Social worker Chris Gilchrist is passionate about raising awareness and lifting the stigma surrounding depression and suicide.
She organizes the Out of the Darkness Community Walk in her hometown in Hampton Roads, Va.
The annual event, which offers awareness, support, remembrance and education for those affected by depression and suicide, has grown to be one of the largest in the U.S., she said. There are about 300 walks across the nation each year.
While suicide can be a confusing and heart-wrenching topic for those affected by it, there are facts that need greater understanding, said Gilchrist, who is a member of the American Association of Suicidology and a therapist working with individuals and families with bereavement or other life issues.
“Ninety percent of all people who die by suicide have a diagnosable psychiatric disorder at the time of their death,” she said. “The primary cause is untreated depression. Depression is a disease that is treatable.”
Gilchrist has been organizing the community walk, now in its ninth year, with the support of the Hampton Roads Survivor Support Group, in partnership with the national American Foundation for Suicide Prevention.
“Every walk has a sad part, but also an uplifting part with hope that we can make a difference,” she said. “If the No. 1 cause of suicide is depression, the walks make a difference by educating people about the symptoms of depression.”
A prioritized research agenda
While Gilchrist is an example of the many social workers who work to raise awareness and understanding of depression and suicide in their communities, social workers in federal agencies are part of a network striving to reduce the nation’s suicide rate on a macro level.
Suicide may appear to be a private problem, but it is a public concern that has inspired a newly designed approach initiated by the National Action Alliance for Suicide Prevention.
Started in 2010 as a first-of-its-kind public-private partnership, the Action Alliance works to explore opportunities for and barriers to progress in reducing suicide rates.
More can be found at Action Alliance for Suicide Prevention.
Despite increased efforts to raise suicide awareness and lower suicide rates in the past 50 years, U.S. suicide deaths have not decreased. In 2010, there were more than 650,000 hospital visits related to suicide attempts and more than 38,000 people died by suicide, the Action Alliance states.
In 2012, an Action Alliance task force, co-led by the U.S. Surgeon General, updated the U.S. National Strategy for Suicide Prevention. Among its goals was the need for a prioritized research strategy that would more rapidly reduce suicide.
From that effort, the Research Prioritized Task Force of the Action Alliance released in February “A Prioritized Research Agenda for Suicide Prevention: An Action Plan to Save Lives.”
It outlines ways to reduce suicide attempts and suicide deaths by at least 20 percent in five years and 40 percent or greater in 10 years. The goal is in line with saving 20,000 lives in five years.
In order to reach that objective, the alliance stresses that key stakeholders in the suicide prevention field — clinicians, researchers and leaders, as well as survivors of suicide loss, suicide attempt survivors and their support systems — are needed to consider the policies necessary to support suicide prevention, including implementation research on effective psychosocial interventions and changes to health services that appear promising.
To determine research priorities, members of the task force collected input from more than 700 individuals from 48 states and territories and 18 countries.
Several social workers from the National Institute of Mental Health who serve on the task force assisted in developing and reviewing the research agenda. They also served as liaisons to other task forces and worked with stakeholders during the process.
One of these social workers is Kathleen O’Leary, chief of the Women’s Program in the Office for Research on Disparities and Global Mental Health at the National Institute of Mental Health.
Having social workers on the task force was beneficial, she said, because they are trained in facilitating community projects and promoting communication and understanding among different groups — in this case, federal agencies, advocacy groups and private organizations.
“This is similar to the work caseworkers do,” she said. “I was able to inform groups about the efforts and resources of other groups.”
O’Leary encourages social workers to review “A Prioritized Research Agenda for Suicide Prevention: An Action Plan to Save Lives,” and its companion document summarizing the research needed, “Suicide Research Prioritization Plan of Action.”
They are available for free download at Action Alliance for Suicide Prevention: Research Prioritization Task Force
O’Leary said social workers can help enhance and promote the action agenda by sharing their experiences, input and research, as well as more data about patient experience with suicide prevention efforts.
“This may help guide the research effort to move this out for bigger system testing, e.g., through the Patient-Centered Outcomes Research Institute,” O’Leary said.
The institute is authorized by Congress to conduct research to provide information about the best available evidence to help patients and their health care providers make more informed decisions.
O’Leary noted that a study just published in the Journal of Internal Medicine highlights possible missed opportunities for the detection of suicide risk. The study shows that of 6,000 individuals who died by suicide, nearly all received health care in the year prior to death. However, only 24 percent of them had a mental health diagnosis in the four-week period prior to death.
The study supports evidence that individuals are interactive with health agencies prior to suicide completion and that opportunities for suicide prevention exist in primary- and medical-care settings.
“All social workers should screen clients for suicidal risk, homicidal risk and domestic violence,” O’Leary said.
Social workers can raise awareness of these public health issues by requesting training for such screenings from their agency and professional societies, and they can participate in ongoing research and find out if their agency is tracking data.
