By SARAH DOOLITTLE, Four Points News
In 2011, Michele and Michael O’Rourke were in need of psychiatric services for Michael’s bipolar type II disorder and a profound depressive cycle that had started in January.
Michele was pleased with the psychiatrist she herself was seeing, but that doctor was not taking new patients. Michael was left instead with a clinical psychiatric nurse who proved to be a poor match, recommending a course of treatment that presumed he did not take his medication regularly, although he did.
Without effective treatment and resources, Michael sunk deeper and deeper into depression, requiring him to take a leave of absence from his job. He ultimately committed suicide by hanging on April 18, 2012.
How did someone with a great job and what Michele describes as “fabulous” insurance fail to find a doctor able to treat his life-threatening illness?
As Michele, who spent years navigating the mental health care system for herself and her husband, explains “It’s not easy to switch (healthcare providers)… Fill out a case history, and if you’re totally honest and say that there’s been any kind of suicide attempt, ‘Uh, we’re not taking any new patients. Try so-and-so.’”
“Which is ridiculous, because of the laws that protect them,” from liability in the event a patient commits suicide. “They are so, so protected in the state of Texas.”
They are so protected that, even when Michele considered filing a malpractice lawsuit after her husband ended his life, she was advised by a lawyer not to proceed because she would likely lose the case.
Add to that the fact that, “In New York City, there are more psychiatrists than in the entire state of Texas,” and it is a recipe for disaster for those seeking mental health services to prevent a suicide.
(Texas has one of the highest employment levels in the nation of those working in psychiatric services, but a low concentration of those services because of its size.)
Nonetheless, help is available. Besides in- and outpatient mental health services, there are numerous organizations dedicated to suicide prevention.
Who is at risk?
Michael carried a number of risk factors for suicide, including his mental disorder and a previous suicide attempt. Other risk factors include: a family history of suicide, medical conditions and pain, environmental stressors such as bullying, suicide contagion, access to lethal methods, and biological factors, which neurologists are still working to understand. Males end their lives at a rate four times that of women, according to experts.
Add to these risk factors the fact that mental illness and suicide are often spoken about in whispers — if at all — and shrouded in a cloak of shame and embarrassment. Without the full knowledge and understanding of one’s family history, and with the isolation that comes from secrecy and shame, it becomes even more challenging to effectively combat.
Michele learned this firsthand after her husband’s death. “It’s shocking how many people do (attempt suicide). When Michael died, people would come out of the woodwork. You know, my sister tried, my brother.”
Michele chose to be very open about her husband’s cause of death, not only with their sons but with the community at large, the result of which is advice she earned the hard way.
“If you know somebody, open up. There’s lots of people out there living with a suicide in their past, or at least a suicide attempt, and it’s a lonely road. For me, it’s good to have people to talk to about it,” she said.
During her own depression, Michele herself thought about suicide. “I can remember thinking, oh, it’s going to be awful for a little while, but people are going to rebound quickly. Because (you think) you’re such a burden.”
Her own experiences in the wake of her husband’s death taught her otherwise. Even at his most depressed, Michele would still rather have Michael, a loving husband and father, than the pain and loss. Both have lessened over time but neither ever goes away entirely.
How to help
If someone you know is at risk for suicide, the American Society for Suicide Prevention provides guidance on their website.
- Don’t be afraid to use the word. Asking about suicide is not shown to increase the risk someone will end their life.
- If you suspect someone is considering suicide, tell them you are worried about them and offer help.
- If you both are minors, involve an appropriate adult.
- If someone has a specific suicide plan, this can be a warning sign. Ask questions using non-judgemental language. Encourage honest, open communication. Seek help.
In 2013, there were 40,149 suicide deaths reported in the United States, the most recent year for which statistics are available. It was the 10th leading cause of death. Compare that to 16,121 homicides for the same year, and people kill themselves in the U.S. at more than twice the rate they die from violent crime, according to ASSP.
Not all suicides can be prevented. And the responsibility for suicide deaths does not rest on the survivors, the family and friends who may have seen the signs and heard the warnings but who cannot ultimately control another person. As Michele said, “You can’t watch someone 24/7.”
Instead, family and friends must continue the work societies have struggled with for millennia. How to care for one another. How to help in the face of things that are not fully understood and are out of control. And how to protect those most vulnerable.
This is part III of a three-part series on suicide, suicide prevention and coping with suicide loss.
|If you or someone you know is considering suicide, local and national resources are available to help.*
Austin-Travis County Mental Health
24/7 Crisis Hotline
(512) 472-HELP (4357)
(512) 703-1395 TTY
TTY: (800) 799-4TTY (4889)
(800) 273-TALK (8255)
Texas Suicide Prevention
* From TravisCountyTX.gov