It's a topic few are keen to talk about, but more and more people are coming together online to make a pledge to "make it OK" to openly discuss about mental illness in an effort to end stigma, lower suicide rates and reduce both violence and injury nationwide.
The 2013 campaign launched by Minnesota-based HealthPartners seeks to end the stigma around mental illness and the online toolkit provides tips to help people learn to broach subjects that may seem taboo.
Visitors to the site are encouraged to take the pledge and share their commitment on social media sites, and the organizations involved contend the sooner it spreads and people start talking, the sooner understanding will replace stigma.
The effort comes at an opportune time for Minnesota, where mental illness is making itself known in the form of a record number of suicides in the state.
Suicide is a growing problem in Minnesota, with numbers increasing year after year for the last decade. In fact, it's the 9th leading cause of death in the state, and the 2nd leading cause of death for Minnesota youth.
The most recent data from the Minnesota Department of Health reported a record number of suicides in 2011. Although the numbers from 2012 have not yet been completely compiled, officials project that 2012 will likely set a new one.
Yet, there is some good news to be found in the 2011 data -- prevention efforts are working. Although adult rates continue to climb, Minnesota youth and seniors struggling with suicidal thoughts are responding to outreach efforts. That has local coordinators feeling hopeful as the state begins to revamp and expand its prevention plan.
In the past 5 years, 3,034 lives have been lost to suicide in Minnesota. With the state's suicide rate increasing year over year and across times of both economic prosperity and downturn, the trend is of great concern to public health officials.
Although the rates among seniors and young adults held relatively steady in years past, death certificate data from 2011 showed suicide rates rose among all age groups that year.
No county in the state is suicide-free, according to state data from 2007-2011. The highest rates are seen in rural portions of the state, particularly in the northeastern portion near Bemidji.
The suicide rate for Minnesotans between the ages of 25 and 64 have continued to increase steadily despite a small dip in 2005, and state prevention experts say outreach geared toward that age group is clearly needed.
Rates have risen among both sexes in the past 10 years. The age-adjusted rate for men increased from 15.4 per 100,000 in 1992 to 20.2 in 2011, a 31 percent increase. For women, the rate increased by 67 percent over the same time period, from 3.0 to 5.0.
Research has shown that 90 percent of those who die by suicide had been suffering with an underlying mental illness or struggled with substance abuse at the time of their death.
A NATIONWIDE CONCERN
Suicide is the 10th leading cause of death in the United States as a whole and the 3rd leading cause of death for American youth, according to the CDC.
Minnesota has the 10th lowest suicide rate among the states, and officials attribute that to the active prevention strategies currently in place.
Suicide is a multiple-stressor problem and is seldom linked to one life event. Rather, a combination of stressors usually leads a person to feel overwhelmed and hopeless, which is why state health officials say promoting hope is a crucial.
Many people experience periods of feeling hopeless at some point in their lives, particularly after a painful personal loss and during relationship transitions; however, outreach specialists and volunteers stress that isolation is a perception and there are always resources available to those in need.
Additionally, prevention experts at the Minnesota Department of Health say outreach efforts are working among seniors and youth, and the state Legislature has approved additional funding to expand hotline services and mental health care access throughout the state.
In 2011, many counties in northeast Minnesota debuted TXT4Life, a texting crisis service providing outreach and education to both youth and adults via Canvas Health and Crisis Connection. It is currently available in the following counties:
- St. Louis
TXT4Life is also available to the Bois Forte, Fond Du Lac, Grand Portage and Red Lake tribes, and the Minnesota Legislature provided funding to expand the initiative throughout the state in 2013.
To use it, anyone in those areas can text the word "LIFE" to 839863 to be connected to help.
Crisis Connection is available to any Minnesotan by phone as well, and can provide counseling as well as referral information or emergency interventions as needed. The toll-free crisis line for Minnesota is 1-866-379-6363, and it is staffed 24 hours a day, 365 days a year. They also have a local number at 612-379-6363.
First responders in Maplewood also are pushing for suicide prevention after an increase in the community. In September, EMTS and firefighters issued a plea to the public, encouraging citizens to reach out to public safety staff for help during depression-related crises. Police and fire personnel have been trained to respond themselves, and they can also provide a list of local resources.
The state also provides grants to local communities to implement suicide reduction strategies, and current grantees include the Evergreen House Youth & Family Services, National Alliance on Mental Illness-Minnesota (NAMI-MN) and Suicide Awareness Voices of Education (SAVE).
There are several warning signs of suicidal thoughts or behavior that loved ones can keep an eye out for. The more of the following behaviors a person exhibits, the greater the risk they may attempt self-harm.
1. Sleeping too little or too much
2. Increasing the use of alcohol or other drugs
3. Displaying extreme mood swings
4. Acting anxious, agitated or recklessly
5. Showing rage or talking about seeking revenge
6. Withdrawing or feeling isolated
7. Talking about feeling trapped or in unbearable pain
8. Talking about being a burden to others
9. Talking about feeling hopeless or having no purpose
10. Talking about wanting to die
11. Looking for a way to kill oneself
Those who are concerned about a friend or loved one are urged not to leave that person alone and to remove firearms, alcohol, drugs and any sharp objects that could be used in a suicide attempt.
In a crisis situation, a person can turn to an emergency room or a mental health professional. Law enforcement officers across the state are also trained to respond to mental health crises, and loved ones can request welfare checks as well.
To get specific recommendations, advocates can also call the National Suicide Prevention Lifeline at 1-800-273-8225.
Going forward, the Minnesota Department of Health intends to expand outreach efforts for middle-aged Minnesotans to stop the increasing rate. Melissa Heinen has been appointed suicide prevention coordinator, and she will oversee the formation of the updated prevention plan.
According to Jon Roesler, Heinen's supervisor in the MDH Injury and Violence Prevention Unit, the updated plan will incorporate national strategies developed by the National Action Alliance, a partnership of public and private entities, as well as localized tactics. Development and implementation is set to begin in earnest early in 2014.
Minnesota's current prevention plans rely on the fact that mental illness is treatable, and significant advances have been made in training health care professionals to identify mental health conditions and refer patients to appropriate treatment.