The Research Agenda for Suicide Prevention identifies six key questions to help reduce the nation’s suicide rate. They are:
- Why do people become suicidal?
- How can we better or more optimally detect/predict risk?
- What interventions prevent individuals from engaging in suicidal behavior?
- What services are most effective for treating the suicidal person and preventing suicidal behavior?
- What other types of interventions (outside the health care settings) reduce suicide risk?
- What new and existing research infrastructure is needed to reduce suicidal behavior?
O’Leary said social workers can help the effort by sharing their research information, in particular relating to questions 2, 3 and 4.
“We need to know what interventions and services are most effective,” she said. “Social workers can offer us provider experience and in particular help us determine the best ways to target high-risk groups of suicide.”
“We need additional ways to overcome barriers to care, and social workers are skilled at doing outreach and patient intakes,” O’Leary said. “Social workers can also help care continuity, as some of the biggest risk periods (for suicide) are after discharge of hospitalization.”
Social workers interested in sharing their research may contact Jane Pearson, NIMH coordinator of the Research Task Force, at jpearson@mail.nih.gov
Walking out of the darkness
More than 4,500 registered participants made the Hampton Roads, Va., Out of the Darkness Walk the largest turnout for the fifth year in a row last year, said social worker and NASW member Chris Gilchrist, who organizes the annual event.
In addition to raising awareness about suicide and its prevention, the event provides support for those who wish to honor the loss of a loved one by offering them a place to post pictures on a memory wall, and the chance to have a loved one’s name read during the program.
The walk provides donations to the American Foundatoin for Suicide Prevention, where proceeds support suicide prevention through research, education and treatment plans, Gilchrist said.
She noted that there are 20 clinical licensed counselors at the walk to provide support, answer questions and hand out information.
The U.S. military has a strong presence in the Hampton Roads area. Gilchrist said since the walk’s fifth year, leaders from all five branches have taken part in the event.
It is especially important to have their presence in light of the increased number of active duty military and veterans who have completed suicide, she said.
This year’s walk takes place Sept. 6 at Mount Trashmore in Virginia Beach. Visit The American Foundation for Suicide Prevention to find a community walk in your area.
Visit NASW’s YouTube channel to hear an interview with social worker Chris Gilchrist and see photos of the Hampton Roads Out of the Darkness Community Walk.
The National Suicide Prevention Lifeline is 1-800-273-TALK.
Speaking of Suicide: Q & A with Stacey Freedenthal
Stacey Freedenthal is an associate professor at the University of Denver Graduate School of Social Work and a psychotherapist who wrote the suicide entry in the Encyclopedia of Social Work.
She maintains the blog/website, Speaking of Suicide, which provides information about many aspects of suicide and its prevention.
It is intended for people who consider suicide, family and friends, psychotherapists and other mental health professionals, survivors of suicide and suicide attempts, and anyone else who wants to learn more about the topic of suicide.
Q: What inspired you to start the blog?
A: I am a university professor and publish articles in academic journals that do not get read by ordinary people — the people who most need the information. So I wanted to get information directly to them in a place where they will actually see it. What better place than the Internet?
I want to reach people who are most affected by suicide — those who are tormented by suicidal thoughts, those who love and care about them, and those who lost a loved one to suicide — and, finally, the professionals who help all of those different folks.
Right now the website is averaging about 4,000 visitors a month, according to Google Analytics. This isn’t bad for its 10th month. I am hopeful that it will be able to reach more people the longer it’s out there.
Q: Have you received any feedback from your blog?
A: Yes, I have received feedback pretty consistently since I started it last May. Some of it is quite painful, some is quite hopeful, and some is a little of both.
As one example, a woman in Great Britain contacted me saying that she’d read many times throughout the night my post about it not being someone’s fault if they are suicidal.
She said that she cried every time she read it, because she blames herself for having attempted suicide. And she said that my post helped her to look at her suicidal thoughts and attempt in a different, more compassionate way so that she no longer blames herself.
THAT is really the reason I started the website. That is exactly the kind of message that I wanted to send and she received it exactly the way I hoped it would be received. It is my greatest hope that the website makes a difference in some people’s lives, perhaps even keeping some people from dying by suicide. So far, I’ve received feedback from a few people that one post or another did help them get through a very dangerous night.
I’ve also heard from other people who are affected by suicide. Recently the mother of a young woman who is suicidal said that she keeps re-reading the post I wrote about how loved ones are limited in what they can do to help a family member or friend who is suicidal.
That might sound like a depressing post, because I talk about how we can only do so much. But it helps people — and I think this can apply to professionals, too — to recognize that we are not superhuman. We cannot read people’s minds. We cannot predict the future. We cannot suicide-proof the world. Of course, we do what we can, but we need to recognize that if someone dies by suicide, assuming there was no outright negligence, it is not our fault. These sentiments gave this mother solace, because she was able to let go of some of the paralyzing anxieties she had that only made it harder to really listen and empathize with her daughter.