Kevin Graham was living in a world of nothing but possibilities.
An ROTC cadet training to be an Army doctor, he had a close, loving family and a bright future, according to his father, retired Maj. Gen. Mark Graham.
But Kevin Graham was also depressed, and no one knew the depths of that sadness. He saw doctors, and called his mom once to ask, “Did you know depression is an illness and not just a sad feeling?”
He also told her that he felt like his brain just did not work any more.
“We knew he was struggling, but we didn’t know the warning signs,” Mark Graham said during a September conference call with reporters.
And then one day in 2003, the family got the call. Kevin had killed himself.
“The world as we knew it ended in one call,” Graham said.
Kevin Graham was one of more than 31,000 people who took their own lives in 2003. That year’s suicide rate of 10.8 people per 100,000 is consistent with a longstanding, stubborn pattern. Every year, more than 36,000 people in the United States commit suicide — more than 100 per day — and for every person who dies, more than 30 people make an attempt. Suicide is the 10th leading cause of death in the U.S.
In an attempt to bring the rate down, the National Action Alliance for Suicide Prevention, a group created by Health and Human Services Secretary Kathleen Sebelius and former Defense Secretary Robert Gates, released a new national strategy for suicide prevention on Sept. 10.
“We know these are preventable deaths,” Sebelius said at a Sept. 10, Washington, D.C., event to unveil the strategy and talk about the path forward.
The 2012 National Strategy for Suicide Prevention has 13 goals and 60 objectives for reducing suicide over the next 10 years.
Goals include integrating and coordinating suicide prevention activities across multiple sectors and settings — including workplaces, schools, health provider offices and faith-based organizations — and developing effective programs that promote wellness and prevent suicide.
Broadly, the strategy seeks changes in the ways Americans think about and address suicide.
The Action Alliance highlighted four priorities to reduce the number of suicides: integrating suicide prevention into health care policies, encouraging change in health care systems with a goal of preventing suicide, changing the way the public talks about suicide and suicide prevention, and improving the quality of data on suicidal behaviors.
As part of the strategy, Sebelius announced $55.6 million in new grants for national, state, tribal, campus and community suicide prevention programs. The grants are available under the Garrett Lee Smith Memorial Act, named for former Sen. Gordon Smith’s son, who committed suicide in 2003, and are funded in part by the Affordable Care Act’s Prevention and Public Health Fund.
Gordon Smith, who co-chairs the National Action Alliance for Suicide Prevention, said the new strategy has the potential to save 20,000 lives in the next five years.
“This is something we can do something about,” he said. “The worth of souls is great, and I ask people to join us in this. It is the work of angels.”
The Affordable Care Act also has a role to play in suicide prevention. The health reform law will extend insurance options to many of the 6 million to 10 million people who are believed to have untreated mental health disorders, including depression. It also forbids insurance companies from denying coverage to people with pre-existing conditions. Those conditions have, in the past, made it difficult for those with mental health disorders to find and keep coverage, said Pamela Hyde, JD, administrator of the Substance Abuse and Mental Health Services Administration.
The Centers for Medicare and Medicaid Services also has new standards that doctors will have to meet under the Affordable Care Act. People with major depressive disorder will be given suicide risk assessments. And people on Medicare will be given annual screenings for depression, as older Americans have the highest rate of death by suicide, Sebelius said.
But beyond governmental efforts, some private companies are also making an effort to help those at risk of suicide.
In 2011, social media behemoth Facebook created a service that allows people to report a suicidal comment posted by a friend to Facebook. The person who posted the suicidal comment then receives an email encouraging her or him to call the National Suicide Prevention Lifeline at 1-800-273-8255 or to click on a link to being a confidential chat session with a crisis worker.
HHS Secretary Kathleen Sebelius discusses the new suicide prevention strategy during a Washington, D.C., press event.
Photo by Mark Wilson, courtesy Getty Images
“Every day on Facebook, people share millions of joyous moments,” said Marne Levine, Facebook’s global vice president for public policy, who also spoke at the event announcing the new national strategy. “These are the happy moments of life. But life, unfortunately, is not always filled with happy moments. Sometimes people turn to social networks in their most vulnerable moments.”
The service is useful, she said, because sometimes people in crisis do not know how, or who, to ask for help.
“By enabling connection to trained and caring professionals around the world, we can do our part to let users know help is available,” she said.
The last decade has seen a jump in the number of suicides by members of the armed forces, so the Veterans Administration is also participating in efforts to lower those numbers.
Graham said his son Kevin had been on medication for his depression, but he stopped taking his medication because he did not want the Army to know about his illness. Graham said stigma about mental health issues is still strong in the Army, and VA Deputy Secretary W. Scott Gould agreed.
The VA’s crisis line has received more than 655,000 calls since its inception in 2007, Gould said, and has rescued more than 23,000 callers from potential suicide. Gould told the story of a mother who was living several states away from her service member son, a veteran who was having difficulty adjusting to his post-war life. She called the crisis line and said her son needed help, and crisis line workers were able to get people in their network to go see the man.
“Today he is alive and in active recovery at the VA,” Gould said. “But the costs of war are going to continue to rise, and we’re going to need to provide more mental health care. We still miss many opportunities.”
As part of the effort, the VA has created a new public service announcement, a video called Stand By Them. The video provides information about how to recognize a person in danger and who to contact.
“The goal is to have people be able to recognize that something is wrong and know what to do with that insight,” Gould said.
In March, the VA wrote and funded a supplement to APHA’s American Journal of Public Health that looked at the issue of veteran suicide. One study examined the implementation and utilization of the crisis line for veterans and found that the veterans were using the line and accepting follow-up referrals.
For more information on the 2012 National Suicide Prevention Strategy, visit www.samhsa.gov/prevention/suicide.aspx.
- Copyright The Nation’s Health, American Public Health Association
