At Week's End; 625; AWE #625 Teen Suicide

Can you hear the connection? You walk out now, stand by the loose lake, and let's do the slaves. Let's go anyone. Anyone's hot. Stand by the losing the box. Stand by the fading music. Fade music. And cue Raj. The United States loses 50 ,000 teenagers to suicide every year. In New Mexico, suicide is the second leading cause of death for our youth. On this program, we'll try to gain some understanding of what is an often hidden yet gray problem. But we begin our program with a quick look at some of the main headlines around the state with Mary Kate Mendoza. In a celebration of survival, the Albuquerque community, many of whom were women, marched on the streets this week,

demanding their right to take back the night, referring to themselves as survivors, not victims, they marched in protest of sexual assault, abuse, harassment, and discrimination. Their goal, they say, is to raise community awareness about these issues and to fight the fear of violence. President Clinton was in New Mexico touring the state's national laboratories. Although he reassured lab employees that proper training and jobs would be provided for the transition into peacetime pursuits, he failed to offer any specific plan. Shoshone leader Clifford Dan was sentenced this Monday. He was arrested and allegedly beaten last November by federal agents. Monday, he received two years and nine months probation and was fined $5 ,000. Meanwhile, across the nation and New Mexico, protesters gathered in support of Dan, and also called for an end to environmental racism, and asked the U .S. government respect Native American treaties and their freedom of religion. The group will also be appealing, Dan's case. Advocates of New Mexico say that they

are not dead yet. The group is organizing itself under the name New Mexico Healthcare for All, and is seeking healthcare coverage under what's called a single payer system. President Clinton has proposed a system of managed competition so far. A positive drug test alone doesn't constitute drug possession. That's the ruling of the States of Peel's Court. The three judge panel decided six cocaine possession appeals from Curry, Lee and Roosevelt counties this week. The court consolidated the appeals into a single case, citing a State Supreme Court definition that says possession occurs when something is on a person. The court says the presence of drugs in the urine or bloodstream doesn't constitute possession. Disney film crews were in Navajo, New Mexico this week filming a Navajo Pine High School teacher, Paulina Watchman. She was chosen as one of 60 teachers out of 3 ,000 candidates to be featured in a Disney program that will be broadcast next year. That's this week's news around the state. It's truly a life and death issue. It cuts across all age, sex, race,

and class barriers. It's a problem that cuts to the very core of human life. The issue is suicide. And it's killing New Mexico's teenagers at twice the national rate. Most affected are on any of American communities, dying at nearly three times the national average. Are we taking this issue seriously or is it so complex, mysterious, painful that all too often we choose to look the other way out of sight, out of mind? But how long will we look the other way as those who are only beginning their lives decide so tragically to end them? How long can we turn a blind eye to such a deadly issue? Join us for a compelling discussion about this very, very grave topic. And now we hear from some of those people who have survived this experience and lived to tell about it. The thoughts that ran through my head were not

feeling loved by people that I gave everything to. It felt like it was just the one way thing and that I was just giving all of my love to people and I was never getting it back. And I felt alone, very alone, and that was to me at that time the worst thing anybody could be. I would try to talk to a lot of people. But it seemed like no one really cared or no one seemed to listen or no one seemed to really understand how I felt. Plus I was younger so I thought everything I felt, no one had ever felt before. My mom would tell me, go make friends, go out and just have one friend and me. And as she said, go out and meet people and do things with other people. And I said, well, who's going to want to hang around someone who's always suppressed and talking about their pain all the time? Because that's all seemed to be able to talk about because that's all I knew.

I felt like I would be a burden to people if I talk to them or hang out with them or whatever. So I just withdrew from everybody. I felt like life had its own plans for me and I didn't quite agree with it. So it's kind of clashed. I didn't like what life was doing to me. I finally, it was one day I went to school and it was an awful, awful day. And I finally just realized that I didn't have to be in this pain anymore. And it seemed like the only way to stop the pain was to just take my life. Once I finally realized that I could do something about it, I took fast means to do so. My room was pitch black and I woke up and I wasn't quite sure where I was. I was like, where am I? Am I dead or what? And I liked around and noticed I was in my room and I just totally felt so awful. I felt

