The US Centers for Disease Control and Prevention define suicide as “Death caused by self-directed injurious behavior with any intent to die” (HHSOSG & NAASP, 2012, p. 14). It is a major health problem in the United States, where the rates of death by suicide have been increasing steadily over the last decade (Curtin, Warner, & Hedegaard, 2016). According to the information provided by the National Institute of Mental Health, there are over 41 000 deaths from suicide each year in America, which is twice the number of deaths by homicide (NIMH, 2015, p. 1). This research aims to propose a program for suicide prevention in Baltimore, MD, as well as a scheme for its evaluation. The paper also provides an overview of local statistics and risk factors that have to be addressed in order for the program to be effective.
Baltimore, MD Statistics
Whereas the national suicide rate is around 12.5, Maryland ranks 46th on the list of states with highest suicide rates with a score of 9.08 (The Baltimore Sun, 2015, para. 4). Nevertheless, there is a concern about the rise of suicides in the recent years: it is the top 11th death cause in the state (The Baltimore Sun, 2015, para. 4-5), with 6.7% rate increase between 2013 and 2014 (Hogan, Rutherford, Mitchell, & DHMH, 2014, p. 5). There is no significant difference between suicide statistics in Maryland and Baltimore, MD (Hogan et al., 2014, p. 53). Out of the 593 deaths by suicide in 2014, 457 victims were male, 363 of which white and non-Hispanic (Hogan et al., 2014, p. 157). There were 93 black victims, and 20 of them were females (Hogan et al., 2014, p. 157). In young people aged 15 to 24 and 25 to 44, suicide was the third and fourth leading cause of death respectively; however, it was not among the top eight causes of death in older adults (Hogan et al., 2014, p. 157). Out of the five areas of Maryland, Baltimore Metro Area accounted for the majority of suicide deaths among adolescents aged 10 to 19, as well as among adults – 303 out of 539 suicides in Maryland occurred in this area, with 151 located either in Baltimore City or in Baltimore Co (Hogan et al., 2014, pp. 165, 184).
Addressing the Risk Factors
Clearly, there are certain risk factors – both demographic and personal – that have to be taken into account when developing an intervention program. For instance, evidence suggests that women are more likely to contemplate and attempt suicide, but are far less likely to die as a result of a suicide attempt (HHSOSG & NAASP, 2012, p. 18). This is primarily because men are more inclined to use firearms to end their lives, whereas women often opt for drug poisoning (HHSOSG & NAASP, 2012, p. 18). Other demographic factors affecting suicide rates are race – the greatest number of suicide deaths occur in the white U.S. population (HHSOSG & NAASP, 2012, p. 26) – and age – among the causes of death, suicide ranks higher in adolescents than in adults (Goldston et al., 2010, p. 246).
Some research suggests that bullying is one of the factors that can trigger suicide, which is why the rise of cyber-bullying in the past years has caused an increase in the number of young girls committing suicide (Curtin et al., 2016, p. 1). Gender identification and sexual orientation can also become risk factors for suicide: “Across studies, 12 to 19 percent of LGB adults report making a suicide attempt, compared with less than 5 percent of all U.S. adults; and at least 30 percent of LGB adolescents report attempts, compared with 8 to 10 percent of all adolescents” (HHSOSG & NAASP, 2012, p. 121). The National Transgender Discrimination Survey shows over 41% of transgender respondents have attempted suicide at some point in their life (HHSOSG & NAASP, 2012, p. 122). Personal risk factors indicated by NIMH (2015) include mental disorders, such as depression and anxiety, substance abuse, family history of suicide, family violence, including intimate partner violence, and owning firearms (p. 1).
To this day, the majority of programs for suicide prevention have attempted to address certain populations that are considered to have a higher risk of suicidal behavior – for instance, by implementing anti-bullying programs and policies in schools and by training mental health providers on the specific needs of LGBT patients (HHSOSG & NAASP, 2012, pp. 40, 47). However, it has been noted that in order to reach the entire community, a reasonable program for suicide prevention should target the population as well as the individuals that are at a more significant risk of suicidal behavior (HHSOSG & NAASP, 2012, p. 40).
Suicide Prevention Program for Baltimore, MD
Thus, the proposed local program for suicide prevention should encompass all segments of the community, including families, workplaces, and offices, as well as schools and colleges. Overall, the primary goals of the proposed program are to promote connectedness, raise awareness, and provide qualified support to those who need it.
