Alaska is consistently among states with the highest rate of suicide in the country, and suicide touches almost every Alaskan to one degree or another. Whether we experience it directly among family members, friends, neighbors or co-workers or we know someone who has experienced such a devastating loss, the ripple effect is profound. Suicide is an enduring issue and has been a major public health problem in Alaska.
This begs the question: how do we combat this significant and profound public health problem? First off, I want to express my gratitude for all the efforts Alaskans put into preventing suicide each and every day. We have made some great strides in raising awareness, including training of thousands of Alaskans across the state in suicide prevention. People are learning that it’s OK to ask someone if they are thinking about suicide, it is okay to talk about suicide, suicide is not a taboo subject, and that help is available.
In addition, more people are reaching out for help. In 2017, over 17,000 calls were received by Careline, Alaska’s statewide crisis “someone to talk to” call center at (877) 266-4357 (HELP) anytime, day or night. The service is free, confidential and anonymous. Public awareness efforts such as the American Foundation for Suicide Prevention’s Out of Darkness Walk have also experienced large turnouts in both urban and rural communities to remember the lives lost to suicide and those who carry on as survivors.
We are also seeing some movement at the national level. The National Strategy for Suicide Prevention has promoted a health care model called “Zero Suicide.” The “Zero” in the title is an aspirational goal to propel and encourage health care organizations to make suicide prevention a core component of their health care system. These efforts have demonstrated that reducing suicide is entirely possible and that is something to celebrate wholeheartedly.
If we wish to create a prioritized agenda, we must think and act “upstream” of suicide beyond the health care system to reach people within their communities. The title of the newly revised five-year Alaska Suicide Prevention Plan is “Recasting the Net.” Since the net was “cast” in 2012, the Statewide Suicide Prevention Council has been working tirelessly to emphasize that the “web of causality” (the factors that contribute to our understanding of what causes suicide), needs to be better understood if we expect to reduce and prevent suicide. It would be irresponsible to suggest that suicide has a single cause requiring a single solution.
We are learning more about Adverse Childhood Experiences (ACES) and how predictive early childhood trauma and abuse can be in determining increased risk of suicide as an adult. We are also learning more on how historical trauma and the profound effects of colonization among Alaska Native people have contributed to suicide in very distinct ways. And I would be remiss if I didn’t bring up the relationship between firearms and suicide which represent the majority of firearm deaths in the United States.
Unfortunately, we have yet to see the rates of suicide drop. So what is the answer to prevent suicide? I believe, in simple terms, it is to instill hope, increase human connection and belonging, and most importantly to help those who are struggling to relieve the pain that accompanies suicidal thoughts and behaviors.
How to do that collectively with our family, friends, neighbors, communities and as a state is the bigger question. It requires us to think about our relationships and how we interact and talk about the larger questions and issues that surround mental health. It requires us to move out of our comfort zones, and to speak openly and honestly about difficult subjects. It requires us to break through the codes of silence that surround suicide that brings with it the stigma, fear and shame to what should be otherwise viewed like any other treatable and preventable health condition. It requires leadership to create a prioritized agenda for suicide prevention that will allow us to put our best efforts forward. And lastly, it should include in our words and actions as stated in the Alaska Suicide Prevention Plan, “Promoting wellness to prevent suicide in Alaska is a call to every Alaskan … In ways big and small, we can work together to prevent suicide.”
• James Gallanos has a master’s in Social Work and served as the Suicide Prevention Coordinator for the Department of Health and Social Services, Division of Behavioral Health for the 10 years. He now serves on the Colorado National Collaborative for Suicide Prevention for the Colorado Department of Public Health and Environment. My Turns and Letters to the Editor represent the view of the author, not the view of the Juneau Empire.