why didn't it work? And so I got up and I couldn't walk very well. So I was really weak. I didn't want to be alive. So I felt guilty every time someone would call and tell me how much they loved me and how much they cared about me and how they would be so upset if I had actually succeeded. Things seem to be so overwhelming. We've got school, we've got, I mean everything, it seems like the world is just collapsing on them and that there's no way to turn it around. And if life is going to be like this for them for the rest of their life, they don't want to deal with that. So I think that could be part of the reason why teens will tend to take their lives. I believed in myself that I would never try it, you know, maybe thinking about it was one thing but I would never try it. And that's just what I always thought about myself, that I was the kind of person that would try anything like

that. And I've known people who have tried it and been disabled for life because of it. And they'll never be the same again because of it. And they wish that they could be healthy and those normal lives, normal life, like everyone else. I think, and I know exactly what it feels like. And now I'm living a happy, really happy life. And I want people, I guess, to kind of look and know that this can be them someday or, you know. And I'm sure bad times will come for me again, but now I'll know that things will work out to be the best that they can be. I'm just happy to be here. It was a surprise to me in that I knew my son was ill, but

I didn't know that he was that sick. He was working with a doctor at the Indian Hospital in Gallup. And the doctor, as in those days, did not include the family in the healing process. So we really didn't know the doctor start working and really helped him. But when he went on vacation, he did not take his medication and the voices came back. I didn't realize that these voices were that self -destructive. I really did not understand. I knew he was ill, but he was so normal and so many other ways. When it happened, I was totally devastated. Our whole family had to deal with all of the pain. And for seven years, I didn't deal with it very well. I tried everything to escape from the pain. And then, seven years ago, I decided it was time.

I got off tranquilizers. I stopped working my program. And I started using every support system I possibly could. I really believe, unless you work through grief, truly work through it as painful as it is, you can never, never deal with living. We really had to deal with the stigma of suicide. And also, the tragedy of realizing that our older son also had the same type of mental illness. We tried to do what we could for Robert. He too became suicidal. And it was very scary. And it was really a time, a real time of pain and suffering. He went back up to the state of Washington and worked for a while. And he himself got off medication, got very sick. And he tried a couple times, very serious attempts. I did a lot of things to, say,

to come out of the closet about mental illness. I still was not ready to deal with a suicide factor. I didn't share with many people how my son died. And I'm sure people knew. But I wasn't, you know, I really wasn't ready. This is the first time that I have felt comfortable to come out and really say my son took his life. When I heard or read of other families what they went through, that gave me courage to say, this is what happened to me. I'm taking a chance. I'm living again. I guess that's it. You're taking, you're overcoming whatever. And not wasting the pain you've been through. I realize how sensitive the topic of suicide is. And I know that mental illness has always been a sensitive. But unless we talk about it and share our pain and minister to

the people who need it, it's just going to take over. And I'm not going to allow that. I'm not going to allow it in my family and I won't. That's a life and death issue. Untreated. Any kind of mental illness untreated or substance abuse usually ends up either through someone committing suicide. Our Indian people, our reservation, our dying, our young people, our dying of suicide from perhaps the mental illness that is treated with a substance. Many, many people treat depression with alcohol. And they have to understand and be educated number one. As my Indian people, what is serious mental illness? I believe that the mentally ill can sometimes be totally healed. More than that, the majority of

them with the proper care, medications as, for instance, my son can come full circle back to a normal healthy life. Warning signs to look out for, a change in appetite, sleeping patterns, persistent or strong feelings of depression, moodiness, withdrawing, hopelessness, an inability to concentrate, alcohol or substance abuse, cleaning house or giving away of special possessions, a recent loss in the person's life. Joining me now are three gentlemen who are trying to grapple with this epidemic problem. Jeff Rebels is a suicide survivor. He's now an advocate and president of the Depressive and Manic Depressive Association of Albuquerque. Dr. Kim Smith of Albuquerque is a clinical psychologist. He's on the board of the American Association of Suicideology. He has done extensive research on the difference between attemptors and completers of suicide. And Jim Perings is Program Director of the

Suicide Crisis Emergency Telephone Service at the University of New Mexico Hospital here in Albuquerque. Welcome to all of you. We had hope to have some representatives of the Native American community in New Mexico, unfortunately they couldn't be with us. But we want to shed some light if we can on this terrible issue. First gentleman, I wanted to spell some of the common myths if we may about suicide. People who talk about it don't really do it. False, they do. People who attempt aren't really serious just doing it for attention. No, that's false too. When someone has been depressed and then begins to feel much better, they are better. Not always, as we know, tragically. Talking with someone about their suicidal feelings may encourage them to do it. No, in fact, talking may help. And finally, women who overdose are the most common suicides. No, men out, number women, three to one in completing suicide and 60 % of them use guns. Jeff Rebels, are we dealing with this as the