Families
Promoting social gatherings and communication between the families of the local community (e.g. by organizing various local events and festivals) would help to raise connectedness across the entire area. Fundraising events could be highly beneficial as they encourage positivity and feeling of self-worth; moreover, they can be used to spread information about local suicide prevention centers, hotlines, and other means of support. Providing free short courses for parents who are struggling to maintain a warm and understanding relationship with their children could also inspire a healthy interaction within the families. Forster families and the parents of LGBT youths should be targeted through separate courses and training, as these categories of children are far more prone to suicidal thoughts and behavior (HHSOSG & NAASP, 2012, p. 20).
Workplaces
Introducing psychological wellness programs in workplaces would result in an immediate decrease in suicidal behavior among employees, as it would help to “affirm the value, dignity, and importance of each person”, which is a crucial step to suicide prevention (HHSOSG & NAASP, 2012, p. 97). Including psychological education and counseling as part of employee benefit plan will also have long-term effects, such as decreased levels of stress and depression with the help of timely treatment. To promote these activities, local government could hire several qualified specialists to provide educational and therapy services to the employees of local businesses.
Schools and Colleges
One of the main steps in ensuring a safer school and college environment is to train teachers and staff to recognize the hidden signs of risk factors, such as bullying, family violence, drug abuse, and eating disorders, in their students and to ensure that the student receives support, even if he or she refuses to speak to the school or campus counselor (Goldston et al., 2010, p. 247). Introducing anonymous online services to report bullying and harassment would help to identify students who pose a risk to the safety of the student community and affect the psychological wellbeing of others. The immediate effect of such practice would be the decrease in bullying, which will eventually lead to a decrease in suicide rates among students: recent research suggests that students involved in bullying in any way are at increased risk of depression and suicidal thoughts (CDC, 2014, p. 5).
Evaluation
To monitor and evaluate the program, it would be necessary to establish a local coordinator and a scheme of follow-up surveys and statistical analyses that would reflect the progress or lack thereof. It is also important to notify the people of the local community about the program to draw their attention to the issue and its importance, which would encourage people to participate in future surveys and local events. Short surveys with multiple-choice questions that are focused on the issues of depression, stress, and suicidal behavior would be useful in evaluating the effect of the program. The results of the comparison drawn between pre- and post-program answers should be supported by death statistics, which is a more objective source of information. A combination of the two would evaluate both the attitudes of the people towards the program and the actual results, providing a clear evaluation of the program’s effectiveness.
Conclusion
Overall, a successful local suicide prevention program is built both on the previous research and on the past experience of suicide prevention, such as the 2012 National Strategy for Suicide Prevention and The Garrett Lee Smith Memorial Suicide Prevention Program. Both of these strategies emphasize the importance of a well-rounded approach that would tackle all the different sectors of people’s lives to decrease the prevalence of suicide on a national level (HHSOSG & NAASP, 2012, pp. 39-40). Developing connectedness, raising awareness and encouraging supportive behavior, as well as introducing qualified psychological training and counseling would be an example of such approach that could benefit the people of Baltimore, MD.
References
Centers for Disease Control and Prevention (2014). The Relationship Between Bullying and Suicide: What We Know and What it Means for Schools. Web.
Curtin, S. C., Warner, M., & Hedegaard, H. (2016) Increase in suicide in the United States, 1999–2014. NCHS Data Brief, 241(1), 1-8.
Goldston, D. B., Walrath, C. M., McKeon, R., Puddy, R. W., Lubell, K. M., Potter, L. B., & Rodi, M. S. (2010). The Garrett Lee Smith Memorial Suicide Prevention Program. Suicide and Life-Threatening Behavior, 40(3), 245-256.
Hogan, L., Rutherford, B., Mitchell, V., & Dept. of Health and Mental Hygiene (2014). Maryland Vital Statistics Annual Report. Web.
National Institute of Mental Health (2015). Suicide in America: Frequently asked questions. U. S. Department of Health and Human Services Publications. Web.
The unseen epidemic. (2015) The Baltimore Sun. Web.
U.S. Department of Health and Human Services (HHS) Office of the Surgeon General and National Action Alliance for Suicide Prevention (2012). 2012 National Strategy for Suicide Prevention: Goals and Objectives for Action. Web.