Throughout the developed world, self-harm is now the leading cause of death for people age fifteen to forty-nine, surpassing all cancers and heart disease. Even as you’re reading this post, there will be one U.S. suicide every 16 minutes. And while these and other sobering statistics on suicide paint a grim picture, awareness of the problem is an important first step toward prevention.
This month at the Patheos Book Club, we’re featuring an important new resource for faith leaders called Preventing Suicide: A Guidebook for Pastors, Chaplains and Pastoral Counselors. Author Karen Mason is an associate professor of counseling and psychology at Gordon-Conwell Theological Seminary and a psychologist working in the mental health field since 1990. She took a few minutes to answer some questions for us on common myths about suicide, signs we can be looking for in suicidal individuals, and the single most important thing we should know as pastors about suicide.
Why were you compelled to write this book, at this time?
My first compelling reason for writing Preventing Suicide: a Handbook for Pastors, Chaplains and Pastoral Counselors was finding that many of my suicidal clients wanted to find another solution to their pain besides suicide and that some suicides may be preventable. The second compelling reason was reading about a large national study where approximately 25% of people with all types of mental health problems contacted clergy for help, and suicidal thinking, plans or attempts were some of the significant predictors of making contact. In talking to clergy, I found that many clergy felt underprepared to help suicidal people and that there are very few resources for clergy about preventing suicide. Those realizations compelled me to write Preventing Suicide: a Handbook for Pastors, Chaplains and Pastoral Counselors.
What are the common myths about suicide?
Some people believe that individuals who are suicidal or attempt suicide are just trying to get attention and that the best approach is to ignore them, the way one would ignore a two-year-old having a tantrum. Two problems with this perspective are that suicidal people describe feeling intense despair. They say that they are contemplating suicide because they can’t think of any other way to make their pain go away, not because they want to die. In suicide notes, many ask for forgiveness from their loved ones because they would prefer to not hurt them. This perspective doesn’t fit with the idea that suicide talk or a suicide attempt is attention seeking in all situations. The second problem with this myth is that not taking suicide talk seriously is taking a life-and-death gamble. Just as you wouldn’t think that a woman is faking a birth if she experiences Braxton Hicks contractions, so a person who is talking about suicide should be taken seriously. Preventing Suicide describes many other myths including that Christians do not experience suicidality.
How can pastors help to prevent suicide in their congregations?
There are several ways to prevent any tragedy. For example, to prevent drowning you could stand by the edge of a stream and pull people out. But you could also go upstream and build a fence around the stream to prevent people from falling in. Pastors prevent suicide both upstream and downstream. Upstream, pastors build in place protections against suicide like giving people reasons for living and guidance about how to build lives worth living, teaching people how to manage suffering faith-fully, offering people a community to which to belong and contribute, and providing people with moral objections to suicide. Preventing Suicide makes the point that pastoral caregivers like pastors, chaplains and pastoral counselors are uniquely prepared to build these protections into the lives of people through practical theologies of life, death, suicide, suffering and community. Further along the stream, pastors also recognize people who are suicidal; they minister to a family and faith community following a suicide while being alert to the risks of suicide contagion.
Who is most at risk for suicide?
Suicide is a serious problem across all ages and for both genders though the genders and age groups experience suicidality differently. Suicide attempts are highest in adolescence and young adulthood. When we look at deaths, suicide is the 3rd leading cause of death in the 10-24 year old age group and the second leading cause of death in the 25 to 34 year old age group. But when we look at the actual numbers of people who die, people in the middle years of life are at highest risk and older adults have some of the highest suicide rates. Almost 4 times more men than women die by suicide each year though more women attempt suicide. What these numbers suggest is that anyone in any age group and of any gender could be at risk. Preventing Suicide suggests other ways of recognizing suicidality besides age and gender.
What are some of the signs of suicidal tendencies pastors can be looking for?