epidemic, the pandemic that it is in American life? No, we aren't. When it comes to depression, only one third of the people that have depression get any help at all about it. So there's two thirds of the people that have depression that are not being treated. Is that simply a huge crevice, a canyon in our medical system? Yeah. Major depression is often called the common cold psychiatric illnesses because it is so common. Recently, there was an AMA study that documented the rise in depression due to the complexity of our living. It was about 5 % in 1900. Now it's up to 15 % or 20 % of the population. You've got a lot more depressed people out there and therefore a lot more suicides. Dr. Smith, are we talking here about a mental health phenomenon? Is it a clinical phenomenon or is it also very much a social and economic and cultural phenomenon in America? It is certainly both, but good research shows that most people who commit suicide

have diagnosable mental illness. The problem is that a lot of people feel that because of the complexities of their lives, because of how much pressure it takes now to live a comfortable life, because how much advertising sets up images for us to be successful in certain ways, it requires tremendous amount of aspirations from people and expectations, and it is the high expectations and the failure to meet those and disappointments that are one crucial factor that culturally is being added to the mix at this point. So we're literally pushing people to such a level that disappointment means a great crash. Jim Perings, are there really services out there? Can you distinguish in your work and the emergency telephone service between just the ordinary crises of everyday life that we all have and the life and death crisis that we're talking about here? I think

in general, suicide crisis lines such as the service that the university has are fairly widespread. Most major communities have a hotline structure set out trying to address these problems. In Mexico and throughout the country, both, they're fairly standard at this point. On our service, we take about 600 calls a month on that. 600 a month. Roughly. Probably 12 to 15 % of those are people who are talking about suicide. The bigger majority, 60 to 70 % are people going through other kinds of family or lifestyle, kinds of pressure problems such that Dr. Smith was referring to. Is there a fairly simple way that a layman can tell the difference between a small crisis and a major one? I think in terms of a layman, one of the things that I'm not sure was mentioned earlier in terms of warning signs, is when somebody begins to talk about suicide, if they verbalize or wishes to die, they wish to die, or they're feelings that they don't want to be around anymore, they're tired and they don't want to wake up, that's one of the first and probably most

important warning signs to look at. To think about, and that's the time to talk with a person and really listen and try and get a sense of what's going on with the individual. And that's something that families can do, friends can do. Jeff Rebels is New Mexico taking this issue seriously in terms of the resources we're devoting. Jim Perings talks about the service we have at UNM, but is this become the kind of public health priority that it ought to be given our statistics? We lead the nation. I would say not, given the statistics with the Indian population, that really is appalling. So many, I think there was an article in the paper yesterday that Indians are very lucky if they live over 35, that is as horrible. So we're foreshortening a whole population here. Dr. Smith is mental illness as a component of suicide taken that seriously in New Mexico. Are we treating our mental illness epidemic in this state?

You're going to get an opinion about this and I feel very strongly about it, and that is that we don't have good mental health services in this state. We have a number of people who are poorly trained. We have a number of people who don't know how to do verbal psychotherapies, but instead wish to give medications or wish to hospitalize somebody when they start talking about suicide. And while those can be prophylactic, those can help. It's very important to have a verbal psychotherapy that accompanies those kinds of important adjuncts. And it's important to see good qualified people who know how to interact. Jim Perry, it's much more than just medication, isn't it? It really is involving the patient, the person in their own recovery. Oftentimes depression is probably the leading or the contributing factor towards someone taking their life. I think what Dr. Smith is making reference to is what's going on in the person's life

that's gotten them to the point where depression is a major issue for them. And I think if you can go back and help a client or a patient deal with some of those issues and strengthen those areas, you're gaining much more. Jeff, do we need to hear more from the people who are suffering here from the patient? Yes. In my own case, I had four major depressions. And in my fourth major depression, I knew what I was in for. I was going back to a psychotherapist or a psychologist or a psychiatrist that I couldn't relate to, that couldn't relate to me. Getting on medications that sometimes with the medications, it takes a number of them before you find one that really works. And that's hard to get through. Being able to look at one's life, as Dr. Smith was saying, the psychotherapy is just about as important as the medication. So you really have to look at what's going on inside and work through a lot of the issues that we grow up with. Do you experiment with different medications?

