efforts.

An inspiring example comes from the U.S. Air Force, which has proven that a comprehensive, community-based prevention effort can work and even bring other important benefits.

In the early 1990s, a staggering 24 percent of all deaths of airmen were due to suicides. Alarmed, in 1996 the Air Force embarked on a major prevention program that focused on enhancing social support and interconnectedness, developing individual coping skills and promoting cultural norms that encourage help-seeking behavior — emphasizing the true courage it takes to ask for help when one needs it. Airmen were told it is honorable to seek early help for mental and emotional difficulties, and not honorable to try to cover them up.

The result of this program, which has been scientifically evaluated, was dramatic: a sustained one-third reduction in such deaths, dropping the rate substantially below the national average in the general population.

In addition, there was a significant reduction in the number of homicides and cases of family violence, and even in accidental deaths. By now all branches of the military have created similar programs.

Suicide is a major cause of death beyond the military, and many families and communities experience the pain that comes with it. An average of 90 people die by suicide every day in the United States, twice the number of deaths from HIV/AIDS and nearly twice the number of homicide deaths. Suicide is the third highest cause of death of youth aged 15 to 24 and the second highest cause of death of college-age young people. It is also estimated that there are 750,000 attempts a year that require medical intervention.

Suicide prevention is everyone's business.

Since the vast majority of victims have a diagnosable and treatable mental illness, suicide will be reduced if these illnesses are more effectively diagnosed and treated, as many have noted. For this to happen, those who need help must be identified and assisted with getting appropriate help.

There is also strong evidence that restricting access to means of self-harm, such as building suicide barriers on bridges, can make a significant difference. A classic example is that almost all who were thwarted from or survived leaping off the Golden Gate Bridge did not attempt suicide subsequently. The recent approval by the Golden Gate Bridge Authority to build a suicide barrier is therefore a welcome step.

Organizations such as the city and school district have important roles to play. Project Safety Net, initiated by the city, has brought many organizations together to focus on prevention efforts that emphasize improved access to mental health resources and an overall raising of awareness that can replace hopelessness with hope.

A number of useful actions and plans have been put into place by students, parents, teachers, administrators and community members. But we can do more if all of us gain a better understanding of all that would be useful — and act without delay.

For example, as in the Air Force, and analogous to required training sessions on sexual harassment in the workplace for managers and employees, teachers and others should undergo regular training on mental health and suicide prevention.

School assemblies and other opportunities should be used to de-stigmatize mental illness and encourage help-seeking behavior.

Prevention efforts should not be left just to organizations. There is much that every individual can do.

Kevin Hines, who survived a jump off the Golden Gate Bridge in 2000, said he would likely not have leaped if someone on the bus or walking along the bridge had noticed his distress and asked how he was doing.

We can all start looking out more for those around us and become more connected and more caring. We can all help in addressing youth stress and bullying, and promoting help-seeking behavior.

Young persons should understand that if someone's life might be in danger being a good friend means making sure they get professional help, even if it means betraying "a secret." Adults can contribute to efforts to restrict access to means of self-harm (check the Safety Net website: www.cityofpaloalto.org/safetynet.)

Some would argue that the success of the Air Force cannot be replicated in civilian communities. While the Air Force is more hierarchical and structured than a diverse town such as Palo Alto, it in fact has faced more obstacles in prevention than we do: Its forces are scattered, its population keeps changing and its traditional culture has frowned upon seeking help for mental conditions. Airmen also have more access to lethal means of self harm. We can and should do as well or better than the Air Force to prevent suicides.

Our community can grow from this traumatic year. If we all, leaders, organizations and individuals, do our parts in this effort we will not only prevent suicides but we will emerge a healthier and happier community.

Anat Admati is a professor at the Stanford Graduate School of Business and a parent. She can be e-mailed at admati@stanford.edu.

Comments

Posted by Gunn Parent, a resident of Midtown
on Apr 24, 2010 at 1:13 pm

Anat, Well said. Thank you for taking the time to write such a well writtenletter. By doing these you are already chipping in to improve our community. I think we all need to wake up and start working for the benefit of our youth. To me the things that are happening at Gunn is a sign that something is wrong with our schools and our community. I think for a while we were all in denial about the suicides in our city, and we were hoping they will go away, but they will not, until we all do something about it. I hope your letter gets to the heart of every person and that our students will see that someone cares. Just like Kevin H. was hoping someone will see his suffering, our students might be experiencing the same thing and who knows your letter might be the one that saves his or her life. Sincerely a Gunn Parent


Posted by MidtownMom, a resident of Midtown
on Apr 25, 2010 at 11:36 am

An increased interaction between the students, parents, neighbors will also go a long way. For most people in Palo Alto, our lives are tied to a clock. The children's' lives are also tied to a clock - there is usually an assignment due, a tournament to go to one thing or another.

We need to have a regular community-fun day ! The scope is wide - a block party, a party in a park or a city wide party. Anything that people are upto. Its summer, the days are getting longer and the weather is wonderful.

There are "community associations" (like MidTown, Palo Verde) already in place. Could these associations take a lead and coordinate this? Announce a day for a block party for a start. There are "block coordinators" if I am not mistaken ( these folks are supposed to coordinate the residents on the particular block during an emergency ). Well, if the association does not have block coordinators - this may be a good time to get signups.

This will give families a good platform to interact; kids to interact and overall a stress-free fun filled evening on a periodic basis.


Posted by a few ideas, a resident of Leland Manor/Garland Drive
on Apr 25, 2010 at 12:28 pm

Speaking as one who approached the brink a couple times in my life, and not in contradiction to this nice editorial, but in addition to it..

How about less "doomsday" scenarios...and passing on more faith in the future to our youth?

How about a focus on all the progress for good that this nation and humanity in general has made, instead of a focus on all that can still be improved?

How about passing on daily gratitude for all we have in goods and opportunities, and all we have accomplished, instead of bitterness for what we don't have or haven't accomplished yet?


Posted by RoyRoy, a resident of College Terrace
on Apr 25, 2010 at 1:20 pm

I believe the worst is over. We have not had another incident in over 5 months, so obviously the guards are working well. The school has done much and the students are reaching out and nearly all students feel safe and well.

We have done all that we can, and I think the next step is to keep it up. I would be shocked if we had another incident, since the community has come a long way


Posted by Midtown Parent, a resident of Gunn High School
on Apr 25, 2010 at 2:44 pm

To RoyRoy
Obviously you are not up to date on the news, there have been more suicide attempts, but because of the paid guards and the volunteers on Charleston, the students have been send to hospitals for evaluation. Our students still feeling sad and depressed. Did you read the article last week where the English teacher expressed himself about what how students are feeling. If you didn't, you should. I hate to say that the worst is not over yet. You said for the last 5 months we have not had another incident, you are wrong our last one was on Jan. 22, and after that there have been more than 3 children who wanted to take their lives, but they did not because their parents call for help, some call the police, others went and ask for help to the volunteers on Charleston. It is not only the paid guard, it is also the volunteers. They cannot do it alone, we all need to chip in by volunteering at least one hour a week. NO THE WORST IS NOT OVER YET, even though I which it was. People need to stop hoping that is over and get out there and volunteer to watch the tracks, and show that you care.


Posted by RoyRoy, a resident of Greendell/Walnut Grove
on Apr 25, 2010 at 3:08 pm

[Post removed by Palo Alto Online staff.]


Posted by Midtown Parent, a resident of Gunn High School
on Apr 25, 2010 at 10:39 pm

[Post removed by Palo Alto Online staff.]


Posted by Misha, a resident of Midtown
on Apr 25, 2010 at 11:22 pm

Absence of evidence is not evidence of absence.

Just the other day, another child was determined to be at risk of self-harm. Thank goodness he or she was identified and taken into emergency care. Just because it was not reported or you did not personally know about this, doesn't mean it is not real.


One significant factor in suicide is mental illness, such as depression. Are you suggesting that because you have not personally heard of any suicide in the past 5 months that the various community efforts have somehow addressed mental health issues throughout the community? However in the world can one know that every single individual in a community is just fine and will always be fine? As we sadly know, someone can look fine but inside feel very badly.

Instead, I think that efforts to protect our children and their friends have been made and must continue to be made, press are far more sensitive to possible contagion, and we must never give in to complacency.


Posted by Jane, a resident of Gunn High School
on Apr 25, 2010 at 11:52 pm

This is not time to declare victory and no one is in a position to say that we have NOTHING to worry about, in fact because this is far from truth. Even if somehow we did not have to be concerned with suicide, we still have pain and suffering from mental health issues such as depression or anxiety, and the more we can "normalize" seeking help, and the more caring we can all be, the better the entire community will be.


Posted by Anna, a resident of Palo Alto High School
on Apr 26, 2010 at 8:52 am

Thank you for bringing up this important subject, which no one likes to hear much about. What I think is particularly useful to think about in your letter is that you point out the value both of catching someone at a critical moment and of providing a long-term good environment for the entire community.

I hope this is the beginning of more discussion with school officials, who can make such a difference by courageously and proactively addressing our shared wish to have all students--whether on the brink of harming themselves or not--get through the difficult years of late adolescence in the healthiest ways possible.


Posted by Ruth, a resident of Gunn High School
on Apr 26, 2010 at 9:28 am

I think this discussion is very useful. We have an opportunity here to do a few very useful things. The schools and the district, while putting "student well being" as a goal, still seem to have the attitude that their main job is academics. However, mental health is every important for academic success, as is physical health. We are beginning to see the parity between these.

Another critical point in this editorial is the issue of "restrictions to means of self harm." This comes into play when we fail to catch someone earlier, which has happen and can happen again. While we are doing all the other stuff, we still must make sure that the scenario does not repeat itself, and now or next fall is way too soon. As a volunteer to this effort, I want to call on all adults in the community to go out there and show the kids that we care ENOUGH to be going outdoors and making sure someone is there. There is advice not to mention our equivalent of the Golden Gate Bridge. And we cannot put in physical barriers. But restricting access IS possible, and it's been done by a small group of dedicated volunteers. Did you know that Yiway Yeh, a city council member, spends five hours in a block on a Saturday night once a month volunteering for this community safety and health? If you go out there and volunteer, you will be thanked by teens and concerned parents alike. I know for a fact that this effort has saved lives. Please all readers, go to the safety net website to find out how you can help. It's one of the easiest ways you can contribute. Just do it. And this in addition to the other stuff about resiliency and mental health. Thank you!!


Posted by RoyRoy, a resident of Embarcadero Oaks/Leland
on Apr 26, 2010 at 9:56 pm

This is my hypothesis. After all this time, all the troubled people have gotten help. Everyone is okay now, or we are almost at that stage. We have almost overcome this terrible thing haunting our great city.

Right now we should be worrying about more important things, like the crossing guards being fired.


Posted by Karen, a resident of Terman Middle School
on Apr 27, 2010 at 1:13 pm

This is not a "one time" deal where you somehow get help for "troubled people" and that's it forever.


Posted by Concerned Parent, a resident of Barron Park
on Apr 27, 2010 at 7:21 pm

I used to think like RoyRoy, but then I woke up, and said "No our children are not ok, the fact that students keep trying to hurt themselves tells me that definitely there is a lot more work to be done, before we call it "almost over" If couple of years passes by and not incidents happen, then we could call it almost over, for now, no, we are not out of the woods yet, even though I would like that very much to be a reality. Our students need us, they need our support, love and the understanding of their teacher. Blessings to all people who want to make a difference on the lives of our children. I heard there is going to be a public meeting at Saint Marks church so things can be a better place for young people. Anybody who cares about our youth can came. I believe it starts at 6:00 or 6:30 pm on May 2.


Posted by Sharon, a resident of Midtown
on Apr 27, 2010 at 7:58 pm


The US military has been and is ahead of the curve in many areas, integration, dealing with drug abuse etc
They now have an evidence based program preventative resilience training program for soldiers and their families see Web Link


Life is what it is, everyone faces setbacks, challenges and conflicts, it is how you handle them and master them that counts and builds resilience.

This new approach--- Positive Psychology-- is a radically new evidence based approach that re-frames and corrects the deficiencies of tradition, non evidence based psychological interventions.

The facts are that there is no evidence that traditional psychotherapy is effective and there is strong evidence that it can be harmful, it creates dependency relationships and a financial conflict of interest for the therapist-- unless the therapist works for a HMO like Kaiser where the incentive is to kept the patient back on their feet fast.
We now see the skewed incentives for Goldman Sachs Mortgages Department, it is time to examine the conflicts of interest and skewed incentives in the psychotherapy industry.
The psychotherapy industry needs evidence based standards, accountability and transparency and more regulation to prevent and punish financial and other abuse, ASAP


Posted by Mom 1st, MD 2nd, a resident of Palo Alto High School
on Apr 27, 2010 at 8:28 pm

Anat,
Thank you for writing this piece.
I have seen how personally dedicated you are to this issue.

I agree with others that it is way too soon to consider this problem to be over. There have been several averted episodes that I know about personally from watching the tracks and likely others as well.

All of our efforts are important, starting in the home, then with our friendships, then the schools, then the larger community. I truly hope we can look back some day and speak of troubling events that ended, once and for all, in January 2010 because of the efforts of all of us.

Until then, we keep working.


Posted by Midtown Parent, a resident of Gunn High School
on Apr 27, 2010 at 11:30 pm

Here is the correct information for the meeting on May 2nd

Special Events

We Can Do Better for Our Youth
The Advocates for Youth Committee of St. Mark's Episcopal Church hosts a community meeting with PAUSD board members Barb Mitchell and Barbara Klausner to explore ways to ensure that all youth feel connected, cared for and supported by the community at large. May 2, 6:30-8 p.m. Free. For more information, call Becky Sanders at 650-269-4194 or e-mail rebsanders@gmail.com. St. Mark's Episcopal Church, 600 Colorado Ave., Palo Alto


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