A pastor can look for risk factors, factors that increase vulnerability to suicide as well as warning signs that someone may be at risk. One of the most important risk factors for suicide is having a mental health problem like borderline personality disorder, anorexia, major depression, bipolar, schizophrenia, or a substance abuse disorder to name a few. But only some people with a mental health problem go on to attempt or die by suicide. People at greatest risk are those who have already attempted suicide. These people are about forty times more likely to die by suicide. One of the reasons this group may have a higher risk of suicide is that they have developed the capacity to harm themselves by attempting suicide; but people can also develop the capacity to harm themselves by handling weapons or being exposed to bodily injury. Pastors should be aware that people with the ability to harm themselves combined with a feeling of disconnection from others and a sense of being a burden to others have a heightened risk of suicide. However, the best way to determine if someone is suicidal is to look for warning signs and then ask the person directly if he or she is thinking about suicide. It’s a myth that asking directly about suicide will plant the idea in an individual’s mind. Warning signs are things like talking about suicide or wanting to die. Any kind of preparation like buying a gun or hoarding pills may be a sign. Because a person may have these warning signs and not be suicidal, asking directly is the best way to know if a person with these warning signs is actually suicidal. Preventing Suicide provides much more information on risk factors and possible warning signs.
Many clergy have told our research team that they would like more training on when and how to respond to people who may be suicidal. This kind of training is called gatekeeper training, and it focuses on helping key people called gatekeepers to recognize suicidality and respond. There are several good options for these kinds of trainings:
i. LivingWorks (https://www.livingworks.net/) or
ii. the QPR Institute (http://www.qprinstitute.com/) or
iii. the Connect Program (http://www.theconnectprogram.org/).
Clergy should also be aware of the National Suicide Prevention Lifeline (1-800-273-TALK), which is a 24/7-crisis line for anyone including veterans and Spanish speakers who may be thinking about suicide.
How can pastors be helpful – and what should they do – in the unfortunate aftermath of a suicide in their community?
Following a suicide, it’s important to be concerned about suicide contagion, which can result in copycat suicides. These copycat suicides occur most often among vulnerable people, like adolescents and young adults (because they tend to gather in small, intense social networks), or among others who may be already inclined toward suicide or are suggestible. What is most important in preventing suicide contagion is being attentive to how suicide is being talked about. Preventing Suicide provides a number of recommendations for how to talk about suicide including not describing location or method.
What should youth pastors be aware of?
Upstream, youth pastors can help young people develop reasons to live and assemble their reasons to live in a Hope Kit, which can be a shoebox or a memo in a phone. Youth pastors should be aware that about half of youth suicides involve alcohol intoxication and that suicidality in young people is often related to relationship difficulties. Problems with parents play an important role in suicidal behavior in younger adolescents and romantic difficulties among older adolescents. So helping young people build stable relationships is important. Downstream, it’s important to understand that suicide is a life-and-death issue and life-and-death issues supersede any promises to confidentiality. Following a suicide, suicide contagion ought also to be a concern as noted above.
What’s the single most important thing a pastor should know about suicide and/or suicide prevention?
The National Suicide Prevention Lifeline (1-800-273-TALK) is one of the most important resources. Veterans, Spanish speakers, indeed anyone can call this number 24/7 to get help. Another very important resource would be the mental health treatment resources in your community because suicidal thinking typically occurs in the context of a mental health problem.
Where can a person go to find more information on suicide prevention?
In addition to Preventing Suicide: a Handbook for pastors, chaplains and pastoral counselors, I would recommend several good survey books about suicide: Kay Redfield Jamison’s Night falls fast: Understanding suicide (New York, NY: Vingage, 1999) and Thomas Joiner’s Why people die by suicide (Cambridge, MA: Harvard University Press, 2005). Some excellent books from a Christian perspective include Lloyd and Gwen Carr’s Fierce goodbye: living in the shadow of suicide (Harrisonburg, VA: Herald Press, 2004), Dave Biebel and Suzanne Foster’s Finding your way after the suicide of someone you love (Grand Rapids, MI: Zondervan, 2005), Al Hsu’s Grieving a suicide: a loved one’s search for comfort, answers & hope (Downer’s Grove, IL: InterVarsity Press, 2002), and Kathryn Green-McCreight’s Darkness is my only companion: a Christian response to mental illness (Grand Rapids, MI: Brazos Press, 2006). Several other good resources include the Suicide Prevention Resource Center (www.sprc.org), the American Foundation for Suicide Prevention (www.afsp.org), the American Association of Suicidology (www.suicidology.org) and the National Suicide Prevention Lifeline (www.suicidepreventionlifeline.org).
For more conversation on Preventing Suicide – and to read the first chapter – visit the Patheos Book Club here.