I mean, is this a process of somewhat of trial and error? I take it for some people it is. It wasn't the past. It's getting a little bit clearer now because they've had enough studies to know that if you have an agitated depression, then you should take something that will lift the mood. If you have a typical depression, it's kind of an agitated depression. It's not where you sleep too much. But a typical one is where you sleep too much, then you need a different kind of medication. They're also finding that lithium works very well with some patients. Do we respond, Dr. Smith, in our institutions? Schools have a role here, obviously, for these young people who are dying in such alarming numbers. Do our institutions become or should they become more sensitive to the warning signs? We're talking about clinical people and family members, but everybody's has this responsibility, don't they? Nationwide, right now, there's a big movement to have programs in the schools that help educate students about what

it means to be depressed. And in particular, that being depressed is a common human phenomena. Being clinically depressed happens to maybe 30 to 40 % of the population. One of the things that we find that is alarming when you first hear the statistic, but our best research shows that about 8 to 10 % of kids by the time they're senior in high school have made one or more attempts. Most of them are not deadly serious. Most of them are expressing a kind of self -contempt, a self -hate. People have a sense that they don't really want to go all the way. But nevertheless, it is a behavior that expresses a lot of depression. But that's a shattering statistic. Let me ask you, Jim Perings, is there really hope here? Are we beginning to lift the stigma that's attached so long to suicide and to attempts at suicide? And is it really treatable? Can we make a difference if we do some of the things that have been suggested here? I think it's very treatable, but I think it's also an

uphill battle to get past the stigma of suicide and mental health care in general. One of the functions of a crisis -linel service, an anonymous place to initially try a step towards mental health care. If someone can call a crisis line and have a good experience here, it makes it much easier for them to take another step and actually see a counselor from that point. I think there is a great deal of stigma still involved. I think that's one of the things that education and public awareness can certainly work towards diminishing. And I think that needs to happen. Jeff, Rebels, do we need to appeal to the patients themselves to come out of the closet as it were and to get this help? Do they have to become more involved in this process? Yeah, you can really only deal with what's going on when you've decided to do it. A lot of people will self -medicate with drugs and alcohol. Some people will reach out in anger to family members and not know what's going on. Once a person has gotten into a mental health

service, as Dr. Smith was saying, sometimes that they care there is not the best. That's where support groups really come in, is the person needs to be able to talk to people that have been there and get a feel of where they're going and get some hope that they can get out the other side. Well, you're a living proof that this can be healed. These support groups are alternatives, aren't they? To the conventional medical system, as we think of it, you don't just go to a clinic, you need your family, you need your friends, you need the community involved. Dr. Smith, let me ask you, does the medical profession and the deliverers of health care, and I'm talking about not only doctors, but psychologists, psychiatrists, are they taking this epidemic seriously enough? No, they don't. One of the things I'm going to task for is for the American Association of Suicideology that is trying to get into medical schools and psychiatry residency training programs, so that they can offer programs in psychology, social work training programs to begin a systematic teaching about crisis intervention,

which is not done in most residency, psychiatric residency training programs or graduate programs in psychology. And to teach them something about what can be done for suicide, and in particular that even though the act itself looks the same, somebody does something to themselves intentionally that causes their death or hurts them deeply. The path up to that is very idiosyncratic, and you cannot make blanket assumptions about what's going on. So there are new studies there, person very carefully. So to answer your question, no, they're not, but they're beginning to. Jim Perring, just a few seconds left. If you could recommend one or two things for New Mexico to do now, what would they be? What important steps? One, I think, is public education at a number of levels in elementary schools and high schools, et cetera. I think the point that Dr. Smith is making is very valid in order to address the problem of the people who are working with it need to be properly trained and have good solid information about how to deal with people. One of the, I think, the whole area of suicide is something that's come about really in the last interview. I mean, suicide has been with us for

many years, but the knowledge about it. So we need to learn and to listen to one another in this. Thank you very much, gentlemen. Jeff Rebels and Dr. Kim Smith and Jim Perring, and good luck to all of you. And for a week's end, I'm Roger Morris. If you are in need of the services of the Suicide Hotline call 265 -7557, if you are anyone you know may be interested in joining a support group regarding mental health issues, you can call the Depressive and Manic Depressive Disorders Association at 857 -3778 or the Alliance for the Mentally Ill at 262 -1602 or Survivors of Suicide at 845 -987. Thank you very much.

For a cassette copy of this at Weeksend Program, send $35, which includes shipping and handling to KNME TV, 1200 University Boulevard Northeast, Albuquerque, New Mexico, 87102, or call 1 -800 -328 -563. Thank you